Reflections on Training Social Workers in Kazakhstan

In September, Assistant Dean of Field Learning and Community Partnerships Helle Thorning traveled to Astana, Kazakhstan, to facilitate a training of health care workers in the fundamental skills of social work professional practice. Over five days, Thorning and colleagues from a local health clinic focused their training on adolescent and families, educating doctors, nurses, administrators, and psychologists about wellness prevention and how to recognize risks for and signs of suicide and child abuse.

Thorning has been to Kazakhstan four times since 2004, working with Associate Professor Tazuko Shibusawa, Professor Ellen Lukens of Columbia University, and colleagues from Astana's Demeu Family Medicine Clinic to develop, implement, and evaluate a Train-the-Trainer model to educate social workers. Assistant Professor Duy Nguyen was also involved in the evaluation phase of the project when he was a doctoral student at Columbia University.

The project has had several phases: a needs assessment; development of a team consisting of U.S. social work educators, Kazakh health professionals, and international volunteers working in Kazakhstan; and the creation of a training manual by the team. An initial training took place in July 2005 with a follow-up training in New York in October 2005. This collaboration enabled the Kazakh professionals to return to their homeland to disseminate information and skills to trainers, who in turn disseminated the information and skills to their colleagues.

"There is a lot of enthusiasm around social work," said Thorning. "People are very interested in looking at the person and the individual psychology, but also in the context of the family and the community, and strengthening individuals, families, and communities in the transition to a free market economy."

The September training was funded by the Kazakh government, which has launched an initiative to develop social work education and build a structure for the profession. In addition, Thorning explained, "The country is undergoing a health care reform where they are trying to build out more psychosocial services in all primary care and health care facilities."

Many social problems went unrecognized in the former Soviet Union, and social work was deemed an unnecessary vocation. Social workers in this young country are similar to home health aids in the United States and most have no formal education or training.

This September session focused on adolescents and families because of the country's serious need in this area. Kazakhstan has the highest rate of suicide in the world for girls aged 15 to 19 and the second highest for boys, according to a recent UNICEF report. Thorning explained that adolescents face a host of psychosocial stressors, including substance abuse, bullying, and high number of birth defects due to above-ground nuclear testing under Communist rule. Despite the country's economic stability, employment and educational opportunities previously available to everyone are now subject to fierce competition.

Evaluations of the 2004 and 2005 training sessions were positive. The New York team has been working with their Kazakh colleagues to develop culturally appropriate approaches to professional social work, a process that will continue as social work evolves.

Thorning has seen the profession develop first hand over the course of the seven years she has traveled to the Kazakhstan. She has observed the development of activities and programming for the elderly and youth, and she knows health care workers understand the relationship between an individual their family and their community.

What most impresses Thorning is the overlap between social work and public health. "It seems that these two disciplines are being integrated more. When we talk about improving lives of populations, we are talking about large numbers," she said. "And they are shoring up the individual by shoring up the community, which is a very nice perspective for social workers."