By Kaitlin Louie
About Charles Berman, ASW: Mr. Berman is a Psychiatric Social Worker who works at the University of California, San Francisco’s (UCSF) Citywide Case Management – Forensic Team. At UCSF, he counsels and assists individuals suffering from severe mental illnesses who are also involved in the criminal justice system. Prior to his work at UCSF, he interned as a Psychiatric Social Worker both at Kaiser Permanente in Richmond, CA and at Service Connect, San Mateo County’s AB109 Re-entry Program.
In addition to directly serving adults diagnosed with severe mental illnesses, Mr. Berman worked as a Graduate Student Researcher with the Chief Justice Earl Warren Institute on Law and Social Policy, where he helped to rewrite the Policy Manual for the San Francisco Juvenile Probation Department and Juvenile Hall. Prior to entering the field of social work, Mr. Berman engaged in Wilderness Therapy work at Outback Therapeutic Expeditions in Utah, and led Jewish Environmental Education trips for The Teva Learning Center in Connecticut and New York, and for Wilderness Torah in California.
Mr. Berman received his Bachelor of Arts in 2008 from UC Santa Cruz, where he majored in Psychology and minored in Literature. He earned his MSW with an emphasis in Community Mental Health from UC Berkeley in 2014.
[OnlineMSWPrograms.com] Can you please elaborate on your core responsibilities as a psychiatric social worker at UCSF’s Mental Health Outpatient Intensive Case Management Program? As you work closely with adults suffering from severe mental illnesses and who are also involved in the criminal justice system, what specific counseling methods do you use, and how do you help them manage the specific mental, emotional, social, and legal challenges that they face?
[Charles Berman, ASW] The UCSF program is called Citywide. I am responsible for a caseload of 17 adults, and lead 3 groups (one is a writing group, one is a cooking class, one is a support group). I also have one shift weekly running the front desk, have weekly trainings and do lots of outreach with clients in addition to office-based work. I bill Medi-Cal, so the paperwork takes up about 20% of my time.
There are social workers, psychiatrists, peer counselors and security staff in our clinic. We all work together to provide intensive wraparound services to clients as they cycle in and out of the jail, the state hospitals, local hospitals, and the community. I spend about 40% of my time outside the office, going to jail or the psychiatric emergency room, psych hospital, state hospital, board and cares, SRO’s, halfway houses, the court, looking for clients on the street, meeting with other providers, going to Social Security, etc.
As far as clinical strategies, they vary from client to client. Many of my clients have schizophrenia, schizoaffective disorders, or Bipolar with Psychotic features, so using psycho-education to promote med compliance is important. Using Cognitive Behavioral Therapy (CBT) for psychosis to build insight and challenge delusions is valuable. Nearly all clients are dually-diagnosed so I use harm reduction for substance abuse. All of my clients face trauma, some extremely complex, and so I try to use exposure therapy for specific experiences or refer to our seeking safety group for globalized trauma. A few clients have Borderline Personality Disorder and so I teach Dialectical Behavior Therapy skills and refer to our Dialectical Behavioral Therapy (DBT) day-treatment program. Teaching basic social skills and life skills (hygiene, money management) is always valuable.
Many clients have affect regulation issues so I refer them to anger management or expressive arts groups. Most of our clients are mandated by behavioral health court to attend our 6-month “Thinking for a Change” group series, which is a CBT group approach to treating “criminogenic” thoughts and behaviors. We also have a pilot dual-diagnosis group called “STOP.” Most of my clients have ambiguous presentations/poor diagnoses so I refer them for neuropsych testing for clarification. For those with Psychotic disorder, we have a computer based cognitive skill building study called “SECT” that they get paid to participate in. For higher functioning clients, I refer them to our employment specialists for vocational rehab and linkage to supportive employment.
Housing is a huge issue in San Francisco, so we try many different approaches to keep clients off the street. We do not offer housing, but link clients to different resources. We put most clients through residential treatment dual diagnosis programs at various times during their work with us to try to build their readiness for maintaining housing.
Half of my clients are in behavioral health court, meaning that the court determined their mental illness contributed to their crime, and by participating in treatment they get their sentences reduced. I give weekly updates to the judge and can recommend the client be let out or taken back to jail, and use the judge to promote treatment goals (med adherence, getting a job, money management, etc.)
Psychiatric social workers and mental health/clinical social workers are all just different titles. I guess we are called psychiatric social workers because our program is an arm of the San Francisco General Hospital/UCSF Psychiatry Department, though we have our own clinic in the Tenderloin [a neighborhood in downtown San Francisco].
[OnlineMSWPrograms.com] Before working at UCSF/San Francisco General Hospital, you also interned at San Mateo County’s AB109 Re-Entry program, where you worked with individuals with severe mental illnesses after they spent time in jail or prison. Could you elaborate on your responsibilities during this internship, and how they differ from your current role?
[Charles Berman, ASW] My internship in San Mateo was similar, the main difference being that the organization I currently work for has been around for 30 years, and the San Mateo organization was one year old, so the staff was much smaller and roles less defined. It was the same principle of Assertive Community Treatment for adults suffering from a serious mental illness (SMI) who were also on probation, but was limited to those impacted by Realignment (AB109), a policy enacted in 2011 to manage adults serving time or under supervision for non-violent, non-serious, non-sexual crimes at the County rather than the State level. In San Mateo we worked more with probation officers and less with a judge. We would collaborate with Probation through weekly multi-disciplinary team meetings, where we would update the officers on our work with the clients. San Mateo is a more rural county so transportation was more of an issue. Also, our work with the clients was limited to the time they were on Probation, whereas at Citywide we work with clients on an open-ended time frame.
During this time, I also volunteered for a semester as a TA in an Intro to Sociology class at San Quentin through the Prison University Project. I used this experience in part to test whether I could work in a locked facility. I would lead weekly discussions for the class, including writing workshops, to augment the weekly lectures given by the head Professor. Outside of the classroom, I graded clients’ tests and writing assignments, spending a large amount of time developing their final essays that asked them to apply a sociological theory to help explore their personal histories. I enjoyed working with these very motivated students. While the class did not have an explicitly therapeutic element, the writing seemed to provide some catharsis for the students, as narrative therapy does for clients, and the educational component helped them understand how social forces shaped their own experiences in the world.
[OnlineMSWPrograms.com] During your MSW program, you also worked with the Chief Justice Earl Warren Institute on Law and Social Policy to re-write the Policy Manual for the San Francisco Juvenile Probation Department and Juvenile Hall. How did you get involved in this project, and what advice do you have for social workers and MSW students who would like to participate in similar initiatives that involve working with policy and the criminal justice system?
[Charles Berman, ASW] I got this job through a colleague one year above me who had held this position and recommended me for it. I advise that people reach out to their networks and don’t be afraid to ask for recommendations. People are often happy to do this, especially if you do this for them as well. This is how most people get the jobs they have in the Bay Area social work world.
The manual we produced updated an existing manual, seeking to synthesize multiple streams of information to inform policies, including what new laws had been made requiring certain practices, what research indicated would be most effective, what practices were currently in place on-the-ground, and what the political and cultural contexts are within which the policies must operate. It was an interesting exercise in program evaluation, talking to multiple stakeholders to try to iron-out what seemed like intractable issues. We made some progress, but it is hard to say whether the new policies we wrote will actually be put into place, or instead dismissed as “wishful thinking.”
[OnlineMSWPrograms.com] Why did you decide to become a psychiatric social worker and work within the criminal justice system? What have been some of your most rewarding professional experiences thus far? On the other hand, what have been some of the most challenging aspects of your job, and how do you manage these challenges?
[Charles Berman, ASW] I decided to pursue an MSW because I was interested in working as a therapist and on the advice of my mentor looked into MSWs vs PsyD/Phd or MFT routes. The MSW degree seemed less expensive, more employable, and did a better job at looking at the person in their environment rather than just at the person. My interest in the criminal justice system stemmed from a Freshmen Feminist Studies course I took at UC Santa Cruz on “How Gender Structures the Prison System” where we went to the two largest women’s prisons in the world and looked at the experience of women in prison through multiple academic lenses.
I have been interested in mental health policy since high school, and the more I learned about criminal justice policy, the more I found they were intertwined as the predominant forms of social control in our society. When I started my MSW there was a lot of talk about serving “the most vulnerable,” and clients at this intersection seem to fit this label. Also, through connections with others working in the field, I knew that this is a time of enormous policy reforms, the largest since de-institutionalization of the state hospitals, that are increasingly transferring the responsibility for supervising adults with mental illness and criminal histories from the state institutions to county community health clinics. I wanted to be on the ground as this transition takes place.
It has been rewarding and humbling to learn so much about the individuals and institutions I interact with. It has been a blessing to use my degree to work towards change at multiple levels: providing individual and family/group therapy, case management to get people entitlements, conducting research to improve systems, writing more just and relevant policies, putting on a colloquium that helped people share ideas, etc.
It has been challenging to set boundaries between my work and personal life that will allow this career to be sustainable in the long-term. I have started forcing myself to leave work on time, no matter if not everything is done. Because the truth is no matter how hard you work, it will never be enough. I have also become more committed to my own weekly therapy, which is important for self-care and professional development.
[OnlineMSWPrograms.com] For MSW students who are interested in becoming psychiatric social workers and/or working in criminal justice social work, what advice can you give them about optimally preparing for these fields while pursuing their degree?
[Charles Berman, ASW]
- Find a mentor. You can look to professors, supervisors, other students, etc. I have been impressed at how open social workers are to mentoring each other.
- Reach out to your network to set up relevant internships/volunteer positions.
- Get training in substance abuse, therapy for borderline and psychotic clients, trauma work, and case management experience for homeless adults.
- If you are going for a state job it will take longer to get but it will pay better.
- Focus on maintaining a good support network.
- Participate in lots of continuing education once you graduate! These courses will help you continue building your skills, allowing you to focus on a particular area that most interests you and is relevant to your clients. They are also great for networking.
Thank you Mr. Berman for your time and insights into clinical social work.