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.

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.

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.

Life goes on and on

So, inspired by the Anti Social Social Worker, who was inspired by someone or another, I'm going to try and write at least a sentance everyday. In all truth, I've been too anhedonic/apathetic to write. Having depression sucks, and September is definitely a trigger time for me.

Work is good though. We finally have a full team as of yesterday, and after three days of practicum, I haven't scared away my student yet! That is ALWAYS a good thing. I'm taking her to a wholesale discount candy store tomorrow, everyone working in non-profits needs to know about resources like that...

Oliver Lockhart just climbed up and is combing my hair with his claws... he seems to find this relaxing. I don't.

and...that's all I got today.

So, I have a social work student...

This is Sophie Cat. See her stare? She is saying "help my girl" (Oliver Lockhart just keeps walking across the keyboard erasing things). So, why do I need help? Well, my social work student arrived yesterday. My very first one. I had done lots of thinking, reflection, and preparation, gone to workshops, done all the paperwork, but now she's here. Now I'm panicking. I am so worried I am going to screw this poor girl up. My biggest problem though, especially this week and next, is figuring out how to balance taking care of my case load and my documentation (which as you know, I'm constantly behind in) and still finding time to do a good job with her. I don't want her to be as bored as I was the first month at my first practicum.

So, for those of you who've been there, cause all us social workers have, what was good about your field instructor? What was bad about your field instructor? If you are still in practicum, what's good, what's bad? If you've had a student, how did you find the balance? Any advice for a first time supervisor?

So yeah. That's what's going in my life. More later though.

The Dreamer.

Workshop

I don't know if I've ever mentioned on here just how hard it is for me to sit still. I'm pretty sure I have, but in any case, I'll say it again... I CAN'T SIT STILL! I mean, I do fine in counselling session, but I limit those to an hour, and when I lead groups I'm up at the whiteboard a lot. I can fidgit all I want when I'm just doing paperwork and no one cares if I walk up and down the hall or take a trip to the photocopy room. Why does this matter? Well, today I have to sit kind of still...

Today I am going to the first of four workshops about how not to screw up my social work student. This is a good thing. I really don't want to screw her up! BUT, I also can't say I'm all that excited about having to go to school all day. Especially because it's at the other university in town, not the one I went to. So it's unfamiliar, I don't know the presenters etc... My hope is that someone from my school will be taking it. See all first year practicum supervisors from that university have to take it, so there should be someone from my class there, you would think. I'm sure it will be fine.

During the workshop today we get all sorts of information about how to get things set up, their learning contracts and deadlines and stuff. We also have to do things about our supervision styles, learning styles and stuff like that. That's the part I'm not excited about. Although I'm an extrovert, I'm not a huge fan of meeting large groups of new people and having small group discussions with them. Oh well.

In anycase, I gotta get out of here. It's wonderful to be able to sleep in, but I suppose I do have to leave eventually. I was planning to take the bus, so I wouldn't have to park, but I finally decided I'm just going to drive afterall. It's funny, becaues last year at this time I didn't have a car yet and I took the bus EVERYWHERE or rode my bike, and now I'm so used to the car.

and, in other news, the cats are fighting...must.go.end.cat fight.