Sunday, February 28, 2010

Ode to the Food Pantry

Oh the food pantry. How you help in bringing together a case manager with a client she hasn't heard from in so long.

"Hi, Anatolia, I was wondering if I could get some food from the pantry... And set up an appointment with you as well."

Tuesday, February 23, 2010

Words Take on New Meaning

Give me a word and I'll tell you its meaning in its case management context. Unless noted otherwise, words relate to clients' statements.

'Urgent' -- Ah, the days before urgent calls meant "I need something and don't feel like waiting." Though we don't handle urgent calls of a 911 variety we sometimes deal with matters that need immediate attention. A client's apartment may have gotten damaged or she has no hot water. A client may show up with an eviction notice. But the handful of clients who make too many non-urgent urgent demands are enough to skew the meaning of this word.

'They' -- A sometimes mysterious, all powerful, virtually always destructive person or group trying to control a client's life. Client may or may not know who 'they' is. Sometimes you wonder how they decide that you aren't part of 'them.'

'We' -- "We're going to need to call their landlord," my supervisor Feona-speak for "You're--"

'Never' - Sometimes*

'Tissue' -- Apparently may also mean toilet paper.

* To be fair it's not only clients who do this.

Sunday, February 21, 2010

Jumping the Gun on Ticket to Work

Something case managers would appreciate: The paradox of a client's friend asking about Ticket to Work when she's only in the beginning stages of applying for disability (SSI or SSDI).

Since if you're applying for disability it means that you need to prove that you're unable to work for a year or more, meaning. . . You aren't physically or mentally able to work. Not to mention the years it often takes to be approved for disability.

Wednesday, February 17, 2010

Sham: Book Review

Steve Salerno takes a stand against the genre of Self Help and Self Actualization Movement, which he says appropriately stands for 'Sham.' Sham includes chapters critiquing self help gurus (like Anthony Robinson), life coaches, motivational speakers who use sportspeak, alternative medicine, to exploring self-help's alleged harmful influences in society.

Sham starts strong. Salerno's points out lack of scientific study as to efficacy of self help approaches, lack of credentials on the part of many self help writers and life coaches. He points out the limitation of enhancing workers' employees' work quality by using sports imagery as it doesn't necessarily translate smoothly into business environment.

However, it's later in the book that I found I disagreed with several of Salerno's claims, particularly when he discuses supposed real life applications of self help. For example, Salerno includes a statistic that 25% of US children live in broken homes. He goes on to say that Americans are finding these households are not positive for kids, as statistics show crime, drug abuse, and teen pregnancy "leave scant room for dissent." (page 162) What? How was this connection made? And how does self help play a role in encouraging divorce or discouraging people from marrying one another?

Salerno also takes a shot at the US educational system, arguing that it discourages males from being males. Discussing the "feminization of America," Salerno writes that it's since the "advent of 'sensitivity', 'self esteem' and 'getting in touch with your feelings' -- that America has seen so many boys and young men acting out in horrific ways." While Salerno continues to ask whether it's "fair to draw a straight line of psychological causation that connects the two?" and answers "no" he adds that "the coincidence is hard to ignore." (pg 240) I fail to see how these two have a causal connection nor was I able to find any evidence shared by Salerno that they are.

Do I have a problem with kids being brought up with radical notions like cooperation or compromise? No. Do I think that teaching young boys that it's OK to show feelings other than anger is a hindrance to developing healthy mental minds? Absolutely not. Nor do I think boys throughout the US are no longer playing cops and robbers or violent video games like Salerno seems to assert.
It's too bad because parts of Sham opened my eyes with insightful observations. Salerno's assessment of self help as focusing on victimization (people are essentially powerless, others are to blame for one's problems) vs. empowerment (people may achieve whatever they want) was interesting. However, Salerno's claims later in the book, particularly in regards to so-called real life applications of self help in relation to sociology detract immensely from Sham's strength and credibility.

Monday, February 15, 2010

Reading Clients' Old Files

Of the tens of clients who have been with my agency for years, a number have been clients for over 10 years. Staff and other clients have become a community and family for them. It's quite a walk to look back at their files, their past work with past case managers. While sometimes clients talk to me about their old case managers ("Why are you doing it like that? Cara used to do it this way,"), reading files gives the case manager's log [Wonder what it would be like to read case notes written by clients].

I had to look over some clients' old files today that took me back as far as 1999. Looking at one client process of going through custody battle (having known where matters stand years after). Reading another client's file and the years she was working on similar issues with her case manager that her and I now work on. A third had half a file dedicated to medical health records and had disappeared for 5 years to reappear this past month. 
I also look at the dates and think about where I was. Thinking about how I was in high school for some of these years while clients and past case managers were working together. And sure I think about how what I've done has led me here.

Saturday, February 13, 2010

Straight Dope Looks at Myers-Briggs Test

I enjoy reading the Straight Dope, a column that aims to answer diverse factual questions, ranging from "Why do songs get stuck in my head" to "Has widespread CPR training resulted in more lives saved?". The column is purported to be written by the mysterious Cecil Adams, with occasional expert guests weighing in their opinions. Answers are typically supported by studies or evidence (sources cited).

I found the following question interesting:
Does the Myers-Briggs personality assessment really tell you anything?

Friday, February 12, 2010

Interesting point

"Why should I go to the hospital? All the germs are there."

-- A client expresses possible disadvantages of getting care in a public facility.

Tuesday, February 9, 2010

You do Noble Work

Every job has it's jabs. By jabs, I mean the predictable reactions other people say once you tell them what you do. As a psychologist you hear, "I better be careful so you don't read my thoughts!" That's actually an easier reaction to deal with than a person who responds with, "So let me tell you what I'm dealing with and tell me what you think."
Upon sharing what he does, a case manager (or social worker) sees a glimmer in the listener's eye and a look of admiration as she says "You do noble work."

Admittedly, I'm not innocent of occasionally making annoying comments to others when they reveal their profession. Putting that aside -- I see what I do as a job. I don't think of it as noble. It's what I do. Maybe I'm reacting to what I sense is a pretentious attitude, even if it's meant genuinely. I care deeply about my work. I'm grateful for working in this field and enjoy the challenge of working with others with goals of helping them through crises or problems. I like that I can be a person on their journey. It becomes a part of who I am, like I suspect delivery people, doctors, or accounts feel.

Monday, February 8, 2010

Case Management Humor (2)

A client of mine moved outside our catchment area around a year ago. I continued to work with him on occasion because in some cases we do even if clients move away. This may be because they don't have a close network of support, because they have a disability, and so on.

Today I found out that he has a case manager in his building. Yet he keeps calling me.

Watch as I wave my magic wand tens of miles away.

Moves wand

Nothing happens

Tries to move wand again


Saturday, February 6, 2010

Helping a Person Outside Agency's Catchment Area

Though we serve a good portion of the city we don't serve the entire city. We sometimes get calls from outside our coverage area -- even from neighboring towns. Typically these folks have heard of us through family or friends. What to do in a case like this but offer an alternative agency or program that may help.

In certain cases it can be tough to tell people we can't help them with case management services, particularly when they seem to be in great need of help (experiencing homelessness or have children for example). They've already made the effort to reach out for help and they aren't able to find it at your agency -- though of course, we're hardly the only social service agency around.

As the caller phoning the agency blindly you may get lucky. Someone may answer your call who has 10 minutes to talk to you and give you advice about applying for help elsewhere. Talk your issue out. Other times no one may be at the office or a worker doesn't know or doesn't have time available to talk. Still, it may help to try and call the social service agency and ask to speak with a case manager or social worker for advice or referral. Not to mention talking to friends, families, and acquaintances for advice on agencies -- which is a good deal of how reputations of agencies spread through the community.

Tuesday, February 2, 2010

What I Learned from Judge Judy

It's a guilty pleasure but I do love this show. I know of at least half a dozen judge TV shows but I have my two favorites: Judy and Mathis.

Additionally to entertainment and educational purposes, I gently incorporated a couple of their methods into my interactions with clients. It has happened a couples of times that I answer the phone and a client immediately embarks on an intricate story about an encounter. Well into their story I learn the event has taken place a few years back and my client happened to think about it when he called me.

OK so at times clients want to vent and they have few people they can talk to. But sometimes you're not available to listen at a particular moment or even in high frequency (i.e. daily). You need to get details quickly. Or a client is upset and it's hard to follow his story. Cue Judge Judy -- when, who, where, what? With a focus on 'when' for context and chronological purposes. 'Who' is a close second especially when the pronouns stream starts ("she said that I told her what he asked him about"). 

And to readers who ask, wait, but all judges use similar methods of asking the 'w' questions I answer: Perhaps, but I don't watch them.