Incoming intakes!

21 07 2011

I was recently in the position of trying to transfer a case to another agency, due to the family having fled for the greener pastures of Brooklyn. A worker from the other agency and I spent a lot of time tracking down this family, going to see them (two hours on the train? Yes please!) and explaining to the mother why we felt she needed her case to be transferred. Mom wasn’t really feeling it. I had been her worker for a year at that point, and the idea of starting over with someone new wasn’t too enthralling.

Plus, I’m awesome.

But eventually, she agreed to give the new worker a shot. Until the new worker helpfully explained that she wasn’t actually the new worker. She was the intake worker. The worker who would get all of the family’s information and history, get them to sign on for services, and then hand this all off, preferrably in a neat little packet, to the actual new worker.

Damn.

This is what prompted my recent, highly scientific, entirely accurate Twitter social work poll: do you do your own intakes? We don’t have those kind of intake workers here at Anonymous Agency. I was wondering if we were in the minority.

Most people who responded did their own intakes. Most people said they preferred it this way, which I can certainly understand. Ideally, we want to avoid situations like the one I described. “OK, open up. Tell me all about your abusive boyfriend. You have how many kids with him? I see. And your father beat you as well, interesting. Drug history? Wow, quite a history. All right, I’ll just type this up, and pass it along to the next person you’re going to have to give all of this information to.”

But I can also see the appeal of an intake worker. For one thing, it would save me a lot of wasted time. (Not time being wasted, which I would be ok with. Time that I could spend doing actual work.)

After a family is referred to us, they have thirty days to sign for services. If they don’t sign within those thirty days, they can be re-referred, or they can be dropped forever. In that thirty day time frame, even if people seem uninterested, we have to show “diligent effort.” You would think that this means placing some phone calls, sending a letter, and stopping by the house. When a family doesn’t want to sign, however, it seems that “diligent effort” means popping out of bushes in front of their homes, stalking them at their place of work, and tagging the children with tracking devices.

When a family is referred by ACS, the stakes are even higher. ACS workers are under a lot of pressure to get families off of their caseloads, and into preventive services. The first thing that I tell a client who has been referred by ACS is, “Our services are voluntary.” The first thing the ACS worker tells them is, “If you don’t sign, we’re going back to court to have services madated.”

Awesome!

We don’t want to sign a family that is not actually committed to participating in services. We are mandated to see the family twice a month, do home visits, and see all of the children. Personally, I do more than enough running after people as it is.

Families tend to be all about preventive services when their ACS worker is present. “Sure, I’ll sign, why not? We could use the help.” ACS then extends the greatest compliment they can bestow on anyone: “They’re very compliant.”

Compliance tends to fly out the window when the ACS worker instantly checks out. I call, I stop by the home, I send carrier pigeons. I start to take being ignored personally. Then the thirty days are up, I have to reject the case, and I get a call from a cranky ACS worker telling me I didn’t put enough effort in.

I immediately transfer all such calls to my supervisor, who delivers a sound bitchslap over the phone.

So an intake worker would be nice. Someone whose job it is to just do all of this. Because in social work, we can’t just think of what would be “best practice.” We also need to consider time management and logistics. Am I not seeing a client who actually wants services, because I’m chasing down a family that wants nothing to do with me? (Fools, I know.)

It would also be nice to have a better idea of what exactly I’m getting into. Technically, we have an “intake worker” for the agency. She accepts referrals, and completes some very basic information which is collected from the referral source. Names and birth dates of everyone in the home, address and telephone number, and the presenting problem.

I don’t know if she’s overwhelmed, or just a little wacky. But the information we’re getting…it’s flawed at best. I recently showed up twenty minutes late and extra sweaty for an initial home visit, because the referral form had the correct building number, but wrong street. (If you saw a white girl running through the Bronx while clutching forms, you might have had an SJ sighting!)

There’s also the time that I was told that an eighteen month old injured himself by turning on the hot water in the bathtub. Turns out he was actually scalded by a pot of boiling water. I also called a home asking to speak to Ms. Smite. Yeah, it was Ms. Smith. Or when I frantically searched for a family’s missing infant, only to find out that our “intake worker” had made the kid up.

What’s my point? I’m not sure. The initial engagement period is important, and it’s crucial to set a good tone for the relationship between client and worker. But mistakes are going to be made. Whether it’s showing up late and out of breath, mispronouncing someone’s name, or accidentally giving them more children than they have, everything isn’t going to go how we like. There are good and bad aspects in both ways of doing things. Making sure we have all the information, and minimize retraumatizing people by not making them tell their story over and over again, goes a long way in getting families to trust our competence and feel that we respect them.

Plus, it saves me looking like an idiot.

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5 responses

24 07 2011
sarahk

I read a couple studies in grad school about how if the intake process is done therapeutically (and they were talking about everything down to the receptionist) that outcomes are much better.

I’ve been to therapy where the first session was an intake worker. I liked her way better than the therapist I ended up with. I’ve always done my own intakes and I do think it’s better that way.

27 07 2011
socialjerk

That makes a lot of sense. We know how much those first impressions matter, and how important it is to set the proper tone. Part of why I was so bummed to go running in like a maniac that time I had the wrong address! 🙂

26 07 2011
Nectarine

I’ve been an intake worker, both of the “recording name and DOB” type and “complete assessment of needs” type. I have received intakes from other workers, and also done my own intakes for my case load.

I say, of all of these I don’t really care what method is used. The REALLY important question is HOW LONG IS THE WAIT LIST?!

27 07 2011
socialjerk

Wait list question is always number one. We’re good about that at my agency. To me the most important thing is that the client and the referral source understands our services. So often they tell me they want help with housing or employment, and I’m like, “Me too! Tell me if you hear of anything.”

27 08 2011
Nadia

I typically do my own intakes. Sometimes I get some that I transfer to another therapist (since I work on an abuse specific tx team). I prefer to do my own – because if I don’t, I end up reviewing all the information anyway so I can get an understanding of what is going on with the kiddo and family

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