From the Ground Up
When Nathan Linsk studied at the School of Social Service Administration in 1972, he developed an interest in geriatrics. But after working in the field for several years he found his career path changed by the HIV/AIDS epidemic.
“The suffering brought on by HIV/AIDS is global, but the ability for social workers to confront the problem is also universal,” says Linsk, A.M. ’74, Ph.D. ’82. Over the course of his career, Linsk, the recipient of SSA’s 2013 Edith Abbott award, given to distinguished alumni, has helped organize HIV/AIDS education programs in Chicago and the Midwest, started a para-social work program targeted at orphans of the disease in East Africa, launched a journal dedicated to social work around the issue and has been an advocate for more support and attention to HIV/AIDS and patients who have the disease.
“I’m really a start-up person,” he says.
Linsk recently retired as a professor of social work at the University of Illinois at Chicago, a job he started in 1984, which coincided with the emergence of the HIV/AIDS epidemic. He quickly found that his background from SSA and working with aging people in institutional and community settings was useful. “Social work with older adults has significant overlap with the HIV social work specialist,” he explains.
Linsk was a pioneer in working to change the landscape for how HIV/ AIDS patients were treated. “At that time, some people with AIDS stayed in hospitals for months to a year because there was no place to send them,” he says. Social workers were reluctant to refer patients to nursing homes due to quality issues and HIV stigma, and nursing homes refused to admit HIV and AIDS residents because of perceived costs and concern about their reputation.
Working with HIV/AIDS advocacy groups, Linsk was able to help lead an effort to establish dedicated units in nursing homes to provide care for AIDS patients. “We did surveys and tracked case progress to identify the situation,” he says, including using Freedom of Information Act requests to determine if complaints to the Office of Civil Rights were resolved. “We also presented educational programs for long-term care staff and administrators, as well as social workers and nurses who were referred to the facilitates.”
In 1988, Linsk founded the federally funded Midwest AIDS Training and Education Center (MATEC ) at UIC, which provides AIDS and HIV clinical training and support to thousands of health care professionals annually in seven states. “The Center targets multidisciplinary health providers, and it was unique for a social worker to lead this team effort,” says Linsk, who served as principal investigator for the grant for 23 years. Linsk also founded and was principal investigator for the Great Lakes Addiction Technology Transfer Center, also based at UIC.
Linsk has been involved in community work in Oak Park, where he and his husband, Mel Wilson, have co-parented two children, now adults, co-founded the Oak Park Area Lesbian and Gay Association and served on the founding board of the local AIDS Service Organization. Linsk chaired the local AIDS committee in the 1980s and helped launch the Northeast Illinois Case Management Cooperative at the AIDS Foundation of Chicago.
As an academic, Linsk has written four books, including HIV Treatment Adherence: Challenges for Social Workers, and authored nearly 50 articles on a wide range of topics related to HIV/AIDS. He also was founding co-editor of the Journal of HIV/AIDS & Social Services.
“It is the only journal dedicated to examining the impact of HIV from the perspective of social service providers,” says Dexter Voisin, a professor at SSA who is now the publication’s co-editor. “It’s a unique journal feature in that it targets both academicians and social service providers. Nathan understands the importance of teamwork and has been both strategic and incredibly generous by expanding the journal’s editorial board.”
Linsk grew up in St. Louis Park, just outside of Minneapolis, Minn. As a member and later an advisor to youth groups, he was drawn to social work by some social workers he met who were working with the youth. As an undergraduate at the University of Minnesota, he did a field placement in a group work unit in the public welfare department and decided to come to SSA to follow that interest. But his experiences and courses at the School changed his path.
At SSA, his field placement near campus was linked to his studies of the emerging field of applied behavior analysis. “I chose to work at Drexel Home for the Aged, which I had visited once in the previous year as part of a policy course,” he says. “I was quickly developing an ongoing interest in work with older adults and disabled people and an interest in how to extend the most optimal independent functioning for them.”
Linsk was part of an SSA behavior analysis team working with the women on the Drexel Home’s 5th floor, which was where those with the most severe mental impairments lived. “With my interest in group work, I conducted a study observing a group activity program, using both behavioral logs and video tapes and then working with the social worker to help to make the group activities more interactive by slowing down the pace and increasing questions to the group members to help make the group more stimulating,” he says.
The approach improved attendance, participation, and interaction among the group members and led to his first professional publication, “Behavioral Group Work in a Home for the Aged” in Social Work. “This was a pivotal experience for me,” he says.
Linsk’s introduction to caring for the elderly was extended while driving around Chicago in a green Triumph owned by SSA Professor Elsie Pinkston as they led the Elderly Support Project based at SSA in the late 1970s and 1980s. The two navigated Chicago neighborhoods visiting people to help them adjust to the demands of growing old and the car time became an extension of the classroom. “Older people are teachers, they want to share what they’ve learned in life and they like talking with a younger person, which was what I was at the time,” says Linsk.
After earning his master’s at SSA, Linsk spent five years as a social rehabilitation worker at Drexel Home, then returned to SSA to complete a Ph.D. He continued to do research on older adults and their families at SSA and work with Pinkston, with whom he coauthored Care of the Elderly: A Family Approach, a guidebook for social work and psychology practitioners. He says that work was instrumental in informing his career building social work roles around HIV/AIDS.
Many of the community-based programs that were developed in early response to the HIV epidemic echoed highly developed services to older adults, including the concept of continuum of care from outpatient, home health, and home-based care, home meal programs, inpatient care, and occasionally long-term care. “With my background, I was able to help think through how to provide services,” he says. “That was the start of my work on the issue.”
Linsk’s work on HIV/AIDS has also taken him far from Chicago. For more than a decade, he participated in developing seminars at a number of international AIDS conferences, including the 2000 Durban Conference in South Africa. In 2001, the Department of Sociology and Anthropology at Addis Ababa University invited him to Ethiopia, where he helped restart graduate social work education. Since then, he has taught and also done research on HIV/AIDS with a Fulbright Award, as well as developing a psychosocial care worker support program.
“His impact in strengthening this continent’s social welfare system—often behind the scenes but always nurturing, ever-present—has been immense,” says Lucy Y. Steinitz, Ph.D. ’80, who has known Linsk since their time together at SSA. Steinitz invited him to visit her in Namibia when she was working there, and the pair organized a conference for caregivers of people living with HIV in the country.
In 2007, Linsk led a team of international social work faculty that created a program to help connect those affected by the HIV/AIDS epidemic in Tanzania, where 2.5 million people, including 12 percent of all the children in the country, have lost at least one parent to HIV/AIDS. Through the program, community-level para-professional volunteers are trained to assist vulnerable children and their families. To date, 4,800 para-social workers have been involved in the program in Tanzania with spin-off programs in Ethiopia and Nigeria. The impact on families has been tremendous. In a report on the program, Alex Ng’ingo, a para-social worker in Tanzania, says, “Before taking the course, there were so many problems that we weren’t able to help with. Now we know what to do and where to send our clients.” One woman who lost all seven of her children to HIV/AIDS or TB recounts how assistance from the para-social worker has been vital to rearing her six grandchildren. “Alex listens to our problems and makes referrals to different places where we can get support. He gave the children school uniforms and has provided vocational training to our eldest girl.”
Steinitz, who now oversees USAID’s largest program for highly vulnerable children in Ethiopia, says that building new programs has long been one of Linsk’s strengths—and that how he approaches the work is key to its success. “Nathan’s effectiveness comes, in part, from his ability to get others to think that they have identified what needs to be done,” she says. “He provides them with the encouragement and support they need to take what they now own, and push it forward.”