Welcome to the latest edition of “Backline Love,” where we post Q&As with some of the people in the movement we love most. This month we are thrilled to introduce Alissa Perrucci, PhD MPH, who is Counseling and Administrative Manager at Women’s Options Center and author of Decision Assessment and Counseling in Abortion Care: Philosophy and Practice.
Can you describe your work (paid, volunteer, life) for us? Give us the what, where, why, and how.
A big part of my life is my current job. I am the Counseling and Administrative Manager at the Women’s Options Center, which is the abortion clinic within San Francisco General Hospital. This September will be my sixth year in the position. Our clinic is the safety net clinic for Northern and Central California, accepting Medi-Cal as full payment to 24 weeks and serving women with all acute and chronic health conditions, including history of Caesarean delivery. Our strengths as a clinic include our counseling program, our nurse-administered moderate sedation, and our physicians who are attending cases and teaching the next generation of abortion providers.
My focus, both within the clinic and beyond, has been creating an approach and framework for decision assessment and counseling for women presenting for abortion. This is a teachable, learnable model that provides concrete skills for people who come from a wide range of educational, life, and work backgrounds. The foundational requirement for being a counselor at WOC is that you must move through your work leading with love and compassion for others, demonstrating openness and respect in your words, tone, and bodily comportment. When a person has that foundation, they can learn the techniques for working with any challenging statement or struggle that a patient brings. It is infinitely rewarding to watch my co-workers build their skills and reach ever-increasing levels of comfort with and confidence in the abilities in challenging situations
Last year I published a textbook that serves as a stand-alone guide to learning this model (Decision Assessment and Counseling in Abortion Care: Philosophy and Practice, Rowman & Littlefield Publishers). The book teaches essential skills for working with women making pregnancy decisions. It prepares the reader for conversations with patients when the difficult issues arise – decision conflict and decision ambivalence. It is full of sample dialogue that can be practiced and critiqued and exercises that can be done alone, in pairs, or in groups. It is my firm belief that this style introduces a new perspective on our work that transforms the patient-provider relationship and can become a part of anyone’s practice – physician, nurse, social worker, reproductive health specialist, counselor.
What four words would you use to describe your role in the movement?
Shepherding the counseling revolution!
How does Backline’s mission and work resonate with you and relate to the work that you do?
One of my grounding principles is that “the patient has the answer” to her dilemma; there is no special knowledge or insight that we possess about how to resolve her pregnancy decision that she herself does not have. Backline lives this principle in its focus on the full spectrum of decisions, feelings and experiences and its work to help us clarify our values with regard to different pregnancy decisions and how those values affect the work that we do in the world. Backline’s mission is essential to our work at WOC. We rely on Backline to create a continuum of care in the pregnancy decision-making process.
In an ideal world, abortion and family planning clinics would align their counseling programs with the mission of Backline. Clinics would strive for their staff to be fluent in *all* pregnancy options. Clinics that engage in values clarification might discover that while staff are resolved about abortion, they may be uncomfortable with people who decide to parent at a younger age or people who place a child for adoption. In the abortion world, we sometimes forget to examine our feelings and beliefs about the other two pregnancy options, and how those beliefs affect the language that we use with our patients. At WOC, we believe that high-quality decision counseling should be available to all women presenting for abortion. That, we believe, should be a value and practice of all abortion clinics. But we can’t do it alone. Backline is there for patients before, during and after decision-making, giving them something tangible to incorporate in their process of coping, healing, and moving forward in their lives.
How do you see Backline as a contributor to your work and the work of the movement as a whole?
On one level, Backline is an important driver in the long-standing movement to promote and prioritize high-quality abortion counseling within the abortion clinic. This movement took root through the work of many abortion counselors after the legalization of abortion in the U.S.; Backline’s mission and ethic upholds and expands upon this tradition. On another level, Backline’s mission seeks to reach people not just within the family planning and abortion field, but those in all sectors of work and life. Backline’s mission is lofty because it strives to change the ways that we think and talk about pregnancy decisions – this requires a shift in consciousness concerning the context in which pregnancy decisions are (ideally) made. It does so, however, while taking into account the reality of women’s situations and their appraisals of what is realistic and acceptable to them.
What are your top three must-read blogs/sites/publications?
At the risk of being labeled a Luddite, I don’t spend a lot of time on the Internet. I prefer public radio, international radio, and print media. Current favorites are programs on KALW FM 91.7. You can access programming from around the world, including “World Have Your Say” (BBC) and local journalist Rose Aguilar on “Your Call.” I read The Nation and the American Psychologist.
You are now a superhero! What is your name, power, and outfit?
If I had to be a superhero, I’d take the shape of San Bruno Mountain. A mountain sticks around a long time and has seen a lot of things come and go. Mountains come about from shifts in the plates of the earth way below the surface. And water, which is soft, wears down rock over time changing its nature. I’m pretty sure Lao Tzu said it better.