Social Work A Lifetime Of Practice
Do you enjoy it?
It’s been quite a week this past week in my Social Work Practice in Brockport, NY where I continue to meet with people three days per week for individual, couple, and family therapy. I also participate on a mental health professionals listserv which is called “Clinicians Exchange.” I also co-facilitate a group called “Growing Older Gracefully Peer Support Group” on Tuesday afternoons, and facilitate “Nurturing One’s Interior Spiritual Life Peer Support Group” every other Thursday evening for the North American Unitarian Association’s Circle program.
The biggest topics which have come up this past week are the confidentiality of patient records, how a psychotherapist should respond to a client request to appear in court for them in child custody disputes, and how therapists should handle patient’s request for service when they were seen previously in an agency when a therapist has moved to private practice and signed a non compete clause with the agency, their previous employer.
In private practice, the Licensed Clinical Social Worker has two jobs, providing the therapeutic services and running a small business. I, over the years, have observed that many Social Workers are good at one of the jobs, but not both. The two jobs require two different skill sets. I have done both successfully over 44 years.
Some things have changed drastically over those 44 years, the most significant of which has been the introduction of computers and the internet and smartphones. The impact of this technology has had many consequences for how a Psychiatric Social Worker such as myself goes about their work. Some of the areas affected in no particular order are:
Marketing
Client registration
Billing
Health records
Communication with clients, collaterals, collaborative partners
Confidentiality
Practice management
Evaluation of client outcomes as well as practice performance.
This article cannot describe all these impacts. To provide one small example, though, we can focus on client communication. If the therapist wants to contact the client should they call, text, email, snail mail, fax, provide a client portal into their office software platform? Just getting on the same wavelength between the therapist and the client is an enormous challenge as clients have different preferences as do therapists and the confidential nature of the communication is always an overriding issue.
Having tried all of the above communication methods, the one I find most effective is the good ole fashion phone call. Texting is only good for the transmission of very specific discrete information, but leaves a lot of room for misinterpretation and misunderstanding. Email should be a “no-no” because one never knows where it is being stored or forwarded to, etc.
People want communication that is fast, efficient, and effective, and accurate. It seems with the multiple methods of communication people can choose from today, these attributes are rarely achieved 100%.
And so a Social Worker is juggling many requirements and expectations from multiple stakeholders as they engage in their work. Human nature and their situations are almost always messy and things hardly ever go as they should. So a good Professional Social Worker has to be fast on their feet, flexible, creative, smart, wise, loving, and compassionate, and it helps to have a good sense of humor about the absurdities and incongruities that one finds in life.
I told my physician, a gerontologist, who I see now that I am 78, “I wanted to let you know that I reopened my office on May 1, and I am going back to work three days per week. How many more years do you think I can practice?” My doctor is a relatively young man, I would guess in his late 30s or early 40s and he looked right at me and asked, “Do you enjoy it?”
I said, “Yes I do. Very much.”
He said, “Well, you will probably practice as long as you enjoy it.”
I wanted to stand up and hug and kiss the guy. What a great answer.
Then, he said, “The oldest patient I have had still working was an accountant. She worked until she was 95.”
I thought to myself, “I don’t think I will still be practicing at 95 nor probably not even alive, but maybe I can practice till I’m 85.”
To have a career and/or profession with work that you enjoy, is meaningful, is useful, and gives one a sense of purpose is one of the greatest blessings in life. I have grown more and more appreciative of my profession over the years.
I look forward to sharing more with you next Saturday about Social Work A Lifetime Of Practice.
Editor’s note: On Saturdays, my substack newsletter will have an article about the Social Work Profession and what I have learned from a lifetime of practice.