Monday, June 29, 2009

it's a lot easier


Lesson of the week: Sometimes it is WAY easier to be a social worker than a friend.

One of dearest and most beloved friends is currently dealing with extremely debilitating anxiety. If she was a client, I would know what to do, but it's so much harder to be a friend. That comes across sounding wrong somehow. I'm not sure it expresses what I'm truly trying to say. Let me try again.

I'm not trying to say that I want to be my friend's social worker, because I very much do not. What I am trying to say is that as a social worker, I have techniques and boundaries, and coworkers to debrief with, and time limited situations etc... Very rarely, does the emotional pain of my clients deeply hurt my heart. This is a good thing. It's what keeps me sane, and what enables me to be good at my job.

When my bestest bud is hurting, it breaks my heart. I hurt with her, and I hurt for her. I want to make all her pain go away. I certainly don't want to throw the responsibility back on her, I just want to fix the situation, so she doesn't have to deal with it. And I know she feels the same way, when I'm in the depths of depression (we've talked about it). Friendship is so deep on such a mutual level.

As social workers, we are able to make amazing differences in people's lives, we connect with people on a deep emotional level, but it's their emotional level, most of the time. We still have that inner running social worker dialogue going on in our heads. When it's our friends that are hurting, there's something else there.

This seems to be one of my more rambling posts, I haven't slept the greatest the past two nights, and I'm trying to express so much in this, and it's just not working.

On a positive note, because I like to end on a positive note, I got a BIKE! My last two were stolen, but hopefully this years bike, complete with even BIGGER lock, will last longer. That's the goal at least... In anycase, I'm riding to work tomorrow, and I'm very happy about that. SO glad to leave the car behind! Oh, and I made a pasta salad for lunch tomorrow, I'm very proud of myself.




and that folks, is a rare picture of the mess inside the dreamers house.

Wednesday, June 24, 2009

Sunday, June 21, 2009

disclosure

Something that was drilled into us during school was the idea that you can't take a client further than you've gone yourself. In otherwords, deal with your own crap before you try and help people deal with there's. If you can't bear to face your childhood, how can you help your clients do so etc... Well, that teaching has been in my mind a lot lately, and here's why.

Working in employment we talk a lot about "disclosure". For my clients, this would mean choosing to disclose to their bosses, supervisors, human resources (whoever) that they have a mental illness. I find that some of our staff, one in particular, really look down on the clients who refuse to disclose, even when they're having problems. In some cases, they'd rather look for a new job. And some of our staff just can't comprehend why a client would feel this way. I totally get it.

See something I've been thinking about a lot since this topic started coming up at work is disclosing my own mental illness, and if I did, who would I "disclose" to, and what would that look like. Actually, I'm not a fan of the word disclose as it really implys something hidden. I kind of prefer to see anxiety as a part of me, and just as I wouldn't share intimate experiences at the work place, I don't share about my experiences of anxiety. Lately though, things have been sucking. They had been going quite well for a while, but then the seasons changed again, from spring to summer, and things haven't been going so well (i'd love to know what it is about the change in seasons that sets me off).

When in comes to the idea of talking to my supervisor about my anxiety, I'm not actually that nervous, I'm just not sure I see a point. One of the objectives of disclosure is to make accomidations, and right now I certainly don't need accomadations. On the other hand, if I was my supervisor, I might like some advanced warning in case things came up and I did need some accomadations. So I can see both sides. I think I'd also feel better around my coworkers if I could say something like, "my anxiety is really bad right now, so I'm going to shut my door and take it easy for half an hour and see how I'm doing". It would be reassuring and less isolating. On the other hand, on our team of 8 there is 1 person I would NOT want to know, and that makes disclosing to the team quite hard.

So in terms of clients. I'm realizing that this is an issue that will be close to my heart if it comes up in counselling. I fully believe I am capable of helping a client through it, I'm not giving the client advice or an opinion afterwards, but even in the questions I ask, and the direction I choose to go with the client, I'll have to be quite careful.

Any thoughts on disclosing mental illness in the workplace? Is it good? Bad? Neither?

Sunday, June 14, 2009

It's SUMMER (almost)

You know, it's a big stereotype that Canada is cold all year round. However, my city has certainly lived up to that this spring. It has been so, so, so cold. Snow in May! So not fair. Anyway though, today was gorgeous. It was our church picnic and it couldn't have been a more beautiful day.

The picnic was great fun. Worship and communion and barbecue and games and games and candy and friends and FUN! Unfortunately however despite my sunscreen efforts I "missed" a couple places and now have a rather wierd "stripy" burn. Not cool. I pride myself on not getting sun burns and the use of appropriate sun protection. I had to go out and by some after sun lotion to try and calm things down a bit where I am burnt.

In other news, the dreamer is doing okay. Worked at the shelter last evening; another detox shift. This one was MUCH better than the last one. I quite enjoyed myself in fact! I really like seeing the clients. I miss them. I popped into the shelter today to bring the leftovers from our church picnic and some of them were quite disappointed that I wasn't staying to work a shift (I actually got offered one, but there is NO way I could ahve worked tonight).

My sister is working on my house. She's done some odd things, but overall, progressing. Actually, right now my house looks worse then it did before. There is stuff everywhere which boggles my mind seeing as I feel like I've thrown out SO much stuff! But, she organized my kitchen today and is working on the linen closet now so I really have nothing to complain about.

And now, I'm going to get some ice cream :)

Wednesday, June 10, 2009

What I'm reading this week: Confidentiality in mental health

Cordless, C. (Ed.). (2001). Confidentiality in mental health. London. Jessica Kingsley Publishers.

One thing of note when reviewing an edited volume is that each article is not equally good or equally relevant to one’s interests.  This book for example had some articles which related more to psychiatry or hospital based care than to the community based work I’m involved in. 

An ongoing theme throughout the book is the shift from a psychiatry/hospital oriented model of mental health care to a community based one and it’s implications confidentiality.  While in the past, patients may have engaged in individual psychoanalysis with one professional, many clients today are involved with interdisciplinary or interagency teams and their personal information may be shared with all members of the team.  Also, in the modern context we place emphasis on supervision, debriefing and consultation with colleagues.  While most of us as professionals would not perceive this as a breach of confidentiality, clients might. 

Another theme in the book is client expectations of confidentiality, informed consent, and whether clients really know what they are getting into.  While a client may be informed that their social worker works as part of a team, do they understand that this may mean common record keeping, or in the case of Assertive Community Treatment, a daily review of their file by the entire team. 

Finally, the book discusses the legal aspects of confidentiality and what constitutes a breach.  When does the threat of harm to others outweigh a clinician’s responsibility to keep confidentiality?  For many, it can be a “damned if you do, damned if you don’t” scenario as they face threat of litigation from both sides. 

I actually liked this book.  I didn’t read all of the legal chapters, but the chapter about social work was particularly good (or perhaps particularly relevant). The only draw back to the book was that it was British not Canadian and so all laws sighted were British.  I’d love to see Canadian authors pull together something similar.

 

Tuesday, June 9, 2009

Workshop Tomorrow: Mental Health First Aid

So tomorrow and Thursday I am taking a Mental Health First Aid workshop.  At first I wasn't all the interested in it, but it's got a really great reputation and I'm really looking forward to it.  

Basically, the idea is that just as we provide first aid for physical injuries we need to be able to provide first aid for mental health emergencies.  At first glance, the course looked like it was very much for people not already involved in the mental health field, but it looks like it will be a lot of professionals, which I'm excited about.  I love meeting other people working in the field, hearing their experiences and being able to network.  

I'm also excited because I feel like it's going to be a great refresher.  I took crisis intervention my last semester in school and ASIST (applied suicide intervention skills training) last april, but it's been quite awhile since I've had any official training.  Put simply, I'm excited to go back to "school".  

Other things I'm looking forward to include the break from the office and being able to walk to the course instead of having to drive.  Also, the fact that I get to leave 20mins later then I usually do!  

I'll post a review of it once it's over!

Sunday, June 7, 2009

cleaning (gulp)

So, things you may not know about the dreamer.  I am VERY messy.  Very, very, very messy.  My apartment was definitely turning into a fire hazard (although some claim it was turning into a bio hazard).  So, naturally, instead of cleaning it myself, I exercised me right to pay someone to do the things I don't want to do... my little sister.  I can't say my mother was too happy about the arrangement, but my sister is currently unemployed, and I'm paying her a very fair wage, more then she'd make working in retail or something.  She spent five hours today.  She did things like take all my plants down and wash my window sill... incredible.  

The Sophie Cat does NOT like the cleaning thing.  The cat doesn't even like it when I clean, but having someone else there while it was happening, was seriously not working for her.  I find is sooo funny that she doesn't like cleaning any more then I do.  She hides generally.  I think she doesn't like the changes that happen.  Things get moved, things get removed etc... Plus there is of coures the noisy vacuum.  

Currently, the cat is lying on top of my arm.  It makes it hard to type, but I think she is incredibely relived that I am no longer cleaning and trying frantically to make sure it doesn't start again... and it won't, till tomorrow.  My sister is coming back when I'm at work to continue tackling the disaster zone.  

Interestingly, my mom looks at this as exploitation.  I look at this as humbling myself enough to admit that things are out of control and I need help to get things back... 

just a bit frustrated

I'm not sure where this post is going to go, so I apologize in advance if I offend anyone.  I'm tired.  I'm a bit grumpy.  And a bit pissed off.  

So, I worked at the shelter today, in the detox unit.  I haven't worked there in ages, so it was kind of nice.  

We had a client in the office tonight who was ready to discharge because I would let her break the rules.  Apparently other staff let her break this rule and she couldn't believe I wouldn't.  I tell my coworker, that with the letter already on my file, I really can't afford to break any rules and that I'm documenting this all SUPER well so that it doesn't come back and haunt me later if the client reports me.  So then, I go do some laundry, and when I come back, the staff member tells me that she explained to the client that I was in trouble over something else and couldn't risk it.  I was NOT impressed.  That's my business and the client does NOT need to know that.  Hardly professional.  

Thursday, June 4, 2009

I'm wearing a dress...

I'm off to a fundraiser for work right away.  Label me not impressed but going to make the best of it (rant to follow).  At least there's decent silent auction prizes.  

(rant begins now).  See the thing of it is, I had to buy a ticket to the stupid thing.  I mean, I totally support fundraising, we're none profit after all.  But I didn't want to shell out money when I could ahve bought at least 5 meals for the same amount... like seriously, a weeks groceries (granted I don't eat all my meals at home, but still).  I could have gone to Starbucks soooo many times on that amount of money.  I'm kinda pissed at my coworkers too.  I told them (the 3 I talk to most) that I'd go if they went.  As far as I knew, they weren't going, and then 2 days ago, I find out they are, and they're like "oh" we thought you were.  Okay, fine, misunderstanding.  Then I found out everyone on our team is going but me.  That's just great.  So then, I go and shell out the dollars.  I'm even wearing a freaking dress.  It's the first dress I've bought since my high school graduation.  I don't do dresses.  But this is a nice affair after all.  Bah.  

So anyway, what's your organizations policy on attending fundraisers, if you're the kind of place that does fundraisers...  Do you have to volunteer a certain number of hours, buy tickets, provide prizes for silent auctions?  Some places here actually have it written into contracts, and our agency may eventually.  But seriously, is it even appropriate to expect your staff to pay back their wages in fundraising?  

Monday, June 1, 2009

What I'm reading this week: Understanding Personality Disorders: An introduction

Dobbert, D. L. (2007).  Understanding personality disorders: An introduction. Westport, CT.: Praeger.  

The stated intent of Duane L. Dobbert when writing this book was to provide a non-clinical explanation and exploration of personality disorders, and he does.  Dobbert approaches the subject from an “us verses them” mentality.  In contrast to much psychological literature of the time, Dobbert sees the individuals affected by other people’s disorders as being “victims” and the personal with a personality disorder as being the antagonist.  The preface states “if nothing else, this book will help you realize that you are the victim, not the person with the problem”. 

Dobbert starts his book with case studies illustrating his position that people are victims of those with personality disorders.  The introduction goes through the DSM-IV-TR definition of Personality Disorders and their associated criteria and characteristics.  Dobbert’s definitions are clear and his explanations straight forwards.  However, Dobbert uses a lot of black and white language and gives a very negative outlook using statements like “they [those with a personality disorder] are not capable of viewing the world from the perspective of another…consequently, it is an egocentric view, albeit inaccurate.” (page 3). 

Chapters two through twelve of Dobbert’s book go through the DSM criteria for each of the ten personality disorders (Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive Compulsive and Conduct Disorder).  For each, he provides at least one case study.  He then discusses expected outcomes and therapies.  An appendix at the end of the book outlines major theoretic perspectives of personality disorder. 

I’ll be honest, and say that I didn’t like the book.  For starters, I found Dobbert to be arrogant, and I can’t stand arrogant authors.  Secondly, I found it boring.  He literally takes the DSM and explains each sentence.  However, I can see that this book could be useful for family and friends of someone with a personality disorder.  I still wouldn’t recommend it though except as a last resort, because I think it has a very negative perspective.  Unfortunately, I haven’t had a great experience with any books I’ve read about personality disorders, so I’m not sure what I would recommend instead (suggestions are always welcome).