This week was quite a difficult one.
THe community was so quiet on Monday and Tuesday that i started to be concerned about whether there was enough going on for me to be able to write all the reports needed for my portfolio. All the clients were in bed all day or out for the day, so i spent most of the day waiting around in the office. GRoups were getting cancelled as clients weren't coming and the client who i was told i would start key working with in a few weeks went out all day both days and so i didn't get a chance to even introduce myself. The other two students told me that the community seemed to be in a dip and they had never seen it this quiet. We believe part of it is due to two staff members and one client leaving, but as i have now found out two more staff are to leave shortly, i'm not sure what effect this will have.
Thursday picked up as i attended my first community meeting which 4 clients came to and although the level of engagement was fairly low, it gave me more opportunity to get to know some of them, including the one i would be key working with. I was supposed to shadow someone keyworking with him this week but that wasn't able to happen so i look forward to doing so next week. All clients present their challenges, but the main one here will be making him believe there is a role for us in the community to support and help him, and that perhaps he does need this help. But it's a challenge i really want to engage with.
Although i'm slightly worried and frustrated by the pace, i do think i could learn a huge amount from this placement if there were more clients around in the day. I also really enjoy the reflective environment, where staff meet before and after every group that takes place to discuss how they feel about how it went, issues that occured, behaviours of clients etc I learn a huge amount from this. Equally i enjoy watching the therapists engage with the clients. I feel i can learn quite a bit about style of communication, putting boundaries in place, dealing with more aggressive clients, or those wishing to avoid the topics at hand.
For now, it's fingers crossed that it picks up a bit.
Friday, 20 January 2012
Friday, 13 January 2012
My first week of placement
This week was my first week of placement and a pretty exhausting one, coming straight after a pretty relaxed 3 week Xmas holiday.
I am working in a residential home for adults with mental illness. Most of the clients have had many other placements that have broken down and this one comes after a difficult journey.
I need to set the context for my blog in that I have virtually no experience in mental health and many of the views expressed might come across as incredibly naïve or downright stupid, so apologies for this in advance! I welcome all advice, criticism, suggestions or anything else!
I knew from my trial day that there would be some aspects of the role that i was less sure about and I has concerns as to whether there was enough social work esque roles to do to help me really learn and develop.
After my first week, I have quite a different opinion. Those tasks do still frustrate me and there are some days I don’t particularly enjoy, days where I barely see a client and only do the above tasks but, the amount there is to learn about mental health is truly incredible. Being in an environment like this is so different to going on weekly visits to service users – it really feels like you see people in all different moods/spirits, you observe different interactions between clients and staff and the pace of the place is quite unreal. Although cheesy, I actually feel quite priviledged to meet some of these people and engage in the way we are able to, joining in community lunches, listening to clients open up about the voices they are hearing and the struggles they are coping with.
I particularly enjoyed Thursday when I had my first proper interactions with clients, one particular session involved myself and another student taking a client to the café as part of “leisure group”. Although it was only 1.5hours, it felt incredibly intense and draining but I also really enjoyed the time I spent with the client. I did notice emotions I felt a bit ashamed about too – while X was engaging with members of the public, talking to them on the street or walking into shops, I was anxious and felt relieved when we left. I think there was a part of me that felt I wanted to protect X from how these people might react to them, or whether they might embarrass themselves – and I felt very guilty for these reactions after.
I had a similar experience one night when on the way home from my shift I encountered a client pleading with a member of public for money. It was for us to decide whether to interact as we were officially “off duty” – it brings up interesting questions around our roles and our boundaries.
Similarly, I think the issue of choice and responsibility within mental health is one that is at the forefront of my mind at the moment. You can’t force people to engage with groups, or therapy or take medication, but at what stage are there consequences for certain types of behaviour? Should there be consequences for not taking part in cleaning the house, or playing music too loudly? We have started to have discussions about what this might look like. (I am obviously presenting this in a very simplistic manner, clearly there are reasons why someone is not engaging but equally is there a point when sometimes it can be used as a scapegoat?)
Today a new referral joined and I will be starting keywork with them in 3 weeks which I’m really looking forward to. I have been reading a lot about task-centred practice and person-centred, strengths based approaches – the humanistic approach is one that I really value.
The staff are great and every Friday there is a staff meeting all afternoon including a staff therapy group with an external facilitator. It’s an intense environment but I can totally see the need for it as even in the short time I have been there so many incidents have occurred. It seems like an open and transparent way to vent frustrations is very useful. I think in many ways its quite incredible how some of the staff are able to challenge the manager about decisions they feel uncomfortable with in this kind of setting.
In all I think I’ll learn a great deal from this placement. I already feel like I want to question so many of the practices and think it is an environment that really encourages reflection. I also am looking forward to having the freedom to research things that feel important to me or to the particular clients I’m working with, and opportunities I can take to carry out the most effective keywork, rather than work strictly around a university syllabus.
The first part of this will just be getting an understanding of some of the main diagnoses in the house; bipolar, schizophrenia and schizo-affective disorder.
I am working in a residential home for adults with mental illness. Most of the clients have had many other placements that have broken down and this one comes after a difficult journey.
I need to set the context for my blog in that I have virtually no experience in mental health and many of the views expressed might come across as incredibly naïve or downright stupid, so apologies for this in advance! I welcome all advice, criticism, suggestions or anything else!
I knew from my trial day that there would be some aspects of the role that i was less sure about and I has concerns as to whether there was enough social work esque roles to do to help me really learn and develop.
After my first week, I have quite a different opinion. Those tasks do still frustrate me and there are some days I don’t particularly enjoy, days where I barely see a client and only do the above tasks but, the amount there is to learn about mental health is truly incredible. Being in an environment like this is so different to going on weekly visits to service users – it really feels like you see people in all different moods/spirits, you observe different interactions between clients and staff and the pace of the place is quite unreal. Although cheesy, I actually feel quite priviledged to meet some of these people and engage in the way we are able to, joining in community lunches, listening to clients open up about the voices they are hearing and the struggles they are coping with.
I particularly enjoyed Thursday when I had my first proper interactions with clients, one particular session involved myself and another student taking a client to the café as part of “leisure group”. Although it was only 1.5hours, it felt incredibly intense and draining but I also really enjoyed the time I spent with the client. I did notice emotions I felt a bit ashamed about too – while X was engaging with members of the public, talking to them on the street or walking into shops, I was anxious and felt relieved when we left. I think there was a part of me that felt I wanted to protect X from how these people might react to them, or whether they might embarrass themselves – and I felt very guilty for these reactions after.
I had a similar experience one night when on the way home from my shift I encountered a client pleading with a member of public for money. It was for us to decide whether to interact as we were officially “off duty” – it brings up interesting questions around our roles and our boundaries.
Similarly, I think the issue of choice and responsibility within mental health is one that is at the forefront of my mind at the moment. You can’t force people to engage with groups, or therapy or take medication, but at what stage are there consequences for certain types of behaviour? Should there be consequences for not taking part in cleaning the house, or playing music too loudly? We have started to have discussions about what this might look like. (I am obviously presenting this in a very simplistic manner, clearly there are reasons why someone is not engaging but equally is there a point when sometimes it can be used as a scapegoat?)
Today a new referral joined and I will be starting keywork with them in 3 weeks which I’m really looking forward to. I have been reading a lot about task-centred practice and person-centred, strengths based approaches – the humanistic approach is one that I really value.
The staff are great and every Friday there is a staff meeting all afternoon including a staff therapy group with an external facilitator. It’s an intense environment but I can totally see the need for it as even in the short time I have been there so many incidents have occurred. It seems like an open and transparent way to vent frustrations is very useful. I think in many ways its quite incredible how some of the staff are able to challenge the manager about decisions they feel uncomfortable with in this kind of setting.
In all I think I’ll learn a great deal from this placement. I already feel like I want to question so many of the practices and think it is an environment that really encourages reflection. I also am looking forward to having the freedom to research things that feel important to me or to the particular clients I’m working with, and opportunities I can take to carry out the most effective keywork, rather than work strictly around a university syllabus.
The first part of this will just be getting an understanding of some of the main diagnoses in the house; bipolar, schizophrenia and schizo-affective disorder.
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