Week 7

This was a pretty interesting week. I got to start working with a patient that I did a psychosocial evaluation on the week prior. We developed starting point for a professional relationship and she was willing to discuss her issues/concerns with me. I am looking forward to working with her over the next 8 weeks.

Activities -

• Interviewed patient
• Attended Diversity Fair
• Participated in Treatment Team Meeting
• Continued working with male patient
• Read DSM-IV sections on Schizoaffective disorder, Bipolar disorder, and Schizophrenia
• Initiated contact with new patient

I met a new patient that my supervisor wants me to follow. He is a difficult patient because he doesn't want to talk and when I have tried to initiate conversation he states he doesn't want to be bothered. Because I am an eager student, I want to "dig in" and start working with patients. I am frustrated that this patient doesn't want to talk but understand and respect his right to choose to keep to himself.

Reflection -

In working with clients, there are many characteristics that a social worker needs in order to be most effective. For example, Lawrence Shulman states that "empathy, relevant self-disclosure by the therapist, and facilitative confrontation, appear to positively affect outcomes" (Shulman, 1978). In other words, Shulman's research has demonstrated that being able to place oneself in the shoes of the client, disclosing relevant information to the client about the worker, and confrontation that is beneficial to the client all can lead to a better relationship between client and worker/therapist. The better the relationship, the more affective the time spent together.

I believe it is important to note the difference between skill and trait. A trait is an inherent part of a person's personality and a skill is something learned that can be applied in some way. Empathy, for example, can be both a skill and a trait. Some workers might have a natural ability to feel what the client feels, and some may have to learn how to step aside and see the world from the client's perspective. Either way, skill or trait, there is still much to learn. A worker cannot rely solely on skill without having some sort of personality trait that directs the skill in a positive direction. Similarly, relying solely on a personality trait can be ineffective because without technical knowledge, one may wonder into unknown territory and not know how to navigate. In my opinion, it is best when a social worker strives to gain skill while also working to bring out positive personality traits.

References:

Shulman, L. (1978). A Study of Practice Skills. Social Work,
23(4), p. 274-280

Total Hours this week : 14.5 hrs
Total Hours to date: 114 hrs and 20 min

Week 6

There wasn't too much out of the usual this week. I did, however, get to do my first psychosocial evaluation with a patient family member.

Activities -

• Psychosocial evaluation
• Attended Carter/gatekeeper meeting
• Attended Diversity Luncheon
• Met new patient
• Continued following male patient

Learning -

With completing the psychosocial evaluation, I learned that it is sometimes difficult to get accurate patient information. A social worker, in many ways, has to act as researcher tracking down information from the client, family members, etc. It is not always easy and information is not always available. I learned to be patient and accept that there is only so much I can do. I look forward to doing another evaluation.

Reflection -

There are many things a social worker can do at the macro level to impact human rights. For example, one could organize an interest group for a particular issue or policy. One could also lobbying to local, state, and national legislators directly, Similarly, a social worker might teach awareness workshops which could encourage society to rally behind his/her cause. There are almost an infinite amount of possibilities, and social workers have the knowledge and expertise to advocate for individuals in a multitude of ways.

Total Hours this week (With Seminar 2 Seminar Hours): 18 hrs and 50 min
Total Hours to date: 99 hrs and 50 min

Care Providers

One of my experiences at Larue Carter thus far has been to participate in care-provider meetings with patients and prospective care-providers. I witnessed several care-providers come and give their sales pitch and tell the patients what they could offer. The patients then went on the decide who to go with. I am concerned and appaled at this process.

Care providers provide housing, employment, and medical/behavioral assistance to clients who are reintegrating into society. The way Indiana is setup, several care providers are sent to the client(s) where the clients interview and decide upon who they wish to go with. What ends up happening is the care providers basically "sell" their company to the clients and the clients alone have to choose who to go with.

With state laws, case managers aren't permitted to influence who the client chooses. Even if the case manager knows something terrible about the care provider, they cannot influence the client's decision. Theoretically, the client is supposed to interview the care providers and choose who he/she feels is the best match. However, there are several problems with this. One, many of the clients who require the services that a care provider offers don't have the intellectual capabilities to choose the best provider. Thus, the provider knows this and plays on client weaknesses, such as offering to take them to McDonald's, etc. Many times, clients end up choosing who they like best, based on what trivial things were promised and not who really is adequate in providing services.

To get to my point, suppose I am selling a car to a person. Ideally, that person has the capability to ask the right questions in order to choose which car is best for him/her. However, try selling a care to a mentally handicapped person, and they may likely choose which one they feel has the "prettiest color" and not necessarily which car is the safest or most reliable. Thus, they don't always have the intellectual capabilities to ask the right questions and companies know this and manipulate in order to be chosen.

Why doesn't the state step in and fix the system so that it is more fair to the clients. I was told that the state wants to be fair to the providers and fears that if the case managers influenced the decision of their clients, they might steer business towards a company they had a personal stake in. As a result of this theory, all the burden is left to the client in determining who to choose.

Case in point: At Larue Carter, we have three deaf/MRDD (mentally retarded) patients that are being discharged and moving together. They had to choose their case manager, interview three providers, and come to a unanimous decision on which provider to go with. I watched the entire process. Three different providers came in, promised that each client would have their own room, own television, be able to choose the color of the walls, etc. Each company knew what to say in order to sound appealing. In theory, the clients were supposed to be able to "interview" these providers, but being MRDD, only asked basic questions such as "Where will we eat?" Can I play Mario?" and "I like the color blue!" In the end, the clients chose the company who had the most flashy props and promised the most entertainment and food outings. Because I have a conection with the company who oversees the care providers for the state, I was able to inquire about the company that the clients chose. I was told flat out that this company was horrible, didn't have enough staff, and was probably one of the worst. What could I do with that information? Nothing! Even if I had known ahead of time, I wouldn't have been permitted to say anything. Remember, the burden is placed entirely on the clients to choose who was best.

My point with this is, who is the state looking out for? Here are three people that chose a company that has been proven to be lacking in many areas and yet the system that is set in place allowed for that company to be chosen to care for these individuals who cannot care for themselves. The state is worried about competition for the care providers to the point where they have set standards that cannot be met by the individuals responsible for choosing the providers. It is probably obvious that I am saddened, appalled, and disgusted by what I consider to be exploitation of a vulnerable population.What can I do? We will see!!

Diversity Luncheon

On Wednesday, February 13th, I attended a staff diversity luncheon at Larue Carter. It was neat to see people from different cultural and ethnic backgrounds come together to share their favorite dishes. As I sat back and watched the people interact, I noticed how unimportant diversity really was at this lunch. And I say that in the sense that everyone came together as humans and collegues and not as different people from different races, religions, or ethnicities. I understood at that moment just how much alike we all are. In the end, we all enjoy to eat, drink, and be merry!!

Talent Show

Wednesday, January 30th, I attended a talent show put on by the kids/adolescents at Larue Carter Hospital. It was touching and saddening to watch. I appreciated the effort they put forth, identified their courageous attitude for participating, and felt sad because I knew that many of these individuals would grow up to face very difficult lives.

I was amazed at the courage these children showed. They participated in something that most people wouldn't dream of doing. They went out of their comfort zones and sang and danced in front of a large audience. I was proud and hopeful to see what resiliance and dedication these kids had. However, with the good always comes the bad. I realized, watching these kids perform, that many of them would go through life with many problems and would probably suffer due to their mental illness. It was sad to recognize this; I realized at that moment just how little we know about mental disorders. I hope that in their lifetime their will be better, more effective treatments to help them cope in society. Only time will tell.

It was a great experience that brought out positive and negative emotion in me. I was happy to see their strength and dedication but sad to know that many of their lives would be difficult. However, I realize that life is what we make of it and believe that each person truly has the opportunity to be happy; at least that is what keeps me going. The idea that we can all find a place where we can be happy and free is my dream.

Week 5 - LEAD Day

This week was a bit different than the previous weeks. I spent one day at LEAD and half the other day at the BSWSA Board meeting. As a result, I only spent four hours at my practicum site.

Activities -

• Attended LEAD Day
• Attended discrimination lecture
• Participated in march to the statehouse
• Completed scavanger hunt at statehouse
• Attended lunchion at IUSSW
• Attended BSWSA Board meeting
• Interviewed new client at Larue Carter and set the tone for a positive working relationship

Learning -

This week, I learned much. LEAD day was an eye-opening experience because it showed me what a diverse, dedicated group of social workers Indiana has. I also learned that social workers play many roles in many different areas of society. Moreover, I learned that social workers are proud of who they are and what they do. Lastly, I learned that it is important to be involved in what is happening around myself. Specialization is an important part of social work, but it is crucial that social workers are informed in as many aspects of social policy as possible. Afterall, if we don't know what's happening, who will?

Reflection -

I think I partially answered this question above but will further express my feelings. LEAD Day was an important experience for me as a social work student because I was able to see the cohesiveness and dedication that social workers around the state share. I was amazed at the amount of people that attended the event. I believe the most valuable aspect of LEAD Day for me was learning how important it is to get involved in public policy. Laws and bills affect us all, and the social work profession is especially affected by legislation. Lead Day was great but I feel that there could have been more "break-out" sessions offered for different interests. Overall though, it was a great experience.

Total Hours this Week (with LEAD Day): 14 hours
Total Hours to date: 81 hours

Pictures of LEAD Day (Statehouse)

Week 4

I have continued developing relationships with some of the patients and am acclimating myself to working with severe mental disorders. This was a busy week and I learned much.

Activities -

• Treatment team meeting
• Rounds meeting
• Attended care-provider meeting with three patients
• Continued working with patient from prior week
  
• Attempted to work on action plan
• Attended adolescent talent show and Larue Carter
• Refined learning plan and identified a few groups I would like to attend

Learning -

Larue Carter has several deaf patients that require interpreters so they can communicate effectively with the staff. My eyes were opened to just how dificult it must be for persons who are deaf and mentally ill. It is difficult for them to communicate how they feel and often feel isolated as there aren't enough interpreters. I have developed an interest in working with the deaf population and am seeking out deaf patients at Larue Carter to work with. I realize that they, just as all persons, deserve an appropriate amount of attention. I don't know where my career as a social worker will take me, but my interest in working with the deaf may alter or influence my course.

Reflection -

My personality affects how I work with clients and co-workers in multiple ways. First, I am a compassionate, empathic person and this influences how I treat the people I work with. When someone is upset or discouraged about their day or life in general, I am typically eager to lend an ear and give advice, if solicited. Also, my compassionate/empathic personality helps me to see people for whom they are on the inside and what their untapped potentials are. I believe that I generally care about people and this influences how I work with and help others.

Secondly, I tend to be an objective person and try to look at all possible perspectives of a situation. When helping people or working with coworkers, I am able to help them look past the obvious and see aspects that they didn't consider. I help by staying clam, taking critical looks at all angles, and staying focused on the issue at hand. I believe my ability to stay objective, even in personal matters, influences how I interact with all the different people I come into contact with.

Lastly, I believe my desire to succeed influences how I work with clients. There are many times in life when it seems easier to give up than to push forward. I believe I instill a sense of hope and possibility in my clients by my ability to express the possibilities I see. Often times, we learn from how others live their lives and not by what they say. My desire to succeed and move forward despite the obstacles brings a positive tone to the relationships I have with clients.

Total Hours this Week (with 2 seminar hours): 18 hrs, 50minutes
Total Hours to date: 66.5 hours