I see amazing changes happening everyday

“The fun thing about working with teen parents is I feel like I’m affecting two generations at once. I’m really getting a lot for my time.” Stephanie Pepitone, Social Worker

April 2003
by Richard Bermack

a Clinica is located in an area with a very high incidence of teen pregnancy. Social worker Stephanie Pepitone works with teenage mothers at Alta Vista, La Clinica’s perinatal clinic for teens. There is no question in her mind that she makes a difference in helping the teenage mothers and their children have a better future. “ I see amazing changes happening everyday. I work with all pregnant and parenting teenagers. They range in age from as young as 13 to as old as 19, and because they are teenagers they aren’t very set in their path of life. They might have some gigantic obstacles in front of them but they still have opportunities to change themselves, and change their interactions with the people in their life. And that’s the kind of work we do here, changing parenting patterns and changing the transmission of inter-generational abuses.”

According to Pepitone, it is common for the girls she sees to have grown up in homes where they were sexually molested, emotionally abused, or neglected. Most of the girls are involved with older men. Not surprisingly, many of the new mothers have already formed relationships in which they are being abused by the fathers of their babies.

“It is extremely difficult work,” she explains, but their secret of success is to give them “tons of emotional support.” They also provide a teamwork approach, offering a comprehensive set of services with referrals to other community services such as women’s shelters, and free legal aid services that specialize in helping the victims of domestic violence. They also provide support groups, individual counseling and therapy, and even couples counseling.

“We also have a male case manager who can work one-on-one with the fathers or can be available for the couple’s counseling sessions. It’s been a little bit harder for them to get the fathers more involved because they are the bread winners. And many of the undocumented men have to work twelve hour days, and never have a weekend. It’s challenging to work with them because of the work schedule.”

Pepitone has a masters in social work, and not only case manages but is able to do real therapy work with the clients who are ready. “I have about five girls who are interested in doing deeper therapeutic work. The majority of them are not in that place yet. They’re not what we call ‘counseling ready.’ But I do have some young women who will say, “I see what’s going on, I want to change my life. I’m ready to take it to the deeper level.”

One of the things she loves about her job is that she is not constrained by bureaucratic regulations, and although there are some restrictions on the number of visits she is allowed to see a client, the rules are flexible. “We put the teenagers first. Our primary concern is quality care, not answering to an insurance billing system. I’ve had a girl now that I’ve been seeing for three years and another girl for a year and a half, and a couple others for a year. They are very, very committed. They’re the cream of the crop. The fun thing about working with teen parents is I feel like I’m affecting two generations at once. I’m really getting a lot for my time.”

Fortunately for Pepitone her perinatal program is federally funded, and safe for now. But the funding for other teen programs is being cut or eliminated altogether. Clinical health educator Aline Gonzales works with Pepitone at the Alta Vista clinic and many of her programs are in jeopardy. Family planning and education programs are expected to be eliminated in the July 2003-2004 budget. One of the programs that is likely to get axed is Teen Smart, which educates teenage boys and girls to help them make wise decisions about birth control and helps prevent teenage pregnancies. Gonzales meets one-on-one with teenagers and consults with them on contraception, sexually transmitted infections, and life choices. She does more than provide sexual education, she uses the opportunity to assess the teens for at-risk behavior and refer them to services such as mental health or substance abuse programs. “We try to catch what other clinics miss. We look at the whole person’s needs, not just the family planning piece,” she states. Gonzales especially looks out for signs of domestic violence, gang involvement, and potential suicide.

Last year she coordinated a program that trained two teams of teenagers to do outreach and educate other kids. The program was very successful. One of the teenage girls that Gonzales worked with came into the program with severe low self-esteem issues. She was engaging in unsafe sexual activities in relationships where she felt victimized and taken advantage of. She was at risk of not graduating. The experience of being given responsibility increased her self-esteem. Her physical appearance and behavior changed radically according to Gonzales: her mannerisms have changed from expressing self-doubt to being able to let other people know what she wants and to assert herself in a positive way. “You can even see it in the different way she dresses.” She is about to graduate and already has received scholarships to attend college. Her goal is to get a masters in health education. “What teenagers need is to see that certain adults have high expectations of them and then they go for it,” Gonzales states.

Gonzales also works with kids in puberty to prepare them for those difficult teenage years. Unfortunately it is the proactive programs like these that are being cut, even though they are much more cost effective in the long run. “We are going to see more pregnancies, drugs, sexually transmitted diseases, and gang activities without these programs,” she states. It is much cheaper to prevent this type of behavior through counseling and education than to deal with the consequences when teenagers show up in the clinic with pregnancies, gang wounds, or drug overdoses.

The problems that Gonzales and Pepitone deal with are much deeper than simply teenagers acting out, “They feel hopeless about the future, and about the world, They feel helpless to do anything about their personal plight, and that is not a good place for a young person to be. It is hard to get them to the next level when they cannot even imagine the next level,” Pepitone states. The Alta Vista clinic offers a teen-friendly environment providing teenagers with understanding and the support to make changes in their lives. Hopefully lawmakers will understand the importance of investing in teen education and outreach programs before they cut them in the July budget.