Home > Life > What can happen in a year.

What can happen in a year.

Yesterday marked my one year anniversary at my job. Last fall, I was hired as clinical case manager for a permanent supportive housing facility for formerly homeless adults with co-occurring mental health disorders. The residents I work with cope with an array of challenging mental health conditions, such as substance abuse, Bipolar Disorder, Schizophrenia, Major Depressive Disorder, and Post-Traumatic Stress Disorder. While living in supportive housing, residents can stay as long as they need to regain stability in their lives and work towards personal goals for independence. My agency houses 66 residents and I work with 33 of them. At times, 33 clients seems manageable. Not everyone is in crisis all the time, and many of my clients are secure in forging their own path in life–enrolling in educational programs, working full-time and part-time jobs, or enjoying time as a grandparent. However, since many of our residents are coping with poverty, life-threatening illnesses, relapse, loss, and past and present trauma, sometimes 33 clients seems overwhelming and I find myself questioning how well I can do my job. I love our residents. They show me insight, reflection, empathy, intelligence, creativity, and humor. Even those that struggle hold tremendous potential.

In the past week, I’ve been smashed with a handful of relapses, evictions, and loss. In the case of some of these clients, I know I already did everything I could. I was available. I extended resources. I was there. I know that. For a couple of these individuals, though, I feel cheated. I remember when I first met them. They were hostile and condescending. They yelled. I was defensive and avoidant. The night before I was to meet with them, I’d pray they wouldn’t show up. But I am stubborn and hate feeling lazy or scared. So I stepped it up. No more me versus them. We would be a team. So we talked. We decided to be honest. We decided to disagree respectfully. We set our boundaries. We made compromises.  After several months, these few individuals who used to glare at me in the hall or straight up ignore me would wave hello to me from two blocks away. They started peeking their heads in my office to say hi. After receiving an achievement certificate, I went to shake one man’s hand, but he went in for a hug instead. I was floored. I still can’t believe it.

I recognize that these people elected to change. They put in a lot of painful work on their own. Some did extra work with family, support groups, and intensive therapy. I will never take credit for their evolution. As I think about these clients, I am thinking about how they made me change. By engaging me in conflict, they made me face my own insecurity and fear. In other cases, I have clients who used to be unresponsive, self-conscious, and silent in my office. Now we can smile and joke when we talk. These individuals taught me to be patient and comfortable with silence. I didn’t know these changes were possible when I started this job. I didn’t know how much agency a person can have over their own life until I saw these immeasurable steps forward. And for me, I didn’t know that I could put my pride, defensiveness, and need for control aside so I could give other people the space they needed.

Over the next few weeks and months, I have to say goodbye to some clients. Not all of them are leaving on their own terms. Some of them, I might not even get the chance to say goodbye. My supervisor told me to remember that all the good these people embody will go with them after they leave. It’s hard to convince myself that everything will be OK for them in the end, but hope is important. Without hope, there’s no future. And I want to be at my job for another year.

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  1. October 2, 2013 at 10:53

    I really enjoyed reading this. It takes a special person to do the work that you do. I’ve toyed with getting my MSW off and on, but I just can’t convince myself that this is the right path for me at this stage in my life. I recently turned down a job in a mental health agency because I couldn’t get adequate after-school care for my own kids, and I felt that the overall stress of the job along with the shifts that I’d be working were just more than I could handle at this point. If a different position comes up I’ll probably take it. My undergrad is in Psychology & Women’s/Gender Studies, and though I’ve worked in a variety of fields, I have a lot of passion for social work. I just don’t want to spend money on school only to discover that I can’t balance my personal life and my career. What I mean by that is that being a parent takes a lot out of me emotionally, and I’m afraid I’d end up half-assing both of my jobs. A good friend of mine worked in mental health but then changed paths altogether after having a family. She said that her biggest struggle post-children was empathizing with her own kids and their “petty, middle-class problems.” I can see myself having that same problem. Sorry — just thinking out loud. It is nice to read a piece like this — you don’t sugar-coat the reality, but I can see that you truly love your work and believe in the people you work with. You are right that having hope is important, and I believe you embody that — even if you don’t always feel like you do. Keep up the good work. The world needs more people like you.

    • October 6, 2013 at 18:16

      Thank you so much. And believe me, I find my job very difficult and I think “balance” is imaginary. I’m working on it though. I also know that realistically, I don’t have the emotional capacity to do direct practice with such a challenging population forever. In a few years, I plan on changing the course of my work towards teaching and research so I can still contribute to the field without burning out.

      There are so many other ways that you can contribute besides direct practice. Actually, you could still get your MSW and then focus on administrative or policy work. OR just find whatever makes you feel good about yourself and your place in the world.

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