Thursday, May 28, 2009

Plea to all Social Workers *Rant Warning*

(Although the title says "Social Workers" this post is actually a plea to anyone who considers themself a "helping professional". So, all you therapists, casemanagers, foster parents, etc... feel free to group yourself in!)

What is the point of Social Workers?

I have had to ask myself this question recently as I wade through the various issues going on in the world of "social services". I have contemplated why I do this job, what I hoped to accomplish when I started out, and what change I actually think I can effect now that I've been doing it for a while.

See, I've spent all week telling my families that I am leaving to take another job. Now, in most jobs this would be considered 'no big deal'. But when you job is to build relationships with people - its a very big deal. Its also all relationships.

Let me provide an illustration - My day today!

*****Part One*******

My day started this morning with a phone call from Savannah's mom - she was in tears. Luckily they turned out they were tears of relief that she'd gotten in touch with me.

Apparently, our receptionists got their wires crossed last week when I called in sick on Friday. So, instead of calling my appointments and telling them that I was out for the day - they told them I had already left the agency!

Savy's Mom was so upset to have thought that I'd left without saying goodbye to her and the kids. It took me 30 minutes to reassure her. I spent the rest of the day figuring out who all they had called and then getting in touch with them to reschedule appointments.

Then Savannah, Colt, and Carter came in for their appointments this afternoon. I talked with Mom for a little bit first - explaining the process of getting a new therapist and being supportive of her feelings about the situation. I have been their only therapist thus far and luckily I know who their new therapist will be and am comfortable with the person. Once I was sure that she was feeling okay, I saw each of the kids individually.

I saw Colt first - he's such a bruiser and he spent most of the session building towers and knocking them down again. He expressed a couple of times that he thinks it "sucks" that I'm leaving. But I didn't get much further than that with him - I rarely do. But I'm pretty sure he might have been imagining my head on top of the block towers...

Then I saw Savannah - that crazy feisty girl. She is pretty young to really 'explain' why I was leaving but I did the best I could. She was generally more interested in playing with my Moonsand than talking - but she'd pipe up with a question every once in a while, so I knew she was processing it. And, she told me she'd miss me about a dozen times...

Then I saw Carter - he's been one of my most challenging kids since he was assigned to me two weeks into this job. He's incredibly sensitive and I knew he wasn't going to take this change well. I was right - he spent the first 20 minutes curled up in a chair with his hands over his face, refusing to talk to me.

I attempted to engage him a couple of times, but then we just sat there in silence. This isn't the first time - Carter needs to come around on his own timeframe. It would be easy to try to 'talk him out' of his feelings - to tell him how much he'll like his new therapist, how much progress he's made, or distract him with fun games. But that would only make him feel like I didn't value our relationship, which would mean I didn't value him. So, I sat quietly and let him be sad and angry and confused by this impending change. He slowly unfolded himself from the chair and sat on the floor - then another 2 or 3 minutes hiding his face before he finally brought down his hands and just stared into his lap. Only then did I attempt to talk to him.

I encouraged him to tell me what he was thinking/feeling but he's never been great at that - so eventually I named some feelings that I suspect he's got swirling around in there. He agrees and I empathize. I can't solve this problem, I can't make it go away. I can't not leave. But I can empathize that it is hard. I can help teach him that not all relationships end abruptly and without resolution. I can share that it is hard for me too and tell him he will be missed. Slowly, we moved towards doing some drawing together - his favorite. Interestingly, he drew pictures of things we did back in the very beginning of our time together.

Thank goodness they were my only appointments for the day - I was emotionally exhausted by the time they all left.


**********************************

Now, I could have made it all much easier on myself. I could have never gotten emotionally involved, never gotten invested in this family. I could have sat behind my desk and dispensed advice. I could have been punitive the times Mom called late to cancel and refused to see her for another week. I could have given two weeks notice and sent out letters informing them of their new counselors name. I didn't have to subject myself to being yelled at, shut out, or ignored. I didn't have to put myself out there so that I felt like crying after Savannah's third 'goodbye' hug (even though I still have 2 more appointments with her!).

****Then, after work****

I was talking with a soon-to-be-adoptive Mom who is frustrated with the system moving SO UNBELIEVABLY SLOWLY in getting her new daughter home. She's been waiting nearly 4 months for this little girl, while the system creates barrier after barrier. She's frustrated, angry, and feeling helpless. I can only imagine that the little girl waiting in a Residential Treatment Center feels exactly the same way. And, I'm guessing that the caseworker whose phone has been ringing off the hook with phone calls from this frantic mom is feeling the same way too.

I couldn't do anything to help her - its is SO hard to not be able to help! But, I am glad I was able to offer some support. To keep her company while she tries not to worry about the little girl thousands of miles away, who she already loves like her own. It isn't much - but it was all I could do. It left me with an even sharper sense of desperation about the state of our mental health/child welfare/social service systems. I could let it make me feel frustrated, angry, and hopeless (and trust me, there are days it does) but instead I choose let it make me feel energized, brave, and determined to not become part of the problem and to fight for a better solution.

**************End Illustration**********************

Most of the parents of the kids I work with have struggled with abuse, trauma, and mental health issues all of their lives. In turn, they are struggling to raise their children. Because they have not had healthy examples of how to parent (or have a healthy relationship of any kind usually) their own children suffer from the effects - abuse, trauma, and eventually mental health issues. I also work with a number of foster/adoptive parents who are also dealing with these same issues - even though they didn't help create them. Either way, the parents realize they need help - so they come to our Community Mental Health Agency because it is the only place that accepts state insurance. However, like I described above, the turnover is so fast and often people leave without notice. What do the parents and children learn? More trauma, broken relationships, and distrust.

Now, my plea!

Social Workers/Casemanagers/Therapist - PLEASE do not fall into this same vicious cycle! Do not let the system beat out every reason that we got into the social work/Child Welfare/counseling field! Do not take the behavior of the wounded, frustrated and hopeless people who come through your office doors personally - it is not about us! It may be somewhat about the last "helper" who passed through their lives. It will only be about us if we follow in that same path of destruction. Do not sit back and accept the system's protocol - we all know the system is broken!

We must keep reminding ourselves WHY we wanted to do this work - it wasn't for the fame, glory, or money! It was because we thought we'd help people. We thought we'd make a difference. But too often we end up perpetuating the vicious cycle until we become the 'burned out social worker' that we swore we'd never become.

One of the most important things about being a therapist in this setting is not the intervention, education, or anything else I do in the actual sessions with my clients. It is showing and teaching them about having healthy, supportive relationships built on trust, care and reciprocity.

They show up for their sessions - I provide them with support. They show respect by calling to cancel instead of 'no-showing' and I work diligently to get them in for the next available appointment. They open up, and show me the scariest, darkest, worst parts of their thoughts, lives - I show them unconditional positive regard and join with them to work towards a better way.

That is the easy part.

Its harder when I have to try to make that parallel process work the other way. When a parent doesn't call me to cancel an appointment it is frustrating on a number of levels. But if I scold them about it, demand that they 'take responsibility' or decide to "show them" by not rescheduling their appointment until 2 weeks from now - that does not help!

Instead, I demonstrate that they (and their issues) are important to me by getting them in to see me quickly - thus making our relationship stronger and, chances are, they will call me next time they can't make a session!

But most importantly: They allow themselves to trust me and form a relationship with me - and I try really hard to NOT become one more person to treat them like crap.

Now, in the agency I work it currently, therapist turnover is extremely high. In fact, in the two weeks surrounding my resignation, one therapist has been fired and two therapists have quit - one having only worked here for a week! Its not that my agency is awful (although there are obviously reasons I'm leaving) but they are facing huge budget cuts, ridiculous state medicaid expectations, and absolutely overwhelming need from the community. Therefore the agency has decided to be run more like a 'buisness' than most social workers were trained to think about or work well in. The bottom line here is either you learn to treat the job like a buisness - or you don't make it.

The ones that don't make it are often so burned out by the time they leave, they just don't care anymore and leave with little notice. Or, if they don't bill enough hours and keep up on the mountains of paperwork they are fired without any notice. For the clients - they are called the next day and simply told "So and so doesn't work here anymore - your new therapist is___________".

The thing is - so many of the clients I work with have been let down by 'the system' time and time again. They barely even blink at another therapist leaving. They get angry but their is often little that they can do, no where else they can go, and few people to understand. Thus the vicious cycle continues.

Now, I'm not suggesting you walk into work tomorrow and tell off your Director, refuse to fill out the pointless paperwork, or stage a walk-out. (Goodness knows we don't make enough to live without jobs!)

But PLEASE:

Think about the decisions you make. Are you making it because it is easiest for you? Or right for your clients?

Listen to the parent who calls you on the phone in a state of panic/desperation/anger and lashes out at you. The most helpful thing I can do sometimes is to sit quietly and listen. The second most helpful thing I can do is say, "I am sorry that happened to you" and mean it.

Suggest a better solution when your supervisor tells you to do something that you know just won't work. We do this work everyday and generally aren't asked our opinion about program changes. Offer your 2 cents anyways - probably won't hurt, might possibly help.

Be an advocate - I think this is the hardest thing for a lot of Social Workers. We like to reason and compromise, but we aren't so comfortable with being assertive and making demands.

Occasionally, pull some strings and cash in some favors when you know that one of your clients just needs a break. It might be the break that keeps them going just a little longer.

If you truly can not DO anything else for someone - then at least put yourself out there, empathize with the situation, take responsibility for the broken system! Even though it is not always "our fault", we are the faces of the system - if our clients can not trust us, they will never trust any social service agency to help them.

If people cannot trust social services to help them - they will continue in their patterns of frustration, anger, and hopelessness.

And then what is the point of social workers?

5 comments:

  1. Thank you so much for caring!! I really mean that. And thank you for reminding me of why I started foster care.

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  2. You would be a great person to teach about your field. Maybe if this was expressed during the educational part of the career this approach would help carry them through the difficulties.

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  3. I just found your blog from the Monster Wrangler and I am a foster mom who has 18 month old twins that we have had since they were 4 days old. They were considered foster to adopt at first, but mom has come around and now we are facing a return home. I was just curious, what job are you going to do now? You aren't leaving social work are you? You have the compassion, understanding and heart for the child that I so desperetly wish that more people in the system had. We thankfully go through a private Christian foster care agency, Youth for Christ, and I couldn't imagine doing this without them. My blog has to be closed, because of the confidentiality of foster kids, but if you are interested in reading it, feel free to email me at Mashelhall@comcast.net

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  4. I don't really fit into any of the categories...but I want you to know that I find it so wonderfully refreshing to know there are social workers out there that indeed care.
    May God continue to stir the gift of compassion within you and may you bloom wherever He plants you.

    Kimmie
    mama to 7
    one homemade and 6 adopted

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  5. One of the very first and most frequently used lessons I learnt while qualifying was about giving the space to rage without personalising it. Yes, often I am representative of the agency I work for but it is the system and the agency that are being raged against and not me personally.
    I find it so hard to understand people who work in this field and then take these things personally.
    The most important qualities are compassion linked in with competence - no good just having compassion without being able to act on it and advocate for those with whom and on whose behalf we work.

    ReplyDelete

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