Social Workers Run More Numbers Than the Mob

7 02 2011

I talk about my clients all the time. I’m sure you’re dying to know how someone gets so lucky as to work with me. Well I’ll tell you!

The vast majority of our referrals come from ACS (New York’s Administration for Children’s Services, which includes CPS) or from PINS (Person In Need of Supervision) diversion.

Go acronyms!

An ACS referral means that there has been a credible allegation of abuse or neglect, but that the children will not be removed. In order to prevent foster care, which is the last resort, families are referred to us for counseling.

PINS is a warrant parents apply for if their child is “out of control.” Skipping school, engaging in dangerous behavior, all the tomfoolery the kids these days get up to. The warrant makes it so that the child can be sent to a residential treatment facility, or something similar.

Because that’s expensive, and the city is a little short on cash (I think they’re going to start charging sidewalk rental fees for walkers) before the courts will grant these warrants, they send the families in for preventive services. So social workers such as myself can fix everything.

Our services are voluntary. However, the ACS workers tell families, “You need to sign on for preventive services.” I then tell them that services are voluntary. The ACS worker looks at me with hatred in his or her eyes, because if the case is not moved to preventive, it stays with that ACS worker. The families are often threatened with returning to court, and ultimately, they sign.

PINS diversion cases are also voluntary. Parents are willing to sign on, often under the assumption that counseling will fail, and then they’ll be granted the magical warrant. These families have been through a lot, and feel that they’ve tried everything. They’re not eager to meet for weekly counseling to explore alternative disciplinary methods, and discuss their own childhoods.

A lot of people who initially seem eager to sign on for services disappear after a couple of weeks. We’re required to see each family at least twice a month, at least once in the home. The goal, of course, is to see them weekly.

This doesn’t sound too hard. But oh, it can be.

I had one family who was at home for a visit by myself and their ACS worker, then came to the office for two visits before singing on. After that, they promptly disappeared. This was over the summer, and it turned out that the mom had sent the two kids to California to visit family for six weeks.

I’ve gone to Staten Island for visits. I could swing San Diego. But my proposal was rejected.

There are people that you need to chase on this job. It’s one if the most frustrating things we deal with. I understand it. These are people who have had negative experience with service providers, and “people just trying to help” in the past. They associate us with ACS, and think I’m there to check up on them. What could be more frightening than the idea that someone is judging you, making a case that you don’t deserve your kids?

But come on. I’m fun! I really am here to help! And for the last time, I cannot take your kids! Even if I really like them. When I haul myself out in a blizzard to try for a home visit , only to find that no one is there when they said they would be…I have to struggle to stay empathetic.

Numbers are incredibly important at my job. I recall one conversation I overheard between my director and my supervisor.

“She’s only seen this family once this month.”
“I know. But she went to the house four times.”
“Yeah, she needs to see them again.”
“I know, she’s trying.”
“OK. She needs to see them again.”

Apparently he’s a believer in The Secret. Just keep saying it, it’ll happen.

A valid excuse doesn’t matter. What matters is results. Stereotypical tough football coaches in movies about high school in Texas are more accepting of, “Well, I did the best I could!” than social work bosses.

My director once decided that a monthly competition would get everything in gear. The person with the most contacts wins a prize!

We can’t afford juice boxes for kids’ group, but we’re going to give out incentives to the workers. Fortunately, it never happened.

I had something to do with this. My supervisor had warned me that I was in the lead during supervision (oh yes, I’m very good.) We wound up talking about how uncomfortable this made me.

I understand that numbers are important. We need to document that we are seeing these families. We need to make sure that everyone in the home is safe. We need to meet our funding requirements.

But there are times that it feels like that is what being a good social worker is. I have run into a family in the bodega and counted it as a contact. (Casework, and Sunchips? Yes please!) Did I get any work done? What did we accomplish? The idea that my work is often judged at my agency based on how many times I see these families, rather than the quality of the sessions, is rather disheartening.

This is what frightens me when I think of being in a supervisory role at some point. How do you achieve a balance between the requirements for funding, and what’s best for clients? When these things are at odds, how do you decide what is most important?

No matter what, at least I know what the answer is not–a monthly contest in which grown professionals compete for a (proverbial?) cookie.

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9 responses

7 02 2011
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7 02 2011
Fi

I left helping type work years ago for this very reason. The help was wanted, so people that didn’t need help got help, so that the numbers were achieved and the service continued to operate and the professional helpers continued their helping careers. And the people that needed the help stayed exactly where they were.
I help for free now.

8 02 2011
socialjerk

It’s one of the most frustrating aspects of the job. As much as you might want to, you can’t help people who won’t engage with you. And very often, those people need help the most. One of the major issues that I wish something could be done about is that we get cases that aren’t appropriate for our services. People with serious mental health concerns, when we don’t have a psychiatrist, or people with real substance abuse issues, when we don’t have the staff for that. Due to budget cuts, they’re sending them here.

At the same time, there are people who really needed help, came in resistant, but came around at some point. I’ve have several cases like that at this point, and (cheese alert) they’re incredibly rewarding. I’ve learned at this job that people surprise me in good and bad ways, all the time. For the most part, I’ve stopped trying to predict.

Thanks for reading! Glad to hear you’re still helping outside of the profession :)

8 02 2011
sarahk

It’s hard, and it sounds horrible to say it out loud. I have a quota. 975 service hours per year. Taking holidays and whatnot into account, it’s 4.5 hours of face-to-face billable service per day and if you don’t make it for the month you get written up.

It’s weird to think that spending 6 hours in a hospital waiting room with someone trying to keep them from getting too anxious while they wait for an x-ray is considered a wildly successful day (33% over the goal!) while a day with 6 separate 30-minute sessions in which things are processed, goals are set and worked toward, and relationships are built would be way below par (33% below, in fact).

It’s hard not to get so focused on those billable hours. I often feel like everything else I do (paperwork, phone calls, paperwork, travel time, paperwork, planning, researching interventions) is just a waste of time because I can’t bill for it.

9 02 2011
socialjerk

I know exactly what you mean about “wasted time.” It’s so frustrating that all of those necessaries count for nothing. You might spend 20 minutes on the phone with a client having a breakdown, but that time registers as zero.

I guess it’s difficult either way. For me, it doesn’t matter how long the contact is, as long as it happens. Six hours, or five minutes and a high five.

It was either my first or second week of work that I ended up in a hospital waiting room with a 14 year old who had been sexually assaulted, from 2 pm until about 10 pm. (Welcome to social work!) My director told me that I should be careful about spending so much time with one client. I understand that, realistically, this is true, but the idea that I should have left this kid so I could go score another contact struck me as pretty harsh.

9 02 2011
Nectarine

sarahk, it’s nice in a way that you count towards HOURS. In my job those 6 hours at the hospital with one client would be considered ONE contact.

socialjerk, I too, spend much time chasing down clients. Up until about 1 year ago we were able to count “in search of client” as a contact visit allowing us to meet our monthy quota even if we had a chonic no-show. Alas, this is no longer so, and it’s hard not to feel like it’s so much time wasted when it doesn’t even count towards your numbers.

9 02 2011
socialjerk

My contacts work the same way. And they are trying to up the monthly quota. Like I said, I try to see everyone weekly no matter what, but realistically it just doesn’t happen.

They always tell us to record all of our attempts, to show a “good fath effort.” But considering that it really doesn’t matter, I don’t quite get it. That time spent recording could be spent hunting clients!

13 02 2011
socialoverworker

It’s the same at my job. The worst one is where we have to do unannounced visits, and it could literally take 10 goes to try and get it right. You have to hold their entire diary in your head. I try and get an idea of when they’ll be in by asking about appointments – but that doesn’t account for when they decide to pop out to the shops!

I record everything. As yet they’re too consumed in other things to notice how many visits I’ve done. I think legally we just have to “make contact” (i.e. an SMS would be fine!) every 6 weeks.

13 02 2011
socialjerk

Unannounced home visits get so ridiculous. Like: ok, I already tried to catch them at 9, tomorrow I’ll go at 7! Maybe I’ll just camp out here for a while.

We should probably start making clients fill out spreadsheets with heir schedules when they sign on for services.

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