It’s a simple representation and not a revelation.

My first internship in social services was at Howard Brown Health Center on the EXPLORE study.  I talked to participants about personal details of their life. They shared with me because they wanted to help the community. Social work and psychology are not prestigious fields. People go to into the helping fields with a desire to help and find an agency that they feel will allow them to do the most good. The EXPLORE team chose Howard Brown Health Center. They knew who Howard Brown was.

My experience helped me focus my career goals. Now, as a social worker, I refer clients to Howard Brown Health Center for psychiatric or medical services, support and social groups. In discussions with other providers about resources, Howard Brown is often the only name that comes up. Howard Brown understands the need to treat the whole person and offers much needed services for the community.

I waited for a while to see if I could get self pay clients but the agency I volunteer at didn’t have any for me. I found out during the school year, interns take a lot of their self pay and sliding scale clients.

So I asked if I could apply to work with insured clients. I filled out all of the paperwork (it’s really long), got an NPI number, turned in copies of my license and learned how to do all of their insurance paperwork and I have been waiting for over a month. I know from a previous job that insurance companies take a long time to approve new clinicians. I know from volunteering that the agency takes a long time to get things done. So right now I am actually losing money by volunteering since I am paying for insurance and a NASW membership.

There is always the possibility of going to another agency to be a contractor or fee for service provider but I like the agency I volunteer at. I can come in on the days I choose and see only adults. The other agencies I have come across want a Saturday and a clinician that will see children and families.

At my job, I’ve started supervising interns and coordinating the internship program instead of just assisting. I like working with interns. It amazes me when I say something and they write it down. I have a good relationship with my students and they seem to accept that I am learning as I go. They tell me “for the next round of interns” when they find mistakes in our supervision or orientation process.
I try to be very hands on to learn how to make everything better for the students. This is a huge time suck. I’ve spent hours meeting with a student that I was not supervising. I am at the point that my job could be split off into two positions, one dealing only with interns and universities. Too bad that I am in non-profit land and that will never happen. So I will have to do a better job of preparing other supervisors “for the next round.”

I came back and had an email about the Obama election night party. I didn’t click on it right away and I should have. By the time I got to it, tickets were gone and the waitlist was up. Already tickets are up on Craigslist, some people are asking $100-200/ticket.

I got a bicycle! Its a purple 15 speed hybrid. It’s a 16″ which I at first thought would be too small but it ended up feeling a lot better than the other bikes I’ve tried. The tires are bigger too which probably helps. When I get more stable on this one I can always trade in. The used bike shop I went to had some supercool old Schwinns that they had restored. I would like to rock the vintage banana seat. I stopped by Target afterward to look for a U Lock and they just had the stupid cable locks that are easy to break. So I went to Home Depot and got some really thick metal chain. I had a padlock at home so tada, $7 bike lock.

I kind of (emotionally) pushed my client today in session. She is having relationship problems and doesn’t want to talk to her partner because she is afraid of making her partner upset and angry. So I tried to get her to brainstorm things to say, find emotion words, use I statements, all that good fighting stuff. She was struggling with it and finally just said she wanted to talk about another subject. So I gave her homework, next session she has to bring in her I statements and emotion words. She seemed to like this idea a lot better and maybe writing the list will push her to have the talk with her partner before next session. But if that happens, I need to think of something else for us to talk about. Dammit!

And clients! I met with 2 of my clients last weekend. I’m kind of bothered at the disorganization of the agency. They didn’t get me a key to the counseling rooms and I was waiting in the lobby for someone to bring one down. I heard my client arrive and asked the receptionist for a key again and he said “Oh, the person with the keys just walked away.” I reminded him I’m NEW and don’t know the person he is talking about. An introduction would have been helpful. So his next solution was to bang on the door of the counseling area. Great. I did and eventually another staff person lent me her key for the day. So far this key thing has not been resolved because (I was finally informed) volunteers don’t get keys.

My clients are awesome and I know I’m capable of handling their issues but I also know it’s going to take a couple sessions for “counselor mode” to kick in. I can snap to “crisis counselor” right away but regular counseling takes a different level of planning and is about much less tangible things. I met with my supervisor and told him my concerns and he seems pretty convinced that I’m on the right track. I’m doing a good job of identifying core issues, I know what Not to do, I’m eager to offer the client something. What that something is…I don’t know. Maybe I’m looking for too concrete of a solution. I’m used to cognitive-behavioral counseling, crisis intervention and substance abuse group treatment. All very structured. Substance abuse treatment even has steps!

So I’m working on not letting my anxiety freeze me. Work isn’t busy this week, I can read up on the very important 2nd session.

Not going to go into detail about the bachelorette party but dammit if I knew the bachelorette’s mom was going to be there, I would have got her something a bit more tame! I was a bit put off by a party goer going “eww” at my gift. Another said her husband didn’t want her having “things like that.” WTF ladies? Take control of your vajays!
Also a nice drunk boy tried picking me up at the bar after the party. He told me he broke his rib the week before and I responded by hitting him. I’m excellent with men. (He still invited me back to his place and then I snuck out when he wasn’t looking.)

The client coordinator at the center I will be volunteering at contacted me and said I can start seeing clients anytime. I’m going to go in next week to see how the logistics of seeing clients works and will probably have my first sessions next Saturday. So excited!

I’ve been looking into a certificate at The Stress Institute at Roosevelt University. The certificate is in relaxation, meditation and mindfulness. It’s not exactly what I’m looking for as far as holistic therapy but I can’t find anything else college/university based in the area. Ideally, I would like something similar to the holistic health program at Western Michigan Uni. Without going to Michigan.

Coincidentally, today’s NASW newsletter had a link to an article on Zen of Therapy. The book seems more of a “how to keep your cool when dealing with crackheads” type guide but also talks about incorporating Zen practice into counseling practice with the client.
Earlier in the week I was watching Brad Warner (Hardcore Zen author) debate a sock puppet. The sock puppet thought he was Noah Levine. Silly socks! Noah Levine is also a punk rock Buddhist but he is more like “Raa I almost killed myself with drugs and smashed people and then I found Buddha! Neck tattoos!” Brad Warner isn’t that intense and I’m pretty sure he would still be alive without Buddha. Noah co-founded an organization that uses Buddhist thought in helping incarcerated teenagers. I’ve found a few different Buddhist counseling programs in California. It would seem California is the place to be for what I’m looking for but I’ve seen what Americans do to Eastern ideas when they attempt to mainstream them. (Who wants a Miley Cyrus feng-shui mat?)

I’m starting to think about what kind of CEU’s I want to do for my LSW. I would like to do workshops on alternative/holistic therapy because my grad program did not explore alternative therapies at all. The ASWB publishes a list of approved CEU providers and I found a couple sites that list alternative therapy online courses.

Another option is to take a class. I started looking at post-master’s certificate programs but can’t find anything I like. There are lots of classes for non-profit management and some classes (not all post-grad) for clinicians but not a lot of in-between. The research courses I’m finding are for real scientists and the math in them would probably kill me.

I might be on my way to restarting clinical supervision. My boss gave me a few referrals. Unfortunately, the referral at the university can’t supervise me but one other person might. One referral I’m not contacting because her agency focuses on parenting resources. I don’t think I need the challenge of a “mommy and me” centered supervisor right now.

So I am still doing some social work based activities and not just writing letters and looking for FedEx envelopes.

I work mostly with substance abuse cases in my new position. Since I have substance abuse treatment experience, my supervisor lets me make treatment decisions and offers help only when I ask. I kind of like it that way. So in our last meetings I mention a difficult case I have. The client should really at a minimum, complete an intensive outpatient program. She has many years of polysubstance abuse and no treatment history. She’s a single mother in a rural area, works far from home at a low paying job and has little family support. She has medical insurance through her job and pays for her own apartment. Those in social service know that things that seem good, like private medical insurance, often disqualify low income clients from services.

The client will lose her job if she does not follow the recommended treatment. The client is not particularly dedicated to her job and may quit her job if treatment expectations are too intensive. She’s not dedicated to sobriety either and has continued to use drugs even after testing positive at work.

So what to recommend? I think an introduction to treatment, some education is better than none. Recommend a combination of self pay group counseling, some individual counseling sessions paid for by the employer and self support groups like NA.  Sounds similar to an IOP but offers more flexibility and lower cost.

My supervisor says no. If she needs IOP, recommend IOP.  A hospital about a half hour from the client offers IOP services. I understand where my supervisor is coming from. The environmental circumstances don’t change the fact that she needs intensive services.  I explained the “some is better than none” theory and my supervisor disagrees. She says it is not our problem if she cannot complete services, we are bound to make a recommendation strictly based on her presenting symptoms/use.

I have to make a recommendation this week. I’ve been “given my orders” but like I said, unless I bring up an issue in a case, my supervisor doesn’t notice what I do.