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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by wishingstar on May 27, 2007, at 0:29:58
As many of you know, I work as a counselor for kids/adolescents in an intensive in-home program (meaning very serious dysfunction). I have a work cell phone that I carry all the time because I'm on call to my kids 24 hours a day, 7 days a week. Well, it rang for the first time tonight. It was a teen girl I've been working with for about three months (we only hold cases for 6 months then they go to outpatient). Cant really share any more details than that, but she was very upset and lots of little (and not so little) stuff building up this weekend.
My own adreneline and anxiety is through the roof right now. I want to say how I handled it and you all tell me what you think. I'm really flying by the seat of my pants with this job.. everything I do is a complete guess, not based on any education or training.
I asked her what was going on. I used my most concerned voice. I stated a few times that she sounds overwhelmed by a few things happening and not very supported at home with it. She didnt really talk much about any of the things.. the questions I asked were mostly just clarifying questions, because what else could I say? Not sure. Asked her how she plans to handle tomorrow. Tried to get her to make a plan of what she'll do to keep busy but she wasnt really able to and I didnt really know what to suggest other than what she'd normally do anyway. Said shed rather not be alone and I asked about getting a friend to stay with her. She said "that'd work if I had real friends." Okay, she got me there. Knowing her friends, they wouldnt do it. I didnt say much to that and kind of let it go. I should have had another suggestion, but what? She apologized for calling and I reassured her several times that I'm glad she called and it's fine. Asked if she could promise she'd be safe and she agreed to call if she wasnt able to. Wasnt supposed to see her until Wed but decided to have lunch with her on Mon. (We spend a lot of time in the community since I see kids usually about 4 hours/wk). The agency is closed that day but doesnt matter.. no reason I cant do it anyway. She seemed genuinely glad I offered. I hope that was the right thing.
I guess I just feel like I should have had something more to say. I told her I wished I had magic answers. I know I cant fix it, but I just felt pretty clueless because all her points were correct (for ex, she said no she cant ask her parents for help because they wont do it. yep, shes right. huh.) Although she is getting a little better, I worry.. heck, I'm fairly sure.. its just because I'm around and she has someone listening.. not because shes learning better ways to cope or anything that will last after I disappear. I only have three more months with her then what? I have to teach her to cope by herself, but heck.. I dont even know how to cope with my own stuff!
I guess I'm just asking for reassurance. Or advice on what would be more helpful if it were you (but please be gentle, I'm feeling really shakey about all this). I hope this post doesnt make anyone feel weird, since its sort of "from the other side of the couch". I dont think most counselors are quite as crazy as I am. If I shouldnt have posted this, well..I cant delete it..but I do really apologize.
Posted by DAisym on May 27, 2007, at 1:02:24
In reply to whoaaa anxiety (work related.. long), posted by wishingstar on May 27, 2007, at 0:29:58
Knowing that you were willing to listen was probably really important to her. Most teens need someone to help them put things in perspective and wade through the chaos they often create for themselves. I don't know this young person so as a general comment I'd guess I would just say be aware of triangulation with her parents or even her friends. Teens have a way of making everything a momentary drama and then moving on to the next crisis. And then they go back to things and wonder why they aren't solved or why things haven't changed!
I hope your agency offers trainings or at least readings, to help you feel more secure in your work. It sounds like you are providing some very important support.
Good Luck.
Posted by frida on May 27, 2007, at 1:14:10
In reply to whoaaa anxiety (work related.. long), posted by wishingstar on May 27, 2007, at 0:29:58
Dear wishingstar..
I think you did well :-)
I guess all I can say is what I would look for or what would help me if i made a phonecall or reached out...
Hearing someone concerned, feeling cared for...just that alone would be really important.
Having my feelings validated would help too...I think it's good that you offered to see her on Mon instead on Wednesday..this will make it easier to hang on.
I know it's different, but when I call my T in a crisis, what helps me is to feel she cares about me, it matters to her if I'm safe or not, she listens to me...sometimes it helps to let it out and know she is thinking with me some way for me to stay safe...
another thing that helps me is if she gives me something to hang on until i see her (if i'm finding it hard to stay safe). It helps me if she tells me to make a drawing, or write, for example, of what i'm feeling and that we'll talk about it...
just to know that she'll listen...
It helps to hear her say I feel how much you are hurting, let's think about this together....
when i reach out, i don't expect her to have magic answers. It truly helps to feel the connection...I think you did the right thing, you gave her something to hold on to...knowing she'll see you on Monday...and i think it's a good thing she called...it shows that you've inspired trust in her...
wishing you the best,
Frida
Posted by gazo on May 27, 2007, at 8:32:38
In reply to whoaaa anxiety (work related.. long), posted by wishingstar on May 27, 2007, at 0:29:58
i think you did just fine. Teens just need contact emotionally. She called because wanted someone to care and you do. Having lunch with her Monday cements that. i used to watch sappy tv shows and listen to song lyrics to try and figure out problems (no sh*t) and i had no one i could connect with. You'll be surprised how resourceful many kids can be when they feel someone gives a crap. You are a catalyst for them.
things to try (and i am just throwing ideas here):
get her to write about events and how they make her feel
do these kids have access to community support groups or programs?
maybe there is something she could volunteer at that would help others - that is a great way to learn about coping, an animal shelter or kids hospital?
something to build self confidence... like an art class, or something sport related?i don't know... i think you did exactly right thing in the moment. The rest is just random sh*t i am throwing out there..
you do better than you think... maybe you need to internalize that and pass it on?
Posted by Phillipa on May 27, 2007, at 11:32:25
In reply to Re: whoaaa anxiety (work related.. long) » wishingstar, posted by gazo on May 27, 2007, at 8:32:38
Sounds like you did the right thing you listened and made yourself available to her. That is more than most therapists would do. Good job I say. Love Phillipa
Posted by peddidle on May 28, 2007, at 0:11:09
In reply to whoaaa anxiety (work related.. long), posted by wishingstar on May 27, 2007, at 0:29:58
I don't really have any better suggestions than what the others have already said. But I just wanted to add that I think the fact that you are concerned enough to ask if you did/are doing the right things proves that you care.
Maybe next time she asks you something, or comments about a specific problem she's having, be honest and say that you don't know the best answer off the top of your head, but that you'll think about it before you see her again. One time after a session, I sent my T a vague email telling her I hadn't been completely honest about something, and that I knew I had to tell her the truth. So I asked her to try and ask me the same questions again the next time. She wrote back saying that she was really glad I sent the email, and that she would think about it before our next session. Just knowing that she would think about it (and think about me) during that time was a huge relief.
Obviously I don't know about this girl's particular issues, but maybe she called because she really wanted someone to talk to in that moment who would actually listen to what she had to say. It sounds like you were able to give her what she needed.
Posted by wishingstar on May 28, 2007, at 17:24:12
In reply to Re: whoaaa anxiety (work related.. long), posted by peddidle on May 28, 2007, at 0:11:09
Thanks everyone for the comments and suggestions.
Saw her today. The session went well. However, due to some crazy family things that happened today I had to call CPS when I got home. After CPS responded, she called me (twice), yelled at me, and hung up. Nice.
I know I did the right thing. However, I do NOT deal well with anger. The emotional part of me isnt coping well with what I just "did to her".. she trusted me so much and I just blew it to h*ll. I didnt mean to.. but I HAD to. I see her Wed after school and I'm already afraid. I can predict how Wed will go for me... I'll feel incredibly suicidal and think of all sorts of ways to get out of having to face this, including killing myself. It's going to be very hard. But I'll try to keep the logical part in check and remind myself that I did do the right thing (the other clinician told me to, and the supervisor agreed) and I really had no choice legally. This is one of those irrational emotional reactions for me that I KNOW is irrational but I'm pretty powerless to stop it.
Oh boy. What a day..........
Luckily I didnt cancel and still have my appt with Ginny for tomorrow. Shes not helpful with "real" stuff anymore but this is somethnig I think I can talk to her about and hopefully get some benefit out of.
And to think, I originally wanted to work in child protection!
Posted by wishingstar on May 28, 2007, at 17:36:41
In reply to thanks.. update, posted by wishingstar on May 28, 2007, at 17:24:12
took a xanax. first time ive ever taken one... this should be interesting. they were perscribed to get me through the intense suicidal despair moments but i guess this is as good a time as any to take one. hope it works.
Posted by muffled on May 28, 2007, at 17:42:33
In reply to thanks.. update, posted by wishingstar on May 28, 2007, at 17:24:12
(((Wishy)))
Sigh, not easy. But I still say you did the right thing. you truly had no choice. Just plain sucks. Give yourself a break, and some credit, for doing the hard, but responsible thing. You are functioning as a responsible adult and thats a hard,but good thing.
IMHO I think you need to be clear to the kid and honest with the kid about how you felt. That the session was OK but with the other stuff there was no other choice for you etc. Maybe you could present it to her as she being reasonable and intelligent to understand? I nhave found in my dealings even with people that are more marginal, that if you are straight with them, and honest, and treat them with the utmost respect and unconditional acceptance, that they tend to calm down and eventually respond with mutual respect.
Just don't make it like you trying to make excuses or explain away yourself. Be strong in your conviction that you did what was needed to be done.
It can be reassuring to have someone calm and sure of themselves. It can be good in a way that someone cares enough to respect you. Its HUGE.
I been in some rough positions myself, and when there, those who treated me with kindenss and esp respect was SO HUGE important to me.
I ramble, but anyhow, wishy, I think you doing good.
Take care,
Muffled
Posted by TherapyGirl on May 28, 2007, at 20:25:29
In reply to thanks.. update, posted by wishingstar on May 28, 2007, at 17:24:12
You absolutely did the right thing, WS. And I bet there are more than a few of us here in Babbleland who wish someone had done the same for us. That doesn't mean we wouldn't have been furious in the moment (the devil you know is better than the one you don't), but I don't believe it would have taken me long to be grateful that I had someone who was watching out for me and keeping me safe.
Believe that, okay?????
Posted by wishingstar on May 28, 2007, at 21:06:30
In reply to Re: thanks.. update » wishingstar, posted by muffled on May 28, 2007, at 17:42:33
Thank you both. Even though the other clinician and our supervisor both said it was the right thing to do, it helps more to hear it from you all. Professionally, I knew it was right... but personally, it feels so bad. Therapygirl, your sentence about "lots of us wishing someone had done the same for us" and "the devil we know is better than the one we dont" really makes sense to me. It's so true. CPS was involved with my family as a teenager and I was SO angry at first, but looking back... well, it wasnt very useful, but it didnt hurt either. It was just scary at the time. But professionally, I had no choice. Even aside from the issues of her well-being, I would be professionally liable and in deep doo-doo if this ended up in court another way (and it easily may have, given the circumstances) and I'd never reported.
I hope this girl decides to trust me again, even if we have to take baby steps with it. She really needs someone to rely on, and I was that person... I hope this isnt one of those unfixable moments for her.
The xanax has been nice for me tonight.
Posted by Happyflower on May 28, 2007, at 22:01:28
In reply to Re: thanks.. update, posted by wishingstar on May 28, 2007, at 21:06:30
Hi Wishingstar,
You did do the right thing for the kid. She may be mad as hell because it will stir things up for her. But eventually she will know it was for the best. I wish I had someone I could even trust enough to tell what was going on in my house at that age. I wish I had someone like you to help me back than, who did the right thing, not just because it was the law, but because you really do care. Just think something really aweful could have happened if she wasn't able to reach out to you. You are an angel, you truely are.
Posted by DAisym on May 28, 2007, at 22:49:09
In reply to thanks.. update, posted by wishingstar on May 28, 2007, at 17:24:12
Calling CPS is a very hard thing to do. We have an agency policy that we tell clients before we do it that we are going to and why, unless they are a flight risk. I find it helps keep the trust somewhat, because they aren't then surprised by the phone call.
And when we don't tell clients, the report is anonymous. Obviously it wasn't in your case. But try not to feel so bad, let yourself know that you did what you had to and you did it to protect your client. She may stay mad for awhile, but that's OK. Mad is better than hurt.
I know it wasn't easy. I'm glad you have someone to talk to about it.
This is the end of the thread.
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