blogging

I've been horrible about blogging this past while. I've been anemic, had bronchitis that wouldn't go away, an ear infection that made me not hear and well just felt generally crappy. Sleep continually won over blogging.

I'm better now though! So hopefully, more blog soon!

chronic suicide ideation

As most of you know, I work in a program for adults with mental illness who want to reenter the workforce. One of the main criteria for program admission is current stability. In other words, you have to be emotionally ready to work and have enough control over your symptoms to function in a work environment. We'll support you, we'll advocate for you, we'll work with your employer, we'll help you, etc, but we aren't a placement agency, we help people find jobs in main stream employment. Of course, because no one is perfect and mental illness can be unpredictable, not all over our clients are able to find employment, and they don't all remain stable. Right now, I'm working with a client who is very not stable, and it's a little bit outside my comfort zone.

Said client is chronically suicidal. Suicide ideation is part of her daily life. However, since entering our program she has attempted suicide on three different occasions. She was not stable enough to maintain employment. So, it came time to discharge her and refer her to more appropriate services. So I did... refer her that is. She and her doctor decided that a hospital day program was a good option for her, it offers DBT and CBT skills training and would provide her with tools and a lot more support then our program can. So the client and I agreed that I would discharge her as soon as she started the program...

The program kept bumping her date of admission back, and so, two and a half months later, here we are. We meet for counselling, but I feel like we're getting no where. Every session is potentially our second last session (we'll do a last one for closing once she starts) and because her suicide ideation is so prevalent it's almost all we talk about. We have safety planned so many times that both of us could probably recite the whole thing backwards, forwards and upside down. The crisis lines have heard from her day in and day out for months. The mobile team won't see her right now because it's a "long standing issue". I was out of ideas.

So, when I saw her for the second time this week, an extra session, just to get her through till her day program starts Monday (we hope, we hope, we hope) I took a totally different approach. Rather then doing the whole ASIST thing where you explore reasons for death, reasons for life, align yourself with the side that wants to live, safety plan and contract (which I don't do anyway), I thought, we'll, this isn't changing anything, screw this. So, we talked about death. We talked about who finds her body, we talked about how long it stays in her apartment, we talked about who feeds her gerbil, we talked about her funeral, her ashes, the affect on different people in her life, and you know what, our session went a whole lot better. I wasn't frustrated (something my student noticed in our last session) and I left more room for silence and thinking. She wasn't forced to answer the same questions (with the same answer "I don't know") as usual. It certainly wasn't the answer, and it certainly didn't fix her suicide ideation, but it seemed to be a better approach.

In April I'm going to a two day workshop about working with chronic suicide ideation and it's connection to trauma. I'm super excited. I felt very unequipped in this situation, and while I did make all sorts of appropriate community referrals, the person she felt comfortable talking to was me. So I did research, I consulted coworkers and my supervisor and I kept in mind that not only do I not know everything, but I don't have to know everything.

second guessing

I'm second guessing myself today. I don't usually do that. In general, I'm pretty good at leaving work and work and not thinking about it once I get home. Every now and again though, there's a situation which gets under my skin. A decision I made that I'm just not sure about. Today is one of those days.

Vacation is going amazingly well. I'm hanging out with this fine canine named Apocalypse. He's pretty awesome, but VERY hard to get a picture of as he doesn't hold still long enough.

As I mentioned in a previous post a couple months ago, my vacation is with someone I met on the internet, a fact which concerned some of my friends, but it's turned out wonderfully. At least for me, I hope she feels the same way! I've known my movie loving friend online for 5 years now and I've been planning this trip for many of them. It feels so great to finally just get to hang out in the same room, even if all we're doing is reading/reading the internet.

Vacation has been so relaxing, and I still have 2 full days left! Today we went to take in some tourist sites, but for the most part we haven't been doing much of anything, something I've been greatly enjoying. We've been to mass, church, small group and movie discussion group. Watched movies and played boardgames with her roommates. I lost horribly at the game of life tonight, but really had quite a good time of it. If you ask me, I should have won, however the money didn't agree.

I hope all of you are doing well and have fun vacations to look back on/look forward too!

Vacation

I'm on vacation right now and it's wonderful! I took that picture on Friday. My friend and I sat on some rocks and just "were". It was amazing. I am soooo relaxed, and I'm finally getting healthy too. It turned out I was quite anemic, which was definitely the cause of my lack of energy and depression. I've been taking double the usual amount of iron and despite the stomach ache, I feel SO much better. Vacation is wonderful. Friends are wonderful. Walking on hills, definitely not so wonderful, but still, in this gorgeous place, it's okay.

realities of life

I haven't posted about death in quite a while. Since switching jobs, I haven't had nearly as many encounters with death, although I will say that every time I work at the shelter, one of the first things I find out is if anyone has died. So, it surprised me yesterday, when my father told me about a client from two jobs ago who died this week, a attender of the church I attended in my first couple years of university, and more recently, someone I locked up in the drunk tank at the shelter.

Anora was a broken woman, rarely have a met someone with SO much anger and pain inside, and yet, she tried to fight, as best she could. A woman, who grew up surrounded by drugs, abuse, alcohol, gangs, neglect and suffering, full of instability, it all came with her to her adult life. Trauma doesn't disappear when you turn eighteen.

Anora was found dead in a pool of her own vomit. She didn't make it through that nights drinking and drugs. We'll never know if she intended to die that night or just went a little overboard and her tired body couldn't handle anymore.

Very honestly, and this really surprised me, I hope she wanted to die. Not because I think her life was so horrible there was no help for her, but because I hope that she was ready to go. I hope this wasn't an accident and there was still some fight left in her, I hope she didn't intend to wake up the next morning full of possibilities, I hope this was on her terms, and her time. Or perhaps, she simply gave up caring, which is the most likely scenario given what I know of her.

And so today, I mourn the lose of Anora, and I pray that people will continue to make an effort for others like her, so that not every tragic story has to end in more tragedy.

there's a cat on my head.

My orange cat is on my head right now. NOT impressed. Oh well.

So, big revelation of the week. I need to SLOW DOWN! Yesterday I came into the office and got right down to business. Things with the student and with new staff had left me kind of overwhelmed, but I came into the office ready to get back on top of the pile and jump start my week.

Well, I not only got on top of the pile, but I just kept climbing. See, I have a habit of being very intense. It's a really ADHD thing (which I've never formally been diagnosed with, but well, I fit all the symptoms...) Anyway, it's that ADHD thing where you can focus really intently on something you're interested in and you just zone right in, but then in other scenarios you're just bored out of your mind and can't focus at all. SO, what I'm trying to say is that I did a TON of work yesterday and really didn't leave a lot for the rest of the week. Or maybe it's that I did all the "interesting" work yesterday, and have boring stuff left for the rest of the week.

See the thing is, yesterday I went through my case load and checked up on them all. Hadn't heard from them? Gave them a call. Missing information? Tracked it down. Needed a letter sent? Wrote the letter and sent it etc... Did I do any class prep or group development? Nope. Now, maybe this is good, but guess which part of being a social worker I like best, class development or dealing with clients...

I'm still working on finding that balance in my day. Finding the time and the pattern so that I spend a good amount of time on my various tasks. Fridays are almost always saved for catching up on my documentation/administration stuff, and since my clients never show up on Fridays I've basically stopped booking their appointments for then. I tend to have most of my clients on Wednesday when we have our job search group, and the rest fall in on Monday, Tuesday and Thursday. I lead class/group on a completely irregular schedule. And I usually see evening clients on Wednesdays.

Basically, what I'm saying is that for me, as it is with a lot of people, it's a lot easier for me to do the counselling/advocacy part of my job then it is to do all the paperwork that comes with it.

busy bee

I interacted with 14 client files today. I cannot tell you how much I hate that expression.

mindlessness perhaps the opposite of mindfullness

I had an awesome day today.

Starbucks, pick up people for church.

I lead the service a church this morning (sermon and all) and I didn't die during the children's story. Children's stories are NOT my forte.

After church I drove people home and then began watching Grey's Anatomy.

Lunch with bestest bud at Olive Garden (Soup, Salad, and Bread sticks).

The a quick bit of shopping with bestest bud including a pair of yoga pants to wear during movie watching marathons while on vacation, which coincidently, commences in 11 days.

The home to watch the rest of Grey's, hug the cats, check out this new NCIS: Los Angelos thing and start to get caught up on my CSI:NY watching. I haven't finished last season on that one yet.

And so, now I'm heading to be early. all in all. a wonderful day.

learning contract

So I haven't given you guys an update on my social work student since my panic earlier this month. I had NO idea having a student would be this much work. Or well, I sort of did, but really, it's A LOT of work! I think I'm settling into a routine with her now though, which is really helpful. There was one week when I came into work an hour early on the days she was there as well as leaving late so that I could get all my work done while still spending time with her. Of course, I also had to work on training our new counsellor, so I was trying to do a crazy amount of work...

So, things I've learned so far (some of which I was warned about, some of which I'm figuring out on my own).

1. Having a student makes you hyper aware of what you are doing. I haven't had someone observe one of my counselling session since I did a video session in third year university. Now I have someone observing and critiquing my counselling. I also have to pay a lot more attention to how I spend my time because two days a week, there's someone watching everything I do.

2. I need to slow down. I always need to slow down, so this isn't actually new, however, having a student forces me to take the time to slow down and really think about what I am doing and why.

3. Shoes are an important thing. I have a habit of not wearing shoes while at work. I wear them when I see clients, but other then that... It drives my boss crazy, and if she "made" me wear them, I would make more of an effort, but mostly she just shakes her head. However, now that I have a student, I've started thinking about what kind of an example I'm setting as a professional, and realizing... hmmm shoes... probably a good thing.

4. Having a student makes me go back to basics. I found her my "basic counselling responses" text book and took a good look at it myself. It made me think about some of those basic things which have in a way become second nature to me.

5. Having a student also brings me back to some of that "impostor syndrome" I've felt in the past. That whole, I can't do this, who am I to be calling me a social worker type thing. Only in this case, it's all about not screwing the poor girl up or having her expose me as a fake.

On the whole, I really like having a student. I think she's going to bring a lot to our organization. Having a student means we all act a little "sharper", but it also means we get a new perspective, someone who is right now reading the most current up to the date stuff and learning lots of great things in school. I enjoy helping some one else learn about their passions, about social work and about being a professional. I love reading her reflections and trying to challenge her thinking and get her to explore some of her own strengths and weaknesses. I hopefully will get to keep doing this, because I think it is such a wonderful thing.