I'm now approaching the midway point of my placement. And i'm enjoying it more than ever. I'm particularly enjoying the work I do with one of my clients who was recently released from prison. After i set up our first keywork session to create some realistic goals we can work on together, i now regularly receive notes under the office door or thrust in my hand with more goals to work on! Whether or not they are achieved, it feels like a good mindset to be in and i feel like i've developed a really positive relationship with him.
And i found out yesterday that I'll be getting a third client next week, which is exciting as students normally only get 1 or 2. This might sound very small compared to the caseloads you get in stat settings but it's very different being a keyworker in a residential setting as the face to face support is much greater.
One of the things i'm loving is the randomness, the charmingness (i know it's not a real word!) of working with people everyday. The unpredictability of it. While some days may be stressful or emotional and full of incidents or clients shouting, many days are spent laughing with the clients. Or sharing lovely days out, like our recent picnic and ice cream in the park which the clients have been talking about ever since.
My uni work has been driving me pretty mad as the uni have totally mucked up all our portfolio requirements. They have realised now, at the midway point, that most of the students on the course were working to the criteria set out by our course leader, that was in fact wrong. So all the students and their supervisors have become somewhat panicked, realising the evidence that has been 'ok-ed' at the midway point, may in fact not be OK. Joy!
Next week I start to have some days off for exam revision. I admit i'm pretty tired now, trying to sustain uni work, placement work etc so I'll be glad when exams are over and I can have a weekend away for a proper break.
Last weekend, I had a fantastic time at the Guardian Open Weekend. I went to four back to back sessions.
One was a panel debate about the nature of communities, including Camila Batmanghelidjh, the founder of Kids Company, and somewhat a hero of mine! She spoke about the fact that the issue of revenge has still not been addressed, young people don't feel they have been heard, for example young people feel they are being used to sell the Olympics and then won't benefit from it. She also discussed how we need somewhere for young, unemployed people to go and do something even if there is no labour. They shouldn't be stuck in their own living space, they need to be encouraged to create a community. She explained that people assume that behind every child is a competent carer but that is not true for 1.5m children in UK who become marginalised with their needs unmet. These sometimes, vulnerable individuals may not have the baseline competences to seeks out social cohesion. You need economic resources and social confidence to seek this out.
Sue Marsh was one of the panellists in a talk about the shape of the welfare state, discussing issues such as the fact that the child in poverty is more likely to have a parent in work than unemployed, alcoholic etc. Parents are not able to make a living wage. She also said that we have the lowest level of benefits in the developed world with 94% of those on JSA getting jobs in the first 6 weeks.
The talk on what the new age of protests was achieving was also interesting - discussing whether they are successful given that often they do not serve to veto law, ie tuition fees, NHS bill etc or is it an acheivement anyway, to get those who are voiceless onto the front page? or to raise the consciousness of a generation. It was also mentioned that while once you could not imagine the end of capitalism, now radical systemic change is more on the agenda.
It was amazing to have so many under 18s in the room asking questions and expressing their desire to be able to vote. It was such a fantastic, buzzing atmosphere and I loved the opportunity to listen to such a range of speakers and be surrounded by people who give a bit of a sh*t about the world we live in. I really wish there were more events like this, even if not on this scale, but with opportunities to hear experts speak and debate on their subject.
Saturday, 31 March 2012
Tuesday, 6 March 2012
Sharing feelings
Before and after every group we run, we have a pre and post group.
The pre group at the start of the day, i particularly enjoy. We go round the room and everyone just discusses how they feel. It could be anything from - "tired, i didn't sleep well" to "anxious about the day because i found yesterday particularly hard..." etc
I think there's something incredibly refreshing about this group. For one thing, it helps just to relieve you of any negative feelings you might have about the day ahead. For another, it allows you to feel some empathy towards your colleagues and judge the way you behave with them accordingly - i.e if you know they're having a bad time in their personal life, or even that they didn't sleep well last night, you might be a bit more patient with them or give them a little extra support. If you know they're feeling demoralising, you can try to inspire them etc.
Anyway....just a little thing i like and think could be transferred in some way across different settings.
The pre group at the start of the day, i particularly enjoy. We go round the room and everyone just discusses how they feel. It could be anything from - "tired, i didn't sleep well" to "anxious about the day because i found yesterday particularly hard..." etc
I think there's something incredibly refreshing about this group. For one thing, it helps just to relieve you of any negative feelings you might have about the day ahead. For another, it allows you to feel some empathy towards your colleagues and judge the way you behave with them accordingly - i.e if you know they're having a bad time in their personal life, or even that they didn't sleep well last night, you might be a bit more patient with them or give them a little extra support. If you know they're feeling demoralising, you can try to inspire them etc.
Anyway....just a little thing i like and think could be transferred in some way across different settings.
Sunday, 4 March 2012
Control issues
Historically the issue of control has always been a big one for social workers and some of the dichotomies involved in partnership working vs control.
One thing that I have found a struggle is my own lack of control in this role. In my past career I felt pretty much in control of everything I did, I had my to do list and I got on with it, in I would say quite an efficient way.
But working with people is different, (it's not rocket science I know!) People won't attend that meeting just because it's on your to do list or answer the phone because you want them to or get up in the morning because you believe it's best. And sometimes however hard you think you're working or however much effort you believe you're putting in, you won't see the progress you were hoping for. In fact they may go backwards sometimes. Basically you can't control what's going to happen, you can only do what you think is best with each intervention and each decision but the control and the responsibility lies with them not you.
People are unpredictable. And that what makes working with them so bloody interesting
One thing that I have found a struggle is my own lack of control in this role. In my past career I felt pretty much in control of everything I did, I had my to do list and I got on with it, in I would say quite an efficient way.
But working with people is different, (it's not rocket science I know!) People won't attend that meeting just because it's on your to do list or answer the phone because you want them to or get up in the morning because you believe it's best. And sometimes however hard you think you're working or however much effort you believe you're putting in, you won't see the progress you were hoping for. In fact they may go backwards sometimes. Basically you can't control what's going to happen, you can only do what you think is best with each intervention and each decision but the control and the responsibility lies with them not you.
People are unpredictable. And that what makes working with them so bloody interesting
Tuesday, 28 February 2012
Ups and downs of therapeutic setting...
My placement is very big on reflective practice (which I realise would be less the case if I was in a social work setting but I’m actually in a therapeutic setting.) There’s lots of positives about this, obviously.
But at times it can be quite difficult. For example, I came to supervision today with a few concerns that I wanted to raise about my placement at the moment. I’ve felt a bit demotivated recently. Partly this is because I have one client who is barely ever in the project and has currently left (can’t disclose more details) and we’re not yet sure will return. My placement should now be picking up pace and I should be getting my second client soon, but I have only had one actual keywork session with my first client and what I feel is fairly little client interaction of late. Although I see clients around the project to have little chats with, I haven’t had a much of a supporting role to any.
My supervisor turned it all back on me and asked me to think about the issues it brings up for me – am I too driven by getting things done, and isn’t the fact my client isn’t around, giving me things to think about and write about too. I meed to think more about my own issues and how I’m dealing with my feelings.
I’ve thought about this quite a lot. At the time I felt quite angry – I felt that my supervisor was absolving himself of any responsibility towards my placement (not just for the above issue but for others brought up too) – but then I thought, there is definitely some truth in the things he is saying. I can be very goal driven, wanting to be busy, efficient etc and perhaps don’t quite know what to do, when there isn’t anything to do.
On the other hand, as this is my placement, I would like to feel constantly challenged and as if I am developing and I feel that the placement can be incredibly slow, with days going by where I really don’t feel I have done anything at all. Today for example I took part in cleaning group with two clients, spent a few hours doing “room checks” – ie measuring the temperature of the water in each bedroom and checking the room for safety reasons. Did some uni work and then had supervision. When a lot of days are like this, I don’t feel I’m achieving too much.
But it is interesting. Partly because I think its teaches me a lot about me. Definitely one of the biggest things I have been struggling with is learning how to give up control – something so important when you’re working with people, as opposed to standard targets – learning the limit of your role and how to leave responsibility with the client.
On the other side, I do wonder how this would differ in a social work setting. As I’m in a therapeutic setting, there’s no abundance of case loads. We have 7 clients in the project at the moment – everyone keyworks with one or two- or is therapist to one or two, and it’s not about working through a time scale, it’s an ongoing process, of possibly years – so in many ways it feels a lot more relaxed, less pressure to get things done…which is counter to all the managerialism and target driven culture complaints that social workers often receive.
Anyway…that’s my rambling.
But at times it can be quite difficult. For example, I came to supervision today with a few concerns that I wanted to raise about my placement at the moment. I’ve felt a bit demotivated recently. Partly this is because I have one client who is barely ever in the project and has currently left (can’t disclose more details) and we’re not yet sure will return. My placement should now be picking up pace and I should be getting my second client soon, but I have only had one actual keywork session with my first client and what I feel is fairly little client interaction of late. Although I see clients around the project to have little chats with, I haven’t had a much of a supporting role to any.
My supervisor turned it all back on me and asked me to think about the issues it brings up for me – am I too driven by getting things done, and isn’t the fact my client isn’t around, giving me things to think about and write about too. I meed to think more about my own issues and how I’m dealing with my feelings.
I’ve thought about this quite a lot. At the time I felt quite angry – I felt that my supervisor was absolving himself of any responsibility towards my placement (not just for the above issue but for others brought up too) – but then I thought, there is definitely some truth in the things he is saying. I can be very goal driven, wanting to be busy, efficient etc and perhaps don’t quite know what to do, when there isn’t anything to do.
On the other hand, as this is my placement, I would like to feel constantly challenged and as if I am developing and I feel that the placement can be incredibly slow, with days going by where I really don’t feel I have done anything at all. Today for example I took part in cleaning group with two clients, spent a few hours doing “room checks” – ie measuring the temperature of the water in each bedroom and checking the room for safety reasons. Did some uni work and then had supervision. When a lot of days are like this, I don’t feel I’m achieving too much.
But it is interesting. Partly because I think its teaches me a lot about me. Definitely one of the biggest things I have been struggling with is learning how to give up control – something so important when you’re working with people, as opposed to standard targets – learning the limit of your role and how to leave responsibility with the client.
On the other side, I do wonder how this would differ in a social work setting. As I’m in a therapeutic setting, there’s no abundance of case loads. We have 7 clients in the project at the moment – everyone keyworks with one or two- or is therapist to one or two, and it’s not about working through a time scale, it’s an ongoing process, of possibly years – so in many ways it feels a lot more relaxed, less pressure to get things done…which is counter to all the managerialism and target driven culture complaints that social workers often receive.
Anyway…that’s my rambling.
Friday, 3 February 2012
Questions on residential homes within mental health settings
While lying in bed, having left placement early today as not feeling well, and feeling sorry for myself, I thought it was time for a short blog post.
I’m not going to write another diary type one, this is a more pondering post…
I had a short chat this week with a senior staff member at my placement about whether we thought social workers should recommend clients to this place.
The setting for my placement is a residential home with groups including therapy group, art and music, gardening etc.
We discussed whether, although it was beneficial to a few people to be there, could it do more harm than good for others?
Whilst I very much like the recovery model, I do question how many of the clients in the house are likely to recover, and obviously recovery is in itself a relative term, but I mean recover to feel confident living in independent accommodation at the least.
While there is obviously a question as to whether this place or places like it can help as much as we’d like towards that goal, there also remains the question as to where these people might be if these places didn’t exist.
Perhaps the answer is the old style institutions. So in that respect, surely these residential communities are a positive step on.
The difficulty with places like this, in typical systems theory – is that everyone in the place has a big effect on others, every incident can be hugely impactful and can serve to slow down or halt other people’s recovery.
Equally, as people choose whether to engage with groups etc, if they choose not to engage with them, or even their therapy, or at worst not to comply with medication, often little progress is seen.
Whilst I understand the trend has been towards community mental health, it’s clear for some that’s not an option – so is there a better alternative than these places? And is it wrong to categorise them as “these places” – do they differ wildly? I assume if there were some renowned for amazing recovery rates it would be known, but maybe I’m wrong. Equally, just because one recovers doesn’t mean one doesn’t relapse shortly after – so it’s difficult to measure success.
Finally but importantly, there’s the question as to what the clients themselves want. There is one client who has been there 5 years, rather than the 1-2 years they predict – and is seen to have been barely progressing of late (although i understand since they joined has progressed a huge amount). But perhaps this person doesn’t want to move on, is comfortable where they are. If the aspiration is not towards independent living then the motivation to engage is low – what’s ideal then??
Anyway, what a disorganised ramble! Apologies!
I’m not going to write another diary type one, this is a more pondering post…
I had a short chat this week with a senior staff member at my placement about whether we thought social workers should recommend clients to this place.
The setting for my placement is a residential home with groups including therapy group, art and music, gardening etc.
We discussed whether, although it was beneficial to a few people to be there, could it do more harm than good for others?
Whilst I very much like the recovery model, I do question how many of the clients in the house are likely to recover, and obviously recovery is in itself a relative term, but I mean recover to feel confident living in independent accommodation at the least.
While there is obviously a question as to whether this place or places like it can help as much as we’d like towards that goal, there also remains the question as to where these people might be if these places didn’t exist.
Perhaps the answer is the old style institutions. So in that respect, surely these residential communities are a positive step on.
The difficulty with places like this, in typical systems theory – is that everyone in the place has a big effect on others, every incident can be hugely impactful and can serve to slow down or halt other people’s recovery.
Equally, as people choose whether to engage with groups etc, if they choose not to engage with them, or even their therapy, or at worst not to comply with medication, often little progress is seen.
Whilst I understand the trend has been towards community mental health, it’s clear for some that’s not an option – so is there a better alternative than these places? And is it wrong to categorise them as “these places” – do they differ wildly? I assume if there were some renowned for amazing recovery rates it would be known, but maybe I’m wrong. Equally, just because one recovers doesn’t mean one doesn’t relapse shortly after – so it’s difficult to measure success.
Finally but importantly, there’s the question as to what the clients themselves want. There is one client who has been there 5 years, rather than the 1-2 years they predict – and is seen to have been barely progressing of late (although i understand since they joined has progressed a huge amount). But perhaps this person doesn’t want to move on, is comfortable where they are. If the aspiration is not towards independent living then the motivation to engage is low – what’s ideal then??
Anyway, what a disorganised ramble! Apologies!
Friday, 20 January 2012
A quiet week in placement
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.
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, 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.
Subscribe to:
Posts (Atom)