Crunch Time

The purpose of this weeks blog is to vent about crunch time and issues regarding social justice.  I had some catch up work to do and finally finished my learning agreement.  I spoke to my supervisor about internship two weeks ago and still have heard nothing back- such a slow process that is out of my control and I dont really want to feel like a pest.  With the book report due next week and only having one chapter read is pushing me into overload.  I still have two competency journals due for 555, the case study for 540, and the book report in this class.

On a celebratory note we almost made it through another semester!!  I am so proud to be on this journey with you all.  You all are so great and to think I almost had to drop this semester.  I was saddened by the news of Karin not being able to continue her teaching, I enjoyed her class, the flow of it and the work load was just right.  We were able to witness how they are also not immune to bureaucratic rules within organizations.  I am glad she shared that with us because it helped me to understand things are not always within our limits of control.

Which leads to my next problem I faced this week on the job.  Without going into great detail, my job as a social worker lead me to assist two clients in finding housing.  Recently both clients were off conservator-ship and wanted to find independent housing.  Both clients have stable history of two years at a room and board.  One client was denied due to not being able to provide proof of the year she was homeless.  They asked her for documentation of where she stayed or if she could find someone to write a note stating they saw her living homeless.  The other client was not denied but needed to call each hospital she stayed to verify her residence.  She stayed at four different psychiatric care facilities. She learned that some hospitals will not release information to apartment complexes. These are just a few of the issues our clients face with regard to social justice in finding adequate housing.  Landlords have the right to say no to whoever they want and when they know our clients have mental illness they do not want to work with them.  They create barriers and make up lies to not rent to them.  I plan this week to visit the rights advocate about this matter to see if there are laws in regards to confidentiality.

Realizations

This week has been an interesting week to say the least.  I have received my first two clients as well as some road blocks. I was given a few clients who are placed in the next county, this was not a surprise being that I am the new social worker.  However, their needs include moving out of their current place and into independent living and as I completed my research on housing, I realized I was already doomed. After the meeting, everyone suggested I only visit these clients less than once a week.  I am not sure how to approach parts of this job.  I thought the mission was to spend time with clients in the field but, at the same time everyone seems resistant of this idea.  I feel like an over achiever at times as well as the only one committed to the well-being of clients, although I know this is not true. In reflection, my expectations of the duties of the job are conflicting with my peers ideas of the way case management has been in the past.  I had a conversation with my superior as she stopped in to ask me how I was doing.  Without throwing anyone under the bus, I simply asked how much time were we supposed to be spending with the clients.  She stated since she came on as Clinical Supervisor she reduced the caseload to under ten and would like more intensive services be provided.  I shared with her that I was unsure this was the teams philosophy.  She then assured me  I had the right idea and the rest would have to come around sooner or later.    

I am realizing many things about my new position and the agency I work for.  Many people are showing great resistance to change as well as the recovery model we are striving for.  I am also realizing there is a big difference in care and how we approach our jobs based on our educational level.  Half of my co-workers have past work experience in psych-hospitals with no formal education and the other half are MFT's.  The approaches are all quite different, the MFT's would like to be somewhere where they can practice therapy and the older Social Workers are resistant to change. I am realizing the STAR team caseload consists with clients who are very ill and have been on and off conservator ship for not being able to care for themselves. Overall, I feel we are dedicated to helping our clients but we all go about it in different ways.  I can appreciate this as long as they will appreciate my way is also different than theirs.

Purpose of Crisis Stabalization

After reading this weeks chapter on "The Audience" I struggled to come up with a topic regarding conflict.   I wanted to discuss something related to my new position and what I have been learning. I then remembered how I spent an afternoon at our crisis stabilization services unit, which is a 23 hour inpatient facility monitoring the clients safety.  I remembered a conversation I had with the nurse working at the Crisis stabilization unit and how she was explaining how she often had to make "judgement calls" on who to admit into the facility.  She asked me to look through the files of repeat clients to develop my own opinion of people who utilizes the unit.  She mentioned how most everyone needed to be cleared through the hospital with lab work.  She stated it is much easier to admit someone with clear undeniable mental health diagnosis than it is to admit and monitor a client coming down off meth or detoxing from alcohol.  She was doing a good job describing how there is a need for both and remaining politically correct with how we treat clients fairly in regards to needed services.

I looked through the files to discover the purpose of the crisis stabilization and how it is used in our community. I came to the conclusion that more people are utilizing the crisis unit with confirmed positive drug tests and other circumstances, such as being displaced.  The unit was created for clients with mental illness suffering a crisis and not for people coming down from drugs/alcohol or having housing issues.  What seems most complicated is people coming off drugs are experiencing a crisis just the same as someone suffering a crisis related to mental illness.  My question is do we utilize the same resources for both?  What happens if a bed is unavailable for a client with known mental illness? Can we explain to the patient after the crisis about their choices and consequences of using and possibly referring to a rehabilitation program tailored to their needs?  Overall, I am not sure what the right answer is but it is getting more complicated with dual diagnosis of mental illness and DOA dependency issues. I also think emergency rooms don't know what to do with them and it becomes an issue about money.   

Storytelling

I am scheduled for a training to discuss patients rights.  I meet with a woman who shares her background as a paralegal.  She provides resources in the community to help our clients with legal issues.  She explains her role and provides examples of why patients may call her. She explains most of her calls are from clients in locked facilities.  She explains she remains non-objective while listening to the grievance and then she begins her investigation.  She provides me with a book explaining rights and her goals of trying to work with both parties to reach a common goal. I think to myself about the difficulty working with the mentally ill population and having to decipher what is real and what may be delusional thinking.

As we continue the training we discuss laws relating to human rights, the discussion turns to my educational goals and how I wished we would have crossed paths sooner.  I shared with her information on a completed advocacy project in mental health and how she would have been a great resource.  Next, I share with her the focus of the distance learning program for Humboldt University and its concentration on the Native American culture.  She shares with me her Native American heritage and I share with her mine.  We both disclose how we are not federally recognized as being Indian.  We then take some time sharing and storytelling the journeys our families have experienced over the years.  As we come together we realize we can not share many of our thoughts and feelings about our culture with many people we work with.  She shares how she wanted to be an attorney to fight for her people and as the years went by she grew tired of fighting.  She has switched her focus to advocate for patients.  As I leave her office, I walk away with not only training on patient rights, but also some healing for each of us.  Through storytelling, I also grew more aware of the loss this Native American tribe suffers but more importantly how connected they are to their culture and people. I visited their website to learn more about the salmon coming home story. I f you have a moment please watch it is a great story between New Zealand and the Winnemem-Wintu.

http://vimeo.com/movingimage/dancing-salmon-home

 https://www.youtube.com/watch?feature=player_embedded&v=mpuqR1hwmgs

Thoughts on Personal Self and Worldview

 

In my opinion, the meaning of “personal self” is how our life experiences influence the way we function as a social worker.  The term “values” was used to describe personal self and our values contribute to how we learn empathy.  Personal values, ethics, and empathy were taught to me as a child.  For example, watching my father feed homeless people as he turns to me and says “don’t ever turn people away who are asking for food”.  My mother told me, “don’t laugh at people who are different because my aunt Barbara-May is retarded (that was the word they used back then).  In childhood it was learning, in adulthood, it was embracing these values instead of pretending they don’t exist.  I believe some people are not taught the value of human kindness and fail to develop empathy for others.  

In regards to personality, I believe I am the same person in public when running into my clients because my relationship with them is genuine.  In past experience, my clients with mental illness approached me in public places.  I would imagine my current clients who are higher functioning, would not want to explain how they know me due to stigma of seeing a counselor or social worker for help.  Due to confidentiality and HIPPA, I am unable to initiate any contact in public.  However, I inform them at intake about the law and invite them to approach me if they want.

At first, I was taught we should not share certain personal experiences because clients may use it against you.  I have found the helping relationship grows stronger with some discretion of self-disclosure and sharing.  I found sharing pieces helps them to understand we are people just like they are with real problems in past or present.  I am well aware of transference and how it may cause us discomfort but being able to recognize it and where you go with it is the important part.  Being open and looking for certain connections is important.  Some examples are relating to a client who has Hispanic roots or someone new to the community from the Mid-west or having someone close to you who abuses drugs or alcohol.  All these situations build rapport with client in identifying how you may have similar experiences.  

Worldviews are described as differences and how one idea does not fit all human races.  Understanding worldviews is meant teach us human kindness as a service and mindful awareness of who our audience is.  I find worldviews important to understand the diversity of cultures we are surrounded with and how every situation is different based on our culture and upbringing.   I reflect to my own place in this world of being different ethnicities and how we all experience life through different eyes.  We have to practice being aware of not bringing judgment or our belief system into the picture while working with clients. 

My favorite part of social work is witnessing the strength in the human spirit and all it endures in each person’s journey.  I have great respect for each story I hear and every culture I am exposed to.  I continue to learn from my clients and find myself thirsting for more in my journey.  I have once sat with a client who insisted I sit and eat a lunch of Puerto Rican food, she shared her recipes and they will always be a part of me.  Recently, working with a Native American client who shared her story of a not so great childhood and worse adulthood, thanked me at the end of the session for sharing a story about my family with her. This was symbolic for me because it made me appreciate her and what I learn from many great people.  I will always remember how a simple thank you from her made me feel competent and solidify my choice in the service field. 

Challenges

I realize in life we all experience ups and downs.  When I started this program it was challenging balancing work and being a student again.  After each semester, it was a little easier, I was able to balance both and I finally found my groove.  I did not expect the obstacles I encountered while trying to negotiate my internship. 

First, my supervisor would not approve me to take 16 hours off in order to complete an internship at Child and Welfare.  At this point, I had an MSW supervisor agree to supervise my hours.  I also had paperwork signed from HR approving internship.  The school was understanding and did not want me to quit school or work and agreed to let me complete internship in my position.  Well again, supervisors would not allow me to use my position for internship hours.  On top of that Human Resources was involved and conducting meetings on my behalf.  Through all this I started to get flack from both the Clinical Coordinator and Clinical Supervisor.  These last couple of months have been real trying and I keep telling myself there is a reason for all of this.  I still have not figured out the reason.  In reflection it makes me glad to be learning about power and position.  I hope to not ever have to tell someone "no I cant help them".  This has been mind blowing and challenging and has made me question power and position in bureaucratic organizations.

I did apply and get a new job working for the STAR team in Mental Health.  I am very excited for this new adventure what ever it may bring.  In my interview I asked about internship and I still was given " we cant promise anything".  On top of all this my financial aid has not gone through because I am not taking 5 units.  I am at a loss and hope things start looking better.  Heavy sigh. 

Freewriting Experience

I actually completed a few free write exercises while reading "Undoing the Silence".  I am really wanting to learn to dig deeper than my surface--ahhh was that a metaphor- anyhow I enjoyed my free write as a purge of my current thoughts about life and work.  I actually wrote in a notebook in pen for fifteen minutes then I picked up the book to read about judging ourselves.  Yes, I do this alot- Im doing it now- and I learned it is hard to get out of that frame of mind.  I worry what I sound like to the reader, is this too boring, can i pick different words, have I made a mistake?  Too many voices and my own critics coming out at once.  I silenced them for a few minutes and the second time, I typed instead for five minutes.  I have an extremely hard time not correcting my mistakes while typing away on a keyboard. I don't know if its habit. I almost cant do it- I cant not correct them.  It is not a perfectionist way, it happens so often, I am too aware of it to not notice.  This effects my train of thought and changes what I am writing about.  I kept going back to correct everything until I finally said ok no more im gonna do it- no corrections and I did, but it drove me crazy.  I deleted what I typed that day so I don't even remember what it was about.

Tonight, I completed another free write this time I saved it so I can add on. I opened the shades and sat in my living room staring out at the view outside.  It was dusk the sun was going down and there was paintbrush clouds int he sky.  I wrote about the five senses and what stuck out the most was the wind shaking the trees and making the house creek.  What I enjoyed was how I found a sense of peace, in my own home.  I never really appreciated sitting in front of this window staring at a beautiful landscape of oak tress and rolling hills.  I asked my husband one day why we bought this particular house and he said the view.  Now, I mostly cover it up with geometric curtains to keep the sun out. This assignment gave me a chance to appreciate something in front of me that I never seen before.  I decided to explore further on my next free write and sit outside on the deck and hope to discover more serenity within my grasp.