Markham's Behavioral Health

40 Years - Chapter One - Take The Client Where They're At

If you asked me “what’s the most important thing you learned in your Social Work graduate education” I would say it was Dr. Maureen Didier telling me, “Take the client where they’re at, take the client where they’re at, not where you want them to be, not where you think they ought to be, where you think they should be, take the client where they’re at!”

I had Dr. Didier for three out of the four semesters of our 64 credit hour Masters in Social Work program. I, as a young person, had some disdain for my graduate work become it wasn’t pure social science but applied social science with lots of methods courses. And so I held a lot of my education in those days in some contempt I am embarrassed to now say because it has served me very well.

Outside of class I would mock Dr. Didier and say to my fellow students, “Can you believe that this is what passes for graduate education, her standing up there saying ‘Take the client where they’re at. Take the client where they’re at” in a high sing song mocking voice. And yet 40 years later I have Dr. Didier on my right shoulder whispering into my ear when I am frustrated, when I am going too fast with a client, when I find myself imposing my values, and hopes and dreams and preferences and desires onto the client, “David, take the client where they’re at.” And I slow down, step back, listen more deeply, try to understand where the client is coming from and what the client wants,  and I realize that things always go better.

I find the maxim, “Take the client where they’re at” to be just as important and just as good advice in my personal life as in my professional life.

After 40 years, I thank Dr. Didier and marvel at her wisdom. I laugh at my vanity, egotism, condescension, and am ashamed to tell you that I laughed and mocked her.

I don’t know where she is, or even if she is still alive. I think she has probably died. I thank her every day and say a prayer of thanksgiving for what she taught me. I am sorry for mocking her. I hope she would forgive me for not appreciating her wisdom when I was younger.

I pass her wisdom along to you and suggest if there is never anything else you learn in your Social Work education and/or practice or life, remember Didier’s dictum – “Take the Client Where They’re At.” It will serve you, your clients, and those with whom you are in relationship very well.

40 years and counting #1

I realized the other day that on October 31, 2008, I will have been a Psychiatric Social Worker for 40 years. I am thinking to myself - "What have I learned in all that time that might be valuable for me to reflect on and remember and might be of value to others?" So I decided to write a book. And part of that book writing effort I am going to put on this blog. I entitleing the book, at least for now, 40 years and counting. (If you have better titles let me know.) So, if you want to follow the progress as I write and comment on this work in progress check in regularly for the latest installment.

Here is installment number 1

On October 31, 2008, I have been a Psychiatric Social Worker for 40 years. I started my career at Kings Park State Hospital in Kings Park, New York half way out on Long Island just over the Nassau County line into Suffolk county on Long Island’s north shore. I started on October 31, 1968 as a Psychiatric Social Worker Trainee II.

My supervisor Fred Ironside asked me where I wanted to work and I told them on the Child and Adolescent unit and they put me in the geriatric building with 900 geriatric patients and where they hadn’t had any Social Worker services in over 1 ½ years.

I learned many things there but most of all to love and respect old folks.

This book is about what I have learned as a Psychiatric Social Worker over 40 years of practice. It is going to be a lot of very personal things. You may find a lot here that you disagree with or even find offensive and that’s OK. Part of practicing any profession is not what you learned in your professional training or what the textbooks say, but how you applied what you learned and made it work for you and made sense out of it.

Social Work is a very personal profession. A good Social Worker uses his/her personality as  their primary professional tool. Most of Social Work depends on developing a helping relationship with individuals, couples, families, groups, communities and representatives of all kinds of organizations, companies, agencies and governmental entities.

The key to good Social Work is the effectiveness of one’s interpersonal skills which depends on one’s emotional intelligence. It also helps if one is smart. It also depends on humility and knowing what one doesn’t know and being able to recognize one’s ignorance, incompetence, and asking for help. Without that humility you are dead in the water and would do better in some other profession or career.

I have taught over the years at various colleges as an Adjunct Professor teaching Social Work courses, Psychology, and Health Education. I have worked over my career as a clinician as well as a manager and administrator and so I bring the experience of several life times to my teaching. Angela and I were married 35 years and have 9 children so I always worked at least three jobs often 60 – 80 hours per week and sometimes more. With all this experience, I find myself saying things to my students like “I know this is what it says in the textbook, but let me tell you how it really works.” Of similarily, “I know this is how it says in the textbook to do it, but this is what it really looks like and feels like as you try to bring those principles, ethics, practices into application.”

Am I cynical? Yes. Do I passionately believe in the field and the value of the profession? Yes and more so with every passing year. I have been abundantly blessed to have entered into the profession of Social Work and my life has been richly benefited both professionally and personally. To be able to earn my living and get paid for something I love doing and passionately believe in is the greatest life any human being could have.

So, enjoy my stories of my 40 years of experience. Hopefully you will find them entertaining, maybe enlightening, and above all else, it is my wish that you find them useful as you go about living your own life and finding your way in the world.

I will be tagging these entries as "40 years"

Quote of the day

"It's clearly a budget - it's got lots of numbers on it."

George W. Bush

The Silenced, the book

The following synopsis comes from the school library journal posted on the Amazon web site.

The Silenced begins with Marena running late for her bus that takes her from her readaptation community to her Youth Training Facility. Classes are lead by instructors of public enlightenment and consist of recitation of Zero Tolerance Party propaganda. Stern, silent state officers patrol the halls. As the book progresses, Marena begins to remember things that she was somehow made to forget. It becomes clear to her that her father was there when the state officers dragged her mother from their home years before. As regulations tighten, she isn't sure who she can trust besides her boyfriend, Dex, and newcomer Eric. She realizes that, like her mother, she cannot remain silent in the face of state oppression. The three friends choose graffiti as their primary form of rebellion. DeVita's novel has many of the same character types and situations as other dystopic works—the enemy who has a change of heart, the unsympathetic character who nevertheless proves to be brave, and the friend who is a traitor. While readers may not find any conceptual surprises, this is a gripping read and young adults will certainly empathize with the characters' conflicts between self-expression and a desire to fit in. They will find the Zero Tolerance credo that the state's first priority must be the safety of its citizens to have a chilling resonance with statements in the news today.—Eric Norton, McMillan Memorial Library, Wisconsin Rapids, WI

While The Silenced is marketed for grade 7 and up, many adults have enjoyed this novel by James Devita. I heard about the novel on the NPR radio show To The Best Of Our Knowledge. Having read it, I am chilled by the similarities to the Bush Administration which we have lived through in the last 8 years. I think this is an important book that all Americans read who are concerned about the direction which our country has been going in especially in the last 8 years.

Chalicefire and GCASA Cares blogs

Some of you may have missed my postings on this blog. There are several reasons why the posts have been infrequent. First, I was on vacation for two weeks in the middle of August, 2008. Second, I post almost daily now on Chalicefire where I have writing a morning meditation which I used to put on this blog. Third, topics having to do with substance abuse and addiction, I am more likely to post to the GCASA Cares blog.

I will continue to post on Markham's Behavioral Health, but also invite you to read Chalicefire and GCASA Cares as well.

Quote of the day

"Rose colored glasses are rarely bifocal."

Kay Martin

Army recruiters use unethical and illegal recruiting tactics on naive young people

How desperate are Army recruiters to fill the ranks to fight in the immoral and illegal war in Iraq? Desperate enough to use unethical and illegal tactics to intimidate naive young people into signing up.

Army recruiters prey upon young people and threaten them with arrest and jail if they don't sign up. Amy Goodman on Democracy Now interviews parties involved in this latest scandal. This show aired on August 6, 2008

If you have young people or work with young people, this is an important show which provides information about unethical recruiting tactics by the military.

You can listen by going to the Democracy Now web site by clicking on the link below.

Democracy Now! | August 06, 2008.

Smoke-Free Policies Prove Effective

Reuters HealthDay reported on July 1, 2008 on a study in the July 2008 issue of Lancet Oncology that found that smoke free policies work.

It has taken a fight in many places to get smoke free policies in place. There have been many obstacles and barriers. It is always difficult to overcome addiction and to give up the profits that accrue from them. It turns out that the Public Health professionals were right all along.

Here is a snippet from the Reuters article:

Smoke-free policies are extremely effective at reducing smoking rates, exposure to secondhand smoke, and even smoking-related heart disease, new research shows.

The report, by an International Agency for Cancer Research working group, also found smoke-free rules don't affect business in restaurants or bars.

The researchers analyzed available evidence and found:

• Implementation of smoke-free policies substantially decreases secondhand smoke exposure.
• Smoke-free workplaces decrease cigarette consumption in continuing smokers.
• Smoke-free policies decrease respiratory symptoms in workers.
• Smoke-free policies don't decrease business in restaurants or bars.
• Voluntary smoke-free home policies decrease adult and youth smoking and children's exposure to secondhand smoke.
• Smoke-free workplaces decrease adult smoking rates.
• Smoke-free policies decrease tobacco use in youths.
• Smoke-free legislation reduces rates of heart disease.

MedlinePlus: Smoke-Free Policies Prove Effective.

Quote of the day

"You can learn many things from children, how much patience you have, for instance."

Franklin P. Adams

Quote of the day

"Don't let life discourage you; everyone who got where he is had to begin where he was."

R. L. Evans