Effective July One

June 27, 2010

So, things are changing at my job. Instead of running from home to home trying to keep families together, I am going to be diagnosing, assessing and outpatient therapizing, which is good for my career, I guess. I will no longer be fighting the good fight. I will be fighting the bourgeois fight, except on behalf of Medicaid recipients. I’ve always had a bias against therapy, if you can believe it. It seems indulgent. My profession would not appreciate this.

But family preservation. That’s the real deal! I mean if you cant get paid to foment revolution and if you are too intimidated by electoral politics to run or lobby, then surely family-based intervention is the next best thing. Because families are the building block of society. I mean, the way that family preservation got started is that agents of the government developed a habit of sending emotionally disturbed kids to therapeutic foster care, putting them in jail or packing them off to psych wards. Which basically means black or poor children, well all children are poor — the children of poor parents. Which leaves mothers feeling worthless and children feeling motherless. So we are, like, fighting against the man, against the modern day slavery of the DSM and the prison industrial complex and the psychiatric blahblah. We teach parents how to parent their children, no matter how difficult. We come out to the house. We empower you to piss test your kid in your own damn bathroom. Nothing bourgeois about that, right?

So, I provide family preservation services. As with all segments of every industry, late to the capitalism party though we may be, the helping professionals are finding new and exciting ways to package and sell our services. One craze is sweeping the nation, something about “science”, maybe youve heard. More and more, local, state and federal governments are requiring human service providers to use evidence-based interventions to prove that they actually help people. Which requires studies, certain kinds of studies, and data, in order to prove that saying this and doing that, rather than DOING this and saying that, really works. So, a few science-based interventions have been developed and trademarked, or whatever, and for-profits sell them to non-profits. My for – profit is one such for – profit. Currently, we do not sell our treatment model to anyone, but we have convinced at least one state to use our treatment model on? with? for? their citizens.

All bitterness, distrust, and alarm aside when it comes to for-profit human service agencies, I have been learning this “treatment model” over the past year, trying to make sense of it and make sense of what I do, to complete the “fidelity measures”, trying to facilitate measurable, positive outcomes for families and therefore, like what I do, therefore want to do what I do and to do it for a long time. I had something to sink my teeth into. They have checklists, gosh darn it. Checklists, and if you got a certain number of checks it meant that you were a good person —  I mean, helper. And there are 16 skills to get checked off in. I’m in the lead. Nevermind my education, experience or moral foundations — I’m getting checked off in social work! There is a bulletin board at work that says so. But now, my check-offs wont really matter.

Because now, I’m licensed and numbered and almost numbered again and my supervisor has asked me to do diagnosis, assessment and outpatient therapy. I’m out of the family pres. game effective July 1, which makes me sad. And confused. There’s no real outline of how this is going to work. I mean, our agency hasnt ever provided outpatient therapy, so they, — er, we — or I guess I, will be starting from scratch.  They said that I still have to go to people’s houses, but maybe less. But, also, there’s this thing where outpatient therapy implies you are in an office, in a room with a child, alone, but I don’t really understand how to help children change outside of the context of a relationship with a real adult who matters.

I mean there’s the therapeutic relationship — you know, the one the kid has with me — but what do I matter, in the long run, to an 8 year old? Like, if I don’t have your eyes and you dont have my toes and if I’m not preparing you for end-of-year testing, do I matter? Really?? I can, like, help you draw pictures of your abuse and everything but, shouldnt your mother be doing that? And if I have to go out to your house anyway and your mom’s right there anyway . . . how is this outpatient therapy, again?

And, also, privacy and confidentiality seem like real important ingredients to the outpatient therapeutic relationship and I’m just wondering how much of that a kid can get of that in their own home. I mean, it’s not like I’m going to use mom’s bedroom for a therapy room . . . right? “Let’s talk about your abuse in private! How about the bathroom? Ill sit on the toilet, you get the tub!”

So, I’m not excited about this new development, because I’m confused and skeptical, but I said yes because:

— It is in my best interest to practice outpatient therapy under clinical supervision in order to assure that I qualify for the highest level of social work licensure in Maryland

— If I would like to provide outpatient therapy in private practice someday, I should start in the loving arms of an agency, er, company, that has lawyers and protocol and free supervision.

— If I get pregnant, this job might less stressful and might involve less driving

— My supervisor wants me to. I’m a sucker for other people’s wanting

— I’m also a sucker for feeling important. Outpatient therapists are more important than . . . whatever pseudo-techno babble title they call people in the my current position. “Something something specialist”, like “customer service specialist”. (I scoff at that word — “specialist”. It’s so totally pompous and meaningless.)

So, that’s the update. On my profession. And my career. And my job.

Three distinctly different beasts.

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3 Responses to “Effective July One”

  1. LPC said

    My sister is a researcher on public policy in your area. From listening to her, I think the pull of more vs. less hands-on is part of your entire field. Progress has to be made from all parts of the system. If it’s good for you, then, well, good for you:).

    • mrsbasement said

      i would do something pretty drastic to sit for one hour with a public policy researcher in the field of family preservation. I feel like I spend all day with the book against my nose trying to read each letter, not even knowing im holding a book if you know what i mean.

  2. iatoz said

    I just stumbled upon your blog and am pretty new to the blogosphere in general but am continually feeling appreciative and validated by reading other’s stories with whom I can actually relate. As a social worker/therapist school counselor currently not working but looking, I’m going through yet another identity crisis (will that ever stop??) and trying to decipher my version of my career, job, profession. It’s almost as hard as when I fell in love with my best friend and realized that I did in fact, love women. So, thank you for sharing, I guess, is what I mean to say.

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