Interviews: Some Never Make it to Prime Time

This one didn't, or maybe I'm too impatient, but have to share. (See post on Googling yourself). I answered these questions in a paper and pen interview on November 23, 2015 only days before the attack on San Bernardino (Dec 2). They are about being a clinical social worker. I've not seen it published anywhere, and since it took some time to formulate the answers, publicity being the payback, we're going proactive, publishing it here. Because hey, they're my words, and we know darn well that kids in school steal words.

1)     What brought you into the field of social work?

Junior year at the University of Illinois in Champaign-Urbana, the Dean of the School of Fine Arts impolitely, with no sensitivity whatsoever, advised me to find another vocation. The rest of the story you can read about when the book, Everyone Needs Therapy comes out, hopefully by the end of 2016. These things take time. Years. Decades. 

2)     How has your career grown and developed over time?

My first social service attempt turned out to be as a Resident Advisor at UICU, the person to make sure that nobody on the floor aspirated after a Saturday night out bingeing. After graduating with a Bachelors in social welfare (everyone should learn social welfare) I married and took a job as a community aid for the Council of Jewish Elderly, a wonderful organization and dream job for someone who likes to be outdoors. Mainly I did light shopping and took an occasional walk with people I would now consider my peers, or maybe ten years older, really, retired persons desperately trying to live independently in their homes.

Someone told me that my state senator had scholarship money to award to adults wanting to go back to graduate school, so I wrote a letter to Senator Art Berman, and the State of Illinois paid my way to a Masters at the Jane Addams College of Social Work, University of Illinois at Chicago. With internships in one school, one hospital, not particularly happy with either, I logged the required two years of agency work and supervision for state licensure, the goal, private practice. Family therapy certification and a sexual dysfunction rotation at Loyola improved my confidence, and many more years later, going back for a social work PhD, thinking the youngest child old enough to handle it, seemed like at good idea. Not sure that was true, the part about the youngest child being old enough. He claims he ate cereal for dinner in those years. But what's wrong with that?

I was supposed to teach, naturally, with a PhD. But the rest of that story is for the book. Not today.

3)     What do you see as the top social issues facing social workers today?
The first thing that comes to mind is what we have learned from the war on terrorism, or the war against the west, western values. Disaffected, disconnected youth seek meaning,  approval, spiritual guidance, and welcoming social avenues, places they feel they belong. This, by the way, is why gangs are so appealing to young people (read My Bloody Life: The Making of a Latin King,  Reymundo Sanchez), they provide the alternative family. Fighting terrorism is the top social issue because this gang isn’t content with petty thievery and drug dealing.

The social work contribution to the war on terrorism could be the political push for refunding and developing services for kids, especially adolescents (think identity formation). Give them a place to go.

 If we can’t provide facilities for recreation, people to mentor, treatment for the myriad of social issues they face, then terrorist organizations will fill the gap.

So the top social issue, to me, is terrorism, and one of the answers, internationally, will be social services, last on the list of hands to feed by debt-bloated state governments.  But now we can point to the dreaded consequences of not funding them.  Social workers need to organize, lobby, change social policy.  

The second thing we’re learning is related to the first, that anger is externalized with gun violence, and the mass murders we hear about at schools, in malls, at movie theaters right here in the USA, a function of mental illness, not terrorism, are usually perpetrated by persons who have previously been seen by mental health professionals. Of course we should be writing to our congress people about gun control, but when we know that a suicidal or potentially homicidal person resides in our community and is not in active treatment, and perhaps the family cannot afford more help, we need to be proactive, connect with law enforcement and schools about it, not stick our heads in the sand hoping the problem, the anger, will go away.

4)     What advice would you give to new social workers entering the field?
I think the thing that knocks us out of the field is not so much burn-out over time, but a few seemingly impossible cases we’ve signed up for that hit us all at once, overwhelm us with a sense of powerlessness, yet responsibility. What will keep us in the game is being a team designer, inviting family members , teachers, psychiatrists, and medical doctors into the assessment and treatment plan, and communicating with them. Often.

5)     Would you do anything different in your education or professional experience if you had the opportunity?

Yes! I would have ditched HMO-PPO provider panels much sooner, believed in my reputation as a good mental health provider and gone out on my own. Years ago I went to a social work task force meeting for private practitioners and one of the organizers looked at my list of provider panels, Magellan, UBH, Aetna, Humana, Value Options, APS, etc., some that have long since gone bankrupt, and called me the Queen of HMOs. I should have got it then that this is not something you want to call your legacy. You’ll work too hard for too little (once you pay the IRS as an independent contractor) and suffer back problems from sitting too long. But my God, will you know a lot about what makes people tick, and if you’ve kept up you CEU’s, how to treat them.

6)     What is the key strength you bring to your career and what would you advise new graduates to mine their own strengths to further their careers?
I think it is assuming that I know nothing, and being open to learning everything. I look to the person I am supposed to be helping to have all of the answers, and what he does not know is my job to find out. It is my willingness to support Ebay and Amazon that has saved me, finding books about everything that is new to me. But even in graduate school I ate up every book on the syllabus, and leaving  Jane Addams, asked for more, syllabi of the classes I missed, read them the summer after graduation.  I still hack into the UIC bookstore to see what they are teaching in graduate schools, buy the books cheaper elsewhere.

My advice? If reading isn’t your thing, if you learn better by hearing lectures, or watching videos, then do that, go to YouTube, watch Ted lectures, listen to podcasts. Keep learning.

7)     What can social worker students do to improve their competitive edge in the current job market?
I guess that all depends upon what kind of job you’re looking for, because social service jobs might be disappearing. I think that networking at conferences and volunteering to work with local agencies increases our worth, puts us in the room, provides us opportunities to schmooze with people who might have connections.

I would tell budding clinical social workers who want to go into private practice to do what new PsyD grads do: Make friends  in school and form a group practice first. Then see if you really want to go it alone.

8)     Social work can be rewarding but challenging as well.  What self-care strategies do you recommend for new social workers?
 Stretch a lot. Or swim. Make sure you can vent to someone, but make that a supervisor or a colleague, a consultant.  It reeks of unprofessional, ranting at lunch to a friend. Also, figure out how much sleep you’ll need so that you don’t fall asleep on anyone. That, or master the art of the catnap. Perhaps both.

9)     Can you give an example of an interesting project or case that you have worked on and your role in helping to achieve a positive outcome? 
(Sure, but I have to change all the identifying details). I had a suicidal patient, a duo-diagnosed young woman with strong suicidal ideation, and attempts in the past. Call her J. She didn’t like therapy and checked in with her last therapist once every couple of months, at best, apparently whether she needed it or not.

A private practitioner’s worst nightmare, J. proclaimed that for sure she would kill herself one day, and described how, a flawless plan. Her psychiatrist didn’t take kindly to any kind of questioning about his prescriptions, and didn’t see J. often. The referring family practitioner liked being kept in the loop, but all he could do was insist that J come in for follow-ups.

I put it all in writing, J’s every suicidal thought, plan, and negative experience, a Suicide Risk Assessment, and faxed it to the psychiatrist and physician. The psychiatrist called me for the first time. He had no idea, had never heard any of this! Surprise, but that isn’t surprising when a visit to a psychiatrist is only a medication evaluation. He changed J’s meds, presented the assessment to his medical students for discussion, actually spent more than 15 minutes with J.

The attention of the team, and frequent therapy visits with me, our focus, always, always, always, on suicidal thoughts, made for a much happier woman, not that she might not kill herself one day, as she likes to tell me. You have to joke about these things or they will drive you crazy.

10)  Is there any further advice you would share with students concerning social work as a career? 

Yes, congratulations on your career choice. It is the best career in the world.