Archive for the ‘Progress Notes’ Category

In each of my social work classes, in both graduate school and in undergrad, my professors have mentioned self care as an important facet of professional life. I found it easy to disregard self care. I always told myself that I simply don’t have time to do self care. In one sense, I did myself a disservice. In another, I did myself a favor.

Through my experiences, especially recently, I’ve learned the necessity of intentional, well-planned self care. I am what you might call a “perform-aholic”, because I am bent on doing absolutely everything I can, even to my own detriment, in the time that I have. In fact, I spend all of my conscious time thinking about things. It could be anything, but there is very little time I spend with my mind in an absolutely neutral zone. I spend very little time watching television or film for this reason. If the television is on, I am likely not the primary one watching the program, or I am multitasking, which isn’t the most effective use of time. I think until I go to bed at night, at which time I have to distract myself and immerse myself into a book, an article, or a game that is unrelated to anything serious in my life. I do this so that thoughts of my life and all the tasks I am working on don’t plague me and keep me too alert and on edge to sleep. Needless to say, I need to do self care very meaningfully and very intentionally. It won’t work to do something halfway because it won’t be enough to pull me out of my element.
The act of relaxing myself is very difficult to do. Even when I am “relaxed” I am normally somewhat tense. I recently went and got my first massage ever. I was happy and it felt great, but the poor massage therapist repeatedly had to tell me to relax myself and various muscles. I consistently carry tension and rarely relax my body.
I need self care just like other social workers do. The chosen activity is much less important than the act of treasuring yourself and your own mental health, so the activity does not have to be the same each time. The beauty of a routine, however, is that it becomes habitual.
While I figure out a decent routine I do know of a great self care exercise to try. It’s called progressive muscle relaxation.  Those who practice it are guided through a track of soothing sounds and step by step instructions to contract, then relax, each muscle group throughout the body. The practice requires great focus to be effective at training one to relax and to distinguish the difference between holding tension and being in a relaxed state. When I do this exercise, I often find I am already halfway tense when I begin and must focus greatly on the relaxation. However, it is a worthwhile and effective exercise to wind down and distracts the mind from worry and stress.

So, here at Progress Notes, things have been very quiet for the past year. As in, no writing, whatsoever. However, I did not have a quiet year. I completed my internship and did well in my classes.  I switched tracks from clinical practice to organizational and community practice.  In making that switch, my classes and internship for this academic year have moved to the  East Lansing area. My jo and my home are still in Oakland County and Macomb County, so I have become a mega commuter. Additionally, my job moved from being agency centered to being hired my a family privately to care for their child. The position has been incredibly rewarding as I have made an impact on the daily life of this family.

In March, I secured my internship at a community development agency on Lansing’s east side. I finished up my courses without issue and worked hard all summer. I even returned to a company I had worked for in the past to do some work, but resigned again when I was hired to care for the family I care for. I am so grateful to work for this family. Last April, I was inducted into the Phi Alpha Honor Society at Michigan State.  Things straightened out with my family and I was able to leave my job at the craft store. Life slowed down and I was able to invest time in loved ones and in myself.

At the community development agency, I am thriving. I love the opportunities I get to meet my course objectives and integrate the material I receive in class. I serve as an outreach intern and program leader for a health awareness club for women. I greet visitors to the center and help to enroll them in the community health program through Ingham County or to complete Department of Human Services paperwork required for assistance programs.  In addition, my involvement with the agency is allowing me to learn the rigors of leading an organization of this type.  I am also still dating my faithful, loving significant other. We have been together for about two years.

I am due to graduate this May and I am very excited about the prospects of finding a career job, finding my own apartment, and keeping up with this blog and other writing projects.

With things going so well, why didn’t I write? Honestly, for the time, it wasn’t as important. Investing time in loved ones took the front seat for me. The other issue that I was facing was a lack of belief in myself. Why was I really writing? What was the goal? I would love to restart and keep going by sharing my experiences in finding a career. It will take commitment and hard work, but I am excited to get into the field and to share what I find. I truly have no excuses for not writing, but I have much more confidence than I had this time last year. I am ready to move forward, full force.

Well, I left you all with a cliffhanger back in August, then never logged on again to bring you up to speed. Let’s start back there and work forward, and you’ll see that this semester proved to be a great experience.

The field review meeting went as well as I could have hoped, and the result was that I would be allowed to continue my schooling part time, gain experience at an informal internship, and hopefully begin a regular, Master’s level placement in my 2nd year of work through my school.  So, I dropped 2 of my 5 classes, keeping 8 credits, and began to intern at my placement, a technical high school campus.  I’ve been working in the student services office with a consultant for special populations and with the counselor. I work on making sure students are cared for, that their educational needs are met, and tending to any personal problems they may be experiencing. Additionally, I check in with students about grades and attendance issues.  I intern two days each week to make a total of 16 intern hours weekly.

In addition to the internship and my classes, I got two jobs: one as a nanny placement two days a week for an agency I’d worked for in

In addition to the internship and my classes, I got two jobs: one as a nanny placement two days a week for an agency I’d worked for in years past, and a seasonal job in a local craft store.  The nanny position and craft store position are in the same general area as the internship and my school so that I can travel easily from place to place.  I work, on average, between 15 and 20 hours at the nanny placement, and between 14 and 20 hours at the craft store.  That means that, between internship, craft store, and being a nanny, I usually have over 50 hours of commitment time each week outside of my classes and studying.  Sometimes the busy pace of my life felt overwhelming, but that was usually because some of my other thoughts and experiences felt overwhelming.

It didn’t take long for me to grow used to working full-time hours, as I needed to be more responsible and helpful at home.  It also didn’t take me long to realize that this time was just what I needed in order to grow and become ready for being a social worker.  I have become much more comfortable in interpersonal work and I have realized things about myself this semester that are wonderful. I have also realized some areas that I’m weak in, areas where weakness can bring shame. Above all, I’ve been learning to do my dreaming heart justice and at least investigate the interests that come to my mind or have been there for a long time.  At these times, it can be easy to doubt what I’m doing and wonder if I’m doing anything right.  The thing I’ve had to learn is, if I don’t ask myself all the questions and sincerely and deeply look for these answers, no one else will search them out for me. I want to emphasize that while I don’t always know these answers, I am absolutely confident that everything is going to work out for the best.

This past week I have found out that what you do not know or realize can hurt you. I’m going to be making some changes in my life and educational track, but in order to explain the context, I need to give you, my dear reader, some history.

As a BSW student. I was in a placement that did not get me the kind of experience that I needed as a BSW student. During my entire placement, which spanned from late August 2010 to late April 2011, I had one client contact. My field instructor had been concerned about liability and skill levels, so another intern and I were told to observe and shadow for most of our time at the placement. I also contributed to some statistics and research projects, but most of my time was spent observing at this agency. When I did raise my concerns to faculty, my placement was not changed, despite the fact that I wasn’t doing anything that would contribute positively to my experience levels.

Despite these placement conditions, I did well in my field courses and practice courses and graduated from my program with a 3.6 GPA in my major. I did not think that my placement conditions would affect my future schooling.  I thought that wherever I went for future placements, I could share my story and my field instructors would bring me up to speed. While that’s an optimistic and sunny way of thinking, it wasn’t realistic at all.  Field instructors are entrusted with the task of equipping students with skills based on program requirements and grading them that way.  I was not equipped with what I needed for my first MSW placement.  Recognizing this, my summer field instructor contacted my field coordinator and informed her of some things that she was concerned about.  I had thought I would be fine, but a phone call on August 17 changed all of that. I was shocked by this call, and on August 18, I had a field review to discuss the issues.  My school wants to work with me for my success.  To this end, they have scheduled a special meeting called an Academic Standing and Student Review for this upcoming Monday at the school’s main campus.  This process is not one in which I am shunned or punished, but the decision that will be made will be best for my future and continuing my education. Despite good academic performance, I need to consider that the experience I have missed must be made up.  Regardless of whether I continue in the program part-time, or take a full year away from school entirely to work on my experience level and return full-time next year, I must recuperate the experience I have lost.  Some have said that this call and this problem has cost me a year of work, but if I continue in field placements, I am doomed to fail because of what I do not know.  While it hurts to think that my program will take a year longer than I anticipated and hoped for, it is the best thing for me and for the social work profession.

Following the field review, I spent some time regrouping with family and loved ones. I then went back to my alma mater and asked for help getting the experience I missed.  My former field coordinator contacted a field instructor in one of their trusted BSW placements, and through a series of calls and emails and a great interview on Thursday, I have a great informal internship. In addition, I hope to take part-time courses and work full-time or nearly full-time hours. There are also several personal goals that I’ll address during this time.

I didn’t know how important the experience that I missed really was. The experience piece is one of the most important components of the BSW, because whether the graduate continues into Masters or Doctorate programs or joins the workforce, the field work gives the BSW practical, professional experience. Without the experience piece, the BSW would present as an eclectic blend of political science, sociology, psychology, and research arts.  The BSW, however, is a professional degree, and that experience is paramount to networking, development, and identification as a social worker.  Never underestimate how much you learn from what you do.  Experience is one of the most effective teachers available.

In a 2-day substance abuse assessment and intervention course I took last weekend, we were discussing access to good substance abuse and dependence treatment and good mental health treatment. One student, named Steve, made a comment that illustrated the disparity between access to medical care and access to mental health and substance abuse treatment.

“We know exactly where to go for cardiac care and where the best cancer treatment centers are and where to go for all of the medical services we need, but we don’t know that there’s a group home just down the street. Access to mental health services is extremely limited.”

Mental health and substance abuse treatment centers do exist all over the nation, but aren’t used or advertised as frequently as more biomedical settings.  In addition, insurance companies are less likely to cover mental health and substance abuse services than other services. Evidenced-based practice is not as much of a factor, we didn’t theorize, as much as the scientific model of the more biomedical treatments. There is a quantitative value to most of these treatments and a predictable, measurable cost and course of treatment. Mental health care stands at a stark contrast. There is not a dose-response relationship with mental health and substance abuse treatment options. No physician can prescribe a set amount of therapy sessions and know that the issue will simply “go away.” Many therapies teach clients to cope with life situations and help to manage and reduce symptoms. Therapy comes in many types with different methods in each type, and each individual responds differently to treatment. Some mental health diagnoses are pervasive and require different types of care throughout the lifespan. These factors make it nearly impossible to create a “dose/response” equation for mental health and substance abuse treatment.

Is mental health care something that you think about often? Do you think access to mental health care is an issue? What would society look like if mental health access were increased, with stigma stripped away? Which would have to change first? Share your opinions and discuss below.

Special thanks to Steve, for letting me use his wise words. Thank you, Steve.

I am in awe about how quickly time seems to pass.  With my schedule, with some parts of it static and others changing often, I really need to stay on task in order to make sure I get all of my work done and meet my obligations.  However, it’s not possible to please everyone or do everything.  It’s not possible to say yes to every obligation or opportunity that comes my way.  Sometimes that means deferring an invitation to dinner out, declining extra hours at work when I know that, as much as the extra funds would be a blessing, it’s over my energy limit, or reminding myself that even though it’s summer, the “lazy” days are over for me.  Sometimes it hurts to have to say no, especially when something sounds exciting or new to me. Excitement, however, is overrated.  I can’t sacrifice what’s important for me to do in favor of something more engaging or exciting.  That’s like sacrificing principles and values I hold dear In order to “have a little fun.”  What’s important to me right now is getting through school, being the best employee I can be, and being a great friend and family member.  Those roles and priorities aren’t without their exciting times, either.  As a graduate student, I often get to research, write about, and discuss topics that are interesting to me, and many exciting networking opportunities come my way.  As an employee, I can challenge myself to be a better one, mastering my paperwork, engaging more effectively with consumers and those at the agency office, and developing my skills as a great problem solver.  As a friend and family member, I can integrate my sense of adventure into time spent with family or find creative ways to express to them that I care.  I can’t say “yes” to every opportunity that comes my way or pretend that I’m living simply for the adventure of life—I have to find the adventure in the circles I move in.  I say “yes” to fun and creativity in the decisions that I already make each day.  When my work is done and it’s my time to have fun, I can seek out the large-scale adventures I crave.  It takes all that time, like sand slipping through the hourglass, and keeps it from being a disorienting and ineffective mess—like a sandstorm.  Instead, time well spent becomes a protection from disaster like a sandbag, a place of refuge like an oasis, or an opportunity for beauty, like sand art. Spending my time wisely takes the seemingly endless desert of my routine and turns it into something wonderful, with effects that don’t slip away as my time seems to.  I try not to worry about the hourglass.  I have better ways to spend my time—like making sure I’m making the most of each moment.

I realized the other day that as people, we all have different organizational styles. Some people develop systems for organizing nearly every object and bit of information they possess. Some don’t really have a certain system that they pay close attention to, but they do what seems to come naturally. It’s not that they don’t have some type of logic, but it’s not an endeavor that they put much time, thought, or energy into.

I fall somewhere in the middle of these two groups. I generally know where all of my things are, and some items I’m very meticulous about. Some people who see my space would tell me that it’s a bit chaotic. Lately, I’ve been more inclined to agree. It’s not that I’ve become more disorganized. I feel more organized than I was a few months ago. I’m seeing areas in my life and things that I have that I want to organize and improve. It’s not enough to be simply tidy. Now I want things in order.

That goes for my thoughts and keeping track of my time, also. I’ve never made this many to-do lists or left myself so many notes. I’ve got a good memory, but if it’s pretty important, I write a note anyway. I even caught myself thinking about color coding my new datebook with a plethora of highlighter colors today as I was driving home. It’s not merely something in me that’s changing—I’m changing because my life is changing. Reorganizing is my form of adaptation. It makes overpriced binders and pens worthwhile—even exciting—to find and purchase.

I didn’t want to admit that I needed to change my ways. Organized chaos is adequate if I’m not concerned about the consequences of forgetting or misplacing something. I’m just realizing that I have a lot of precious things to give my time and attention to. I can’t do that if I’m busy looking for a “whatchamacallit”.

Today in my field orientation, the presenter made a really good point. For a competency in our field education learning plans, one of the practice behaviors was to “reflect upon the meaning of change in [social work students'] lives and the lives of their clients”. She said that we’re all entering this advanced standing MSW program and even though it is a wanted change, we are still going through a lot of processing right now. I appreciated this comment. I’ve been wondering lately if I’m just being forgetful or worrying too much. I may indeed be worrying too much, but it’s not an arbitrary mood swing. I recognize that this semester, seven weeks of very condensed class material, is already challenging and it is going to be even more challenging in the coming weeks. I recognize that life as I know it is changing constantly. I’m learning a large amount of material in a short amount of time. In January, the first month of my final semester in school, I’m supposed to begin looking for an MSW job. This is almost inconceivable to me because I’m just starting. In five months I’ll be presenting myself as an employable MSW? In ten months I’m going to start working full time as an MSW? There are many things to consider, including licensing exams and qualifications. In five months, I need to determine what geographic area I want to live and work in. Right now, I know I want to work with children and families. That’s just about it. The other ideas in my head really aren’t formulated yet.
If the above paragraph sounds overwhelming, hold on. Read a certain way, that paragraph is very overwhelming. However, I know it’s going to be ok. The changes I am making in my routine will become the routine itself before long. I’ll be accustomed to an adjusted social life, sleep patterns that promote the “graduate student” lifestyle, and to spending hours each day reading and writing. Everything really is ok right now, including the feelings of sheer grandness.
The best way I can describe this feeling is comparing myself to a new sailboat. I’m at the edge of the harbor looking out over the horizon, and all I can see is ocean. I can’t turn back now because I have been made to sail this ocean. I’ve been designed to move over the waters. I’m built to win. Everything I need to move forward at this time, I’ve been equipped with, and there will be plenty of places to get what I need along the way. There is always hope for me. There is a beautiful ocean stretched out right in front of me. I can be troubled and ignore all of the provision and hope, or I can be grateful and brave and accept this awesome journey.
This change is good. I’m going sailing!