Writers writing about writing is in no way annoying.

26 07 2012

Possession is, apparently, nine-tenths of the law. (I’m not totally sure, I’m not a lawyer.) Documentation is, in fact, eleven-tenths of social work. (I’m also not a mathematician.)

As social workers, we have to document everything. Everything. Sessions, group meetings, phone calls, outreach attempts, collateral contacts…”collateral contacts” are essentially “everything else, if you’re unfamiliar. This can be problematic, and not just because it’s time consuming.

There are ways we say things, and there are ways we write things. There are, especially, ways we write things professionally. At times, it’s hard to say things in a professional manner, but we still need to get them out there. (If you were wondering why this blog exists.) You might indicate that there are concerns about a teenager’s hygiene. You wouldn’t write, “Jesus Christ, can this child not smell himself?”

Reframing, a social worker’s annoying best friend, sometimes helps. When my teen girls went on a tangent about why Justin Bieber is hot (I felt like I was going to get put on an FBI list just for being present for that one) I explained it as them sharing qualities they admire and would like to emulate in one of their role models. Apparently the Biebs has been through a lot?

When a mother was listing her strengths as a conference and said that, “Don’t nobody fuck with my kids. They get what they need,” we were able to note that as the mother being an excellent advocate and provider.

There are occasions when this doesn’t work. I was at a meeting once that a mother would not allow to end until it was noted on her service agreement that, “I want ACS out of my fucking life.” The poor worker tried to compromise several times, but mom wasn’t hearing it. Finally, a comic strip style #$%! had to suffice.

Sometimes, when more than one agency is involved in a case or when a family is transferred, we have to read things that other people write. That’s when we wonder how it’s possible that we were hired for similar jobs.

Not everyone is a good writer. Ask a teacher. Most people can barely write a clear sentence. How to write a proper progress note, at least in my experience, is something you’re expected to learn in the field. It’s not formally taught in Doggie Day Care social work school. Some people get too wrapped up in writing a narrative, detailing everything from what cartoon characters were on the kids’ shirts to what was blaring on the TV in the background. Others think mentioning that no one was on fire or bleeding to death is sufficient.

Some are just simple mistakes. It seems wrong that “now” and “not” are so similar. “One of the family’s strengths is that the child is not going to school regularly.” What’s wrong with you? Oh, the child is now going to school regularly. “Mother is concerned that the children’s father is now abiding by the order of protection.” That is bizarre…or is he not abiding by this? Why does this keep happening to us?

Some are mistakes that seem to require effort, in order to be so wrong. What are the odds that the parents both have the last name Jones, and their children all have the last name Tones?

Some errors go beyond poor execution or a rushed job. Those notes are the stuff of legend.

“This child is being denied the BEST OPPORTUNITIES EVER!!”

This was written by a worker who transferred a case to me, who was concerned that the parents were taking advantage of a scholarship their high school age daughter was being offered. Caps lock, and stacked punctuation. Here’s a tip: exclamation points are rarely appropriate in a progress note or service plan. I can’t even get into the stunning hyperbole.

“CPS told mom that she has a lot of work to do, so get chopping.”

Never say this. In person, or writing. No.

“This worker suspects that the preventive worker is not accredited and qualified to provide play therapy.”

Writing this in a database the preventive worker has access to is essentially using that database as a Mean Girls-style Burn Book.

“Mother shared that her childhood was not all cookies and cream.”

Bummer. That would have been a delicious childhood.

Progress notes are a necessary evil, of course. Without them, transferring a case would be pretty impossible, and it would be a lot easier for an unscrupulous worker to go to Dunkin Donuts while claiming to be out on a visit. (Not that I’ve ever contemplated this.)

And they can be entertaining. Maybe next time you’re working on a note, slip in a little humor for the next person reading it. Silly, unnecessary caps lock, or throw in a “stop reading, it’s a trap!” midsentence. Your supervisor will thank fire you.

Everything I need to know about social work, I learned from blogging.

4 06 2012

Strike that, reverse it. Wait, don’t. Either way.

Three years ago, I began my social work career at Anonymous Agency. One year later (so two years ago, just in case you have the typical social work math difficulties) I decided to start blogging. Both were things that seemed like really good ideas at the time. Both have brought me joy, pain, laughter, tears, and taken precious time away from Words with Friends. Both at times have kept me sane, while at other times have made me feel like I’m howling at the moon.

That’s not all they have in common, though. So many of the lessons I’ve learned in each of these endeavors are related.

1.) Whatever you do, someone will criticize or think of ways you could have done it better. No matter what. So just do what you think is best and be committed to it.

If you present a case in staff meeting, or write about literally anything on the internet, someone will be willing to tell you what an idiot you are. Sometimes in those words, sometimes not. The worst is when it’s couched in, “Interesting. I mean, I see it differently. Have you considered…?” The point is the same, though–you’re an idiot. You can learn from what others have to say, obviously. But if you spend any significant amount of time trying to avoid controversy or risk, you will be rather comfortably for a moment and achieve exactly nothing.

2.) Looking back, you’ll hardly recognize yourself. Because you were terrible.

When I first started, I had no idea what I was doing. I had some knowledge and education, sure, but for the most part I was relying on my enthusiasm and desire to do good. Am I talking about social work or SocialJerk? I’m not sure. As a new social worker, there were times that I was fighting so hard to come up with a clinical focus in a session that I stopped listening and let things lapse into silence. As newbie SocialJerk, I was at times afraid to commit to a point of view. But with both, I’m fairly certain that I’ve gotten better, and learned from my mistakes (which I continue to make.) In whatever you do, it’s all right to be kind of bad at first. As simple as that seems, it’s pretty liberating to realize.

3.) You can’t argue with crazy.

Hi, commenters. Yes, you. No, not all of you. You know who I mean. (Well, probably not.) This is a really social-work-inappropriate way to say that you aren’t going to change someone’s perception of reality. I can provide facts to those nutty individuals who live in my computer who tell me that I bring girls in for abortions in their ninth month of a healthy pregnancy, just for fun. I can explain to a parent that I’m invested in keeping their child in the home. I can tell violent elevator thugs that I’m not actually who they think I am, and in fact, I’m on their side! If they’re not willing to accept it, and are motivated enough to cling to the fantasy, they will. I can’t change that, and attempting to only wastes time and drags me down.

4.) Write it down, because you will forget it. Even if it’s amazing. Especially if it’s amazing.

There are those times when I have a momentary breakthrough. Oh my goodness, this kid’s relationship with her boyfriend if just like her relationship with her mother who rejected her! How didn’t I see it sooner? Or, ooh, I should blog about why I like Play-Doh! The public has a right to know! No matter how late it is, no matter how much you don’t want to take your work home with you, just write it down. You will forget. You’ll know you’ve forgotten. It will slowly drive you mad. Not that you can’t get it back. There’s just something to be said for the flash of genius.

5.) Be passionate, it’s when your best work gets done.

Figure out what you like in social work, and do it. Groups? Play therapy? Go for it. Find your population. It’s not that easy, I know. Jobs are scarce, sometimes we have to take what we can get. But there’s almost always a way to bring what you love into the job. (My kids all know I love comic books. I assure you, there’s a clinical explanation.) When I’m fired up about a topic, it’s when I do my best writing. Then, or when someone leaves me alone in the playroom.

6.) Take a break when you need it. Don’t force it. (Except for when you have to force it.)

A lot of writers talk about how you have to wait to be inspired. Obviously, inspiration is great. Writing when you feel passionate is amazing. Sometimes, though, you’re not feeling it. Take a break. The world won’t end. But…sometimes you just have to push yourself. If we only write when we are really feeling it, we’ll be very artistic souls who never write anything decent. Writing is something you need to practice, all the time. In social work, we need breaks. A vacation day here or there or a Ferris Bueller’s Day Off works wonders. Except when we can’t, because we’re really needed. So we do what we have to, and live for the vacation at the end of the rainbow.

8.) Appreciate those who support you.

I would probably have chronic ulcers and be wandering the streets of the Bronx drawing genograms of passing families if it weren’t for those who listen to me when I’m freaking out, tell me they’ve been there too, and get my fucked up social work humor. So thank you all.

9.) Know when to shut up.

I would explain this one, but I think it would take away from the point. I’m still working on it.

Ten years on…

8 09 2011

I was unsure if I was going to be able to write about this. As I’m sitting here starting, I’m still a little unsure that I’ll be able to do it. I tried to talk myself out of it. Terrorist attacks are not a social work issue, why do I need to write about 9/11 on my social work blog? But social workers deal with trauma, and that day was nothing if not traumatic. I practice social work in New York, where life is divided into before and after 9/11. I was born, raised, and continue to live in New York, so this is where my mind is. Not writing about it seems disingenuous.

Aside from that, a lot of social work practice is about helping people to tell and redefine their stories. We talk about their lives, their childhoods, their current situation. We reframe what they’ve been through and where they are, learn from it, use it to inform the future. I listen to people’s stories every day.

9/11 has become a day of stories. As much as we don’t like to talk about it, when the topic comes up, it isn’t put to rest until everyone at the table has shared theirs–where they were, how they heard, when they managed to get home. Everyone has one.

This is my attempt to share mine.

I was 17 years old on September 11th, 2001. I had just started my freshman year of college and was living outside of Brooklyn for the first time. I had made it all the way to Westchester, almost forty minutes away. Quite an inspiring tale. I was struggling to adjust to school, thanks to a boyfriend back home and a general lack of direction.

I woke up that morning to the roommate I barely knew, telling me, “A plane just crashed into the World Trade Center.”

We gathered in our common room and watched the news with our suitemates. (Yes, smart kids on scholarships get suites as freshmen. Study hard and dream big, kids.) We watched the towers fall. I didn’t really believe what was happening. It was surreal, but I was also naive. Those planes flew into the twin towers, on purpose? That doesn’t even make sense.

Terrorism was not part of my thought process then.

In those surreal moments, immediately after the second tower collapsed, I jumped up, remembering I had an appointment to meet with my professor at ten. I ran out of the room and to the academic building. I was all ready to apologize for being late when I, almost literally, ran into a secretary. She told me no one was meeting anybody, and to go back to my room.

On the way back, I made my first of many phone calls that day. It was to wish my godson a happy sixth birthday. I don’t really remember the conversation. But I do remember him happily announcing his birthday to people for months and years after that, as little children do, only to meet with a mildly horrified, sympathetic response. “Oh…really?” My aunt and uncle tossed around the idea of changing it. The kid wouldn’t really care. And who would ever be able to wish anybody a happy anything on that day ever again?

We had a school-wide meeting early in the afternoon. They mostly covered logistics–what roads were closed, what public transportation was running, and the fact that the school would be closed for the next week.

I didn’t really care. I stopped listening when we were told that there was no way to get to the city. You could go north, further into Westchester (um, thanks) but you absolutely could not travel south. They had no idea when we would be able to. I was a wreck. I very seriously contemplated walking to the city along the highways, but was talked out of it by a roommate who convinced me I’d be picked up as an accomplice.

This is one thing I think I can’t get across to people who weren’t there. That I will never truly be able to express to my kids. When I say, “we thought the world was ending,” I’m not exaggerating. I’m not kidding. I was very much considering the possibility that this was it. That I was never going to see my friends and family again. I had no idea what was happening. All I knew was that I was 17, was surrounded by people I had known for about ten days, my country, my city, was being attacked, and I had no way to get home to it.

We didn’t turn the TV off for the next 24 hours. We were desperate for news. At one point, I flipped the channel to Nickelodeon, because I couldn’t believe that cartoons could even exist on a day like that. I was right–the screen was blank, except for a message indicating that programming had been pulled, due to mourning.

News stations kept showing a map of cities that were connected to the attacks. Boston, where my brother lived, was highlighted, because the planes took off from there. Pittsburgh, where my cousin attended college, was also starred, because flight 93 had crashed just outside of the city. And of course, New York. Where my parents lived and worked. Where my aunts and uncles, friends, and boyfriend, all were. My entire life seemed to be up there.

I barely got off the phone for the rest of the day. It would have been comforting if I could have actually talked to people. The combination of the towers falling and everyone in the country trying to call their loved ones led to phones not working. My parents, and most of my friends, did not yet have cell phones. My parents were both at work, both in the city, but nowhere near each other. They had to walk to each other, and back to Brooklyn, but tried calling to let me know they were all right. My mother was not yet accustomed to voicemail.

“Oh…hello? SJ? Are you there? It’s ma. What’s going on at school? Hello? Oh, is this her answering machine? I don’t know what it’s doing. Is this recording? I don’t even know if it went through. What do I do…”

I spent a lot of the day thinking that this ridiculousness might be the last time I would hear from my mother.

I did manage to speak with my older brother. As we were hanging up, he told me, “We’ll be OK. I love you.”

Big brother told me he loves me. We are definitely about to die.

I dozed on the couch for about two hours that night, with a suitemate I barely knew, not willing to part from the news. I went downstairs early that morning, trying to find anything out about getting back home. Taped to the front door of the dorm was a sign informing me that MetroNorth trains were running to Grand Central. I ran upstairs, grabbed a bag, and got myself on a train immediately. Other students again tried to talk me out of it, saying that Grand Central was “a target.”

That’s another thing everyone was doing–trying desperately to figure out what would happen next. Because surely that wouldn’t be it. It led to a lot of frightening rumors about bioterrorism, and urban myths spreading like wildfire.

I spent the next week at home. Much of that time was spent crying and watching the news, because it seemed that there was nothing else to be done. I also got together with my friends, and boyfriend. The boyfriend had a lot of free time, as he worked directly across the street from the World Trade Center, and was therefore out of work. We couldn’t talk about anything else. People talked about wanting to hunt down whoever had done it, but at the same time we were terrified. This was a room of 18-22 year old boys, and we were pretty convinced there was going to be a draft.

It was hard to figure out how to react. When could we start watching comedies again? When was it OK to hang out with friends and not discuss it? When could they play baseball again?

I grew up a lifelong, diehard Mets fan, which explains a lot of my cynical outlook. My friends and I happened to have tickets for the first baseball game to be played in New York, a Mets-Braves game, following 9/11. It wasn’t until September 21st. It felt wrong to play before, in addition to the fact that they were using Shea Stadium as a staging area for supplies for Ground Zero.

But being there when Mike Piazza hit that home run, giving the Mets the lead, and cheering and crying with 57,000 other New Yorkers, was an indescribable moment. It felt historic and triumphant, and like too much of a movie moment to even be real.

A lot of things changed. Mayor Giuliani was greeted with thunderous applause, by Mets fans. My parents hung up an American flag, something my family had never done. My dad said he never saw himself doing this when he was protesting the Vietnam War. A woman I had never met sat across from me on the Metro North during one of my weekly trips back home from college, asked about my FDNY t-shirt, that I had gotten from my uncle, and shared her jelly beans with me. (Yes, I took candy from a stranger.)

I also almost caused a riot at Grand Central. A man proposed to his girlfriend, loudly and publicly, and their audience let out a collective shriek. I instantly thought it was another attack, and dove to the ground. That was when I realized how much my way of thinking had changed.

It’s true that there’s no good way to react to what happened. But there were plenty of bad ways. A lot of kids at my college liked to out-liberal one another. They immediately started talking about how America had brought this on itself, with its capitalism and general meany-ness. (That was the level of sophistication of these arguments.)

The “why” conversations needed to take place. But they didn’t need to take place on September 18th, less than an hour from Ground Zero.

My cousin told me about some of her friends who went out dancing the night of September 11th. Hey, they didn’t have classes the next day! When she said she absolutely wasn’t going, they gave her the age old excuse–everyone copes in different ways. This is how we’re dealing.

Really, by going out clubbing? The way you cope with terrorism looks remarkable similar to the way you cope with Thursdays.

I’m not saying there’s a right and a wrong way to mourn. But there is a way to behave appropriately, no matter how you’re feeling. It’s called being a part of society.

At the same time, we want to avoid the misery Olympics. Who lost the most, who suffered the worst, who knew the most people who died. Even when you win, you lose. It’s the opposite of a drinking game.

I recognize that I was fortunate. For all the terror and uncertainty, my family and friends came out alive. Growing up Irish Catholic in Brooklyn, you tend to know a lot of cops and firefighters. So yes, people in my life died. Neighbors, people from church, friends of my aunt, my good friend’s mother. No one remarkably close to me. And yet, I was traumatized, and panic and cry every time I see a memorial, a commercial for a special or documentary, or get into a conversation about the day.

That’s why I struggled so much to write this, and why making it public terrifies me. But it’s my story, and I thought I should share it. It’s what I always ask of my clients. And I do believe that it helps us to heal.

Honesty is the best policy. Right?

7 04 2011

I’ve written about my love of progress notes before. Truly, nothing gives me greater joy than reliving a session, remembering who was there, why we met, what I planned to discuss, and how everything was derailed what was accomplished. I know I speak for all of us.

Sometimes, though, I feel like I’m being dishonest. Reading my notes, or the notes of other workers at the agency, you get the picture of a calm, collected social worker, in control of the situation at all times.

I don’t lie. I just don’t use direct quotes. (I don’t have to do process recordings ever again, and you can’t make me.) I don’t include my hesitations, my random stutters, or perhaps the occasional look of fear.

What would an honest progress note look like?

“SocialJerk conducted a scheduled home visit with the family. Visits have been scheduled the past two weeks, but no one was at home for these. This visit was conducted in sheer desperation and with little hope for a positive outcome.

SocialJerk apologized for being late, which the family thought was weird because she was supposed to be there at 4:30, and arrived at 4:33. SocialJerk needs to chill.

The children were appropriately groomed and dressed, for the most part. Teen 1 is doing some kind of experiment with his hair, and let’s just say it’s not working. Braids were his friend. Toddler 2 didn’t have pants on, but SocialJerk supports freedom of expression within the home. Also, no marks or bruises were observed, except for “Bitch” written in (magic, not permanent) marker on Teen 2’s hand. Eh, kids are weird. Mom was in jammies, which is a little odd considering it was so late, but she’s grown and can do what she wants. Also, they were Tweety Bird PJs, which is kind of cool.

The home was neat and clean. Well, by SocialJerk’s standards. You should see that bedroom. SocialJerk needs to keep up on her laundry, but it’s hard to always have enough quarters. SocialJerk digresses…

The TV was on. Mom was kind enough to reduce the blaring volume, but left it on Oprah. SocialJerk was mesmerized by the topic of suburban housewife prescription drug dealers, and had to request that it be turned off. This did not go over well. SocialJerk pretended not to notice.

We discussed the children’s absentee fathers. Mom tends to blame them for the teens acting out. Mom also blamed the teens falling in with the wrong crowd. SocialJerk attempted to introduce the idea that Teen 1 and Teen 2 are the wrong crowd that the other parents are blaming their kids’ bad behavior on. However, SocialJerk was distracted by Teen 2 calling Teen 1 a “fucking retard” and Teen 1 threatening to set Teen 2 on fire. SocialJerk had a moment of panic and considering making a break for it out an open window. Cooler heads prevailed and SocialJerk reminded the teens of our anger management techniques. Teens clearly humored weirdo SocialJerk, which is enough for her.

Toddler 1 tripped over the carpet. Teen 1 and SocialJerk laughed. Toddler 1 insisted that it was” not funny,” while SocialJerk pointed out that it was, in fact, a little funny.

Wacky Neighbor popped in and spoke rapid fire Spanish, clearly not wanting SocialJerk to follow. SocialJerk nearly got a contact high from his jacket. Wacky Neighbor left, and Mom apologized. She then took a phone call. SocialJerk enjoyed her Notorious B.I.G. ringtone. Brooklyn represent.

We got back on track and discussed Teens 1 and 2 and their attendance. They missed two days last week. We celebrated this as a victory, which SocialJerk secretly felt sad about. Teen 2 then said she had something she wanted to share with SocialJerk. SocialJerk was terrified that she was going to be presented with a positive pregnancy test, until Teen 2 produced a science test with an 86 at the top. SocialJerk praised Teen 2 as if she had cured polio. Mom rolled her eyes and SocialJerk encouraged her to be proud of Teen 2, while thinking that Mom was kind of being an asshole. SocialJerk then remembered the time Teen 2 stole Mom’s credit card, and cut her a break.

Next steps- SocialJerk will plan to see the family in the office next week. SocialJerk will call in vain to remind them, but their phones will be disconnected. SocialJerk will be tempted to Facebook Teen 1 or 2, but recognizes that would be inappropriate. SocialJerk will ultimately conduct more home visits than necessary, to ensure that contact is made, and will question the therapeutic value of her work, which will lead to a personal existential crisis.”

I think it could work.

How to put off writing notes? Writing blog entries!

2 11 2010

I love writing. It’s kind of why I do this blogging thing. I was worried, when I started social work school, that I wouldn’t have time to write anymore. But I was wrong.

I just don’t have much time to write things that I like.

Most social work job listings (not that I’ve been looking) specify that they are looking for someone with good writing skills. I don’t think most people think of this as a field that requires tons of writing.

Let’s all take a minute to laugh at those people, shall we?

Document, document, document. It is the social work mantra. (Well, that and “be nice to each other.”) If you’ve written it down once, surely that isn’t enough. At my job, we have one computer system where we enter contacts that we have with clients. Seeing them in the office, seeing them on home visits, running into them in the bodega (seriously) it all goes in. Along with the purpose of the visit, who you saw, how long it went for, and if anyone looked fat.

Then you get to write progress notes. Every social worker’s dream. (Did a chill just go up anyone’s spine? Just me? Oh, OK.) This is where you record everything else. Did you see the kids? Did any of them have marks or bruises? How was everyone dressed? What did you talk about? If you were in the home, was it clean? Was there food? Why were you there? Type faster, dammit, you’ve got four other people to see today!

I’m beginning to suspect that my computer judges me when I take too long to get my notes done.

Notes can be difficult. It’s like reliving a session. Sometimes, this is fine. We played with play-doh, talked about how we feel about Deadbeat Dad, and drew a picture of an angry monster.

Sometimes, it’s not.

Hmm, what happened first? Well, I think the teen revealed that she had a girlfriend. Then mom screamed at her. Then the teen stormed out. Oh no wait, first she told her mother to “fuck off.” Never mind, she stormed out, came back for her jacket, then told her mother to fuck off.

Am I allowed to write “fuck” in a progress note?

It’s better than social work school, though. In social work school you have a smaller caseload, because you’re in the office for fewer days, but you are still expected to do all the usual documentation. With one additional assignment.

PROCESS RECORDINGS. (OK, I know you all felt it get colder in here that time!)

Is there anything worse than a process recording? Really, one thing, aside from waterboarding?

For those who might be unfamiliar, there are some variations, but here are the basics. One starts off a process recording by making a nifty three column chart. This is where the fun ends.

The first column is where you write what happened in the session. Not bad, right? We do that in the progress notes!

Oh, you poor, naive bastard.

Process recordings are verbatim. Write down word for word what was said in that 45 minute meeting. And don’t leave anything out! You think it’s unimportant, but what the hell do you know? The kid interrupted you? Interesting. The dad needed a bathroom break? Was this before or after you brought up depression screenings? How long was he in there for?

The second column is where you write about the therapeutic interventions and theories you were using. “Yes, that was one of Minuchin’s techniques.” “I brought in CBT to the process.” “I’m going to say this was Freudian, but I’m pulling that out of my ass.”

Then in the third column, talk about how you were feeling while all of this was going on. “I was nervous when she brought this up.” “I experienced some counter transference at this point.”

It’s all so social work-y I could die.

The real fun happens when your supervisor goes over it with a red pen, tearing your work apart and convincing you you’ll never have a clue as to what you’re doing.

But thank goodness we get beyond that. I’ve grown into such a confident, competent, worker.

No time to write about it now, though. I’ve been working on this same note for three hours, and I’m having an anxiety attack about handing it in.