Thread: Feeling the burn!

Quote from TERA

We're talking about people's lives here....people who are on probation, court supervision (parole), have had kids taken away by CPS, some are drug court patients, many with extensive abuse histories and emotional/psychological trauma...behavior issues, drug issues, so much stuff....and I find it hard to imagine how my boss thinks I should just "rush through" the paperwork/interviews..... I don't think it's in our client's best interest to do that.

Tera, trying to come up with some wise words here for you. I think the most important thing for me to say here is, the problems you are dealing with are not your fault. It sounds to me like you are being given a lot of work to do, and not much time to do it in. You talk about how people's lives are at stake here, how you don't think it is in your client's best interest for you to rush through their assessments because of the pressure your boss is putting on you, and you're probably right about that.

The issue here is, it costs your organization money for you to spend 3 hours doing an assessment instead of the 2 hours your boss wants you to spend. Probably, it would be a good thing if you could spend 3 hours doing each assessment, and resources should be put towards giving your clients the attention from you that they deserve.

However, it is not up to you how much money to dedicate to performing the assessments for your clients; that decision is up to someone else to make.

You are doing the best you can to do the best job for your clients, and to help in making the best decisions you can make on their behalf. Your role is still very valuable here, even if you are not allowed to give each client the time they deserve from you.

The moral of the story is, the sin that is being committed, the sin of rushing through the client's paperwork, is a sin being committed by whoever is allocating the insufficient resources that prevents you from doing your job properly.

What I want you to keep in mind is that your value, your moral contribution, is not diminished because of the lack of funding that you are coping with.

There is no need for you to feel "burned out" by this situation, and certainly no need for you to feel depressed by it. You are not the guilty one, you are not the one shortchanging anybody or doing a shoddy job on behalf of your clients, you are not to blame and it is not your fault, so stop feeling bad and guilty about it!

Remember your higher moral purpose and why you chose to go into this line of work in the first place.

Welcome to the mad world of mental 'health' (hah !) Tera. The 'Institutionalising', even the bureaucratising is un-healthy if not madness itself. It can drive a counsellor insane.

I used to supervise young Psychs and watch them 'hurry' to a diagnosis and I would tell them not to even try to diagnose until at least three sessions has been done.

Poeple lie. They 'test' the shrink. They throw bones - a minor problem - to see how the 'Professional' deals with it. The last thing they want, even when desperate for a 'cure', is for someone to see what is really the matter. It is P.E.R.S.O.N.A.L. and they want to keep it that way.

So it takes time to build Trust. And a lot of that is needed before someone will let you into the deep and dark corners of their soul, where even they themselves don't look.

Institutions hate this of course. They have the great God, Paperwork. Most of what you are doing - probably because you are as yet very junior - is clerical work.

You are eager and compassionate. Your heart and head wants to help these people with insight and a path out of their problems.

Marvin the Morose Robot (Hitchiker's Guide to the Galaxy) said, "Here I am, a brain the size of a Planet, and what do they want me to do? Park cars !".

Quote from Percy

Welcome to the mad world of mental 'health' (hah !) Tera. The 'Institutionalising', even the bureaucratising is un-healthy if not madness itself. It can drive a counsellor insane.

I used to supervise young Psychs and watch them 'hurry' to a diagnosis and I would tell them not to even try to diagnose until at least three sessions has been done.

Poeple lie. They 'test' the shrink. They throw bones - a minor problem - to see how the 'Professional' deals with it. The last thing they want, even when desperate for a 'cure', is for someone to see what is really the matter. It is P.E.R.S.O.N.A.L. and they want to keep it that way.

So it takes time to build Trust. And a lot of that is needed before someone will let you into the deep and dark corners of their soul, where even they themselves don't look.

Institutions hate this of course. They have the great God, Paperwork. Most of what you are doing - probably because you are as yet very junior - is clerical work.

You are eager and compassionate. Your heart and head wants to help these people with insight and a path out of their problems.

Marvin the Morose Robot (Hitchiker's Guide to the Galaxy) said, "Here I am, a brain the size of a Planet, and what do they want me to do? Park cars !".

Yes...paperwork...lol! Every time a breath is taken it must be documented in triplicate. I do feel rushed. By the end of summer I'm told I won't be doing assessments anymore. I'll be doing only counseling. When, I wonder, do they expect me to train for this when I'm supposed to be cramming three assessments into one day every day? I suppose my once-a-week facilitating groups is supposed to get me ready for all the one-on-ones I'm going to be doing soon?

I like doing assessments....when the time can be taken to do them properly. You're right...clients do lie. They do test. And it does take time to form a trusting (therapeutic) relationship- which is not easy to do in a couple of hours. With chemical dependency clients, lying is the norm rather than the exception. The word "denial" (though it's outdated now, it's called something else..lol...) is thick and it takes skill to break through it without causing resistance. I like that part of my job. It's a challenge.

I'm doing pretty well with it so far.

This is not atypical: having a client who's afraid that her patient records will be seen by her DOC officer and her CPS worker, she's signed releases for both...so the last thing she wants to do is tell the truth because she knows the truth could get her into trouble...and her drug test results shows she's positive for several substances even though she claims she hasn't used in over a month. In this case, the test results speak for her. But in others, getting to the truth without alienating the client and promoting resistance has to be, and is, an art form.

I enjoy my work, but I take it seriously. I'm not in it for the money (obviously). I'm in it because I really want to help people get well. So for me, rushing through assessments just doesn't make sense. It goes against what I believe in.

I wonder what my boss is thinking? Can he live with two a day that are quality, or will he soon push me again for three? I'm stubborn Percy. I don't intend to push for three a day just because he says I should. If I do that, I might as well hand the reins over to someone else who doesn't mind compromising their own professional ethics. We shall see.

Quote from Seattle Traditionalist

Tera, trying to come up with some wise words here for you. I think the most important thing for me to say here is, the problems you are dealing with are not your fault. It sounds to me like you are being given a lot of work to do, and not much time to do it in. You talk about how people's lives are at stake here, how you don't think it is in your client's best interest for you to rush through their assessments because of the pressure your boss is putting on you, and you're probably right about that.

The issue here is, it costs your organization money for you to spend 3 hours doing an assessment instead of the 2 hours your boss wants you to spend. Probably, it would be a good thing if you could spend 3 hours doing each assessment, and resources should be put towards giving your clients the attention from you that they deserve.

However, it is not up to you how much money to dedicate to performing the assessments for your clients; that decision is up to someone else to make.

You are doing the best you can to do the best job for your clients, and to help in making the best decisions you can make on their behalf. Your role is still very valuable here, even if you are not allowed to give each client the time they deserve from you.

The moral of the story is, the sin that is being committed, the sin of rushing through the client's paperwork, is a sin being committed by whoever is allocating the insufficient resources that prevents you from doing your job properly.

What I want you to keep in mind is that your value, your moral contribution, is not diminished because of the lack of funding that you are coping with.

There is no need for you to feel "burned out" by this situation, and certainly no need for you to feel depressed by it. You are not the guilty one, you are not the one shortchanging anybody or doing a shoddy job on behalf of your clients, you are not to blame and it is not your fault, so stop feeling bad and guilty about it!

Remember your higher moral purpose and why you chose to go into this line of work in the first place.

Thanks, ST- especially for that last part about remembering why I chose this line of work in the first place.

Quote from TERA

Warning: this is a rant. It's intent is not to inform or to educate, but merely to get something off my chest so as to keep the "black dog" at bay.

I'm about two months (almost) into my counseling internship and already I'm starting to feel the burn. You know what I mean...burn out. I was warned of it, but I didn't expect it to come on so soon!

My job is primarily conducting drug/alcohol assessments for clients who enter our in-patient facility for our 28 day residential addictions treatment program. We've been experiencing a low census (due to the recession) so all staff's hours have been cut back to seven a day. My boss approached me today and told me that I should be getting three assessments done per day. The deal is, they force me to take a half hour lunch break and two ten minute breaks in a day (unpaid, of course), so my work day is really only six hours and ten minutes.

Now a single assessment includes preparing a file (about forty pages of material that has to be set in a certain order, some pages pre-filled out). Preparing a file can take about ten minutes or longer. No big deal. But then there's calling the insurance company to get a pre-authorization for treatment which can take (and usually does) up to a half hour. Then there's two sets of admission paperwork (about ten pages for each set) that have to be filled out, and then there's the actual assessment (about 12 pages) to be done with the client, as well as a diagnostic interview. Then after the assessment and interview, there's a master problem list to be made, and an assessment summary to be written. The entire process from beginning to end takes, on average, about three hours, sometimes longer- depends on whether or not you've got someone who's a "talker" or someone who doesn't want to answer questions at all. And then you've got clients who outright lie...and it's my job to probe, collect information, and document it as thoroughly and truthfully as possible. So...there are times it can take four hours for a single assessment.

I'm screening clients for mental health issues, documenting their legal histories (which are extensive in many cases), their medical histories (also usually extensive), and diagnosing their chemical dependency issues. It's also my job to make referrals (when needed), collect signed releases for disclosures (probation officers, lawyers, judges, other agencies, etc..), and call in clinical reviews so insurance companies will pay their clients' claims. It's also my job to make sure the front office gets copies of certain papers in the file, and if needed, bring in intervention specialists if a client needs emergent mental health counseling/intervention. It's also my job to write observation reports to other counselors and review information that comes in to us from other clinics/agencies. Oh...and did I mention I also facilitate the men's combined counseling groups by myself, one day a week?

Sound like a lot? It is. So...I have six hours and ten minutes to do three assessments? LOL! So my boss says, can you do three in a day? (Right now I'm averaging two in a day- and that's really pushing it.) And I said, "sure can- but not if you want quality assessments!"

He just sort of looked at me and said nothing.

We're talking about people's lives here....people who are on probation, court supervision (parole), have had kids taken away by CPS, some are drug court patients, many with extensive abuse histories and emotional/psychological trauma...behavior issues, drug issues, so much stuff....and I find it hard to imagine how my boss thinks I should just "rush through" the paperwork/interviews..... I don't think it's in our client's best interest to do that.

And ya wanna know the really "funny" part? I went to college for two (almost three now) years to do this, graduated at the top of my class, and guess what?

I barely make over minimum wage.

Go away black dog.

Rant over.

__________________________________________________ _

Holy Shit! You have my old job! They're still pulling this crapola! I got carpal tunnel syndrome in both hands from it. Talk about burnout ... I was a crispy critter! You'd think 10 years later they'd have figured out that you need paper-pushers (intake specialists) separate from therapists, and you need the forms on templates in the computer. I got so bad with the methadonians, I used to give them the forms and let them fill everything out (the paranoid ones really liked that; they'd ask for copies they could keep for themselves). My stock went up with them, which is no mean feat. We at least set up a criminal justice unit to handle the courts as something separate, and we had a unit inside the jail. You have my undying respect!

Are these programs only 2 years long? Sounds like a pretty good deal.

Quote from TERA

Warning: this is a rant. It's intent is not to inform or to educate, but merely to get something off my chest so as to keep the "black dog" at bay.

I'm about two months (almost) into my counseling internship and already I'm starting to feel the burn. You know what I mean...burn out. I was warned of it, but I didn't expect it to come on so soon!

My job is primarily conducting drug/alcohol assessments for clients who enter our in-patient facility for our 28 day residential addictions treatment program. We've been experiencing a low census (due to the recession) so all staff's hours have been cut back to seven a day. My boss approached me today and told me that I should be getting three assessments done per day. The deal is, they force me to take a half hour lunch break and two ten minute breaks in a day (unpaid, of course), so my work day is really only six hours and ten minutes.

Now a single assessment includes preparing a file (about forty pages of material that has to be set in a certain order, some pages pre-filled out). Preparing a file can take about ten minutes or longer. No big deal. But then there's calling the insurance company to get a pre-authorization for treatment which can take (and usually does) up to a half hour. Then there's two sets of admission paperwork (about ten pages for each set) that have to be filled out, and then there's the actual assessment (about 12 pages) to be done with the client, as well as a diagnostic interview. Then after the assessment and interview, there's a master problem list to be made, and an assessment summary to be written. The entire process from beginning to end takes, on average, about three hours, sometimes longer- depends on whether or not you've got someone who's a "talker" or someone who doesn't want to answer questions at all. And then you've got clients who outright lie...and it's my job to probe, collect information, and document it as thoroughly and truthfully as possible. So...there are times it can take four hours for a single assessment.

I'm screening clients for mental health issues, documenting their legal histories (which are extensive in many cases), their medical histories (also usually extensive), and diagnosing their chemical dependency issues. It's also my job to make referrals (when needed), collect signed releases for disclosures (probation officers, lawyers, judges, other agencies, etc..), and call in clinical reviews so insurance companies will pay their clients' claims. It's also my job to make sure the front office gets copies of certain papers in the file, and if needed, bring in intervention specialists if a client needs emergent mental health counseling/intervention. It's also my job to write observation reports to other counselors and review information that comes in to us from other clinics/agencies. Oh...and did I mention I also facilitate the men's combined counseling groups by myself, one day a week?

Sound like a lot? It is. So...I have six hours and ten minutes to do three assessments? LOL! So my boss says, can you do three in a day? (Right now I'm averaging two in a day- and that's really pushing it.) And I said, "sure can- but not if you want quality assessments!"

He just sort of looked at me and said nothing.

We're talking about people's lives here....people who are on probation, court supervision (parole), have had kids taken away by CPS, some are drug court patients, many with extensive abuse histories and emotional/psychological trauma...behavior issues, drug issues, so much stuff....and I find it hard to imagine how my boss thinks I should just "rush through" the paperwork/interviews..... I don't think it's in our client's best interest to do that.

And ya wanna know the really "funny" part? I went to college for two (almost three now) years to do this, graduated at the top of my class, and guess what?

I barely make over minimum wage.

Go away black dog.

Rant over.

but you still have a job !!

they obviously want quantity not quality and folk get what they pay for

so give them what they want !!

Quote from bababob

__________________________________________________ _

Holy Shit! You have my old job! They're still pulling this crapola! I got carpal tunnel syndrome in both hands from it. Talk about burnout ... I was a crispy critter! You'd think 10 years later they'd have figured out that you need paper-pushers (intake specialists) separate from therapists, and you need the forms on templates in the computer. I got so bad with the methadonians, I used to give them the forms and let them fill everything out (the paranoid ones really liked that; they'd ask for copies they could keep for themselves). My stock went up with them, which is no mean feat. We at least set up a criminal justice unit to handle the courts as something separate, and we had a unit inside the jail. You have my undying respect!

Many agencies do have computer templates now for all the forms but...not the agency I work at. We still do everything the old-fashioned way- tons of writing- everything by hand. We normally do have just one person who does the intake/assessment stuff, and right now that's me...but we're short one full time female counselor, so that's me, too, in training. Our female counselor is pregnant and ready to deliver. She resigned her position about about two months ago so she could focus on her family, and since then they've been prepping me to take over her job. In the meantime they moved our former assessment person up to step in for her while I took his assessment job. Since at our agency the policy is that men counsel men, and women counsel women, my co-worker (the original assessment guy who's now counseling women) won't be counseling women for long. Our director doesn't like it. She insists on separation of the clients by sex. So...I'll not be spending a whole lot more time in the assessment department. Sadly, the guy who's doing the women's counseling now, by the end of summer, will be back doing assessments again when my supervisor deems me ready to take over the women's groups. Sound confusing? It is...it's like we're playing musical chairs. Unfortunately, the man I work with seems to be the one who's going to end up with one chair short when the music stops. He's a good friend of mine and I understand his frustration with the whole thing. He's actually thinking about quitting. He doesn't want to go back to doing assessments again.

Quote from TERA

Many agencies do have computer templates now for all the forms but...not the agency I work at. We still do everything the old-fashioned way- tons of writing- everything by hand. We normally do have just one person who does the intake/assessment stuff, and right now that's me...but we're short one full time female counselor, so that's me, too, in training. Our female counselor is pregnant and ready to deliver. She resigned her position about about two months ago so she could focus on her family, and since then they've been prepping me to take over her job. In the meantime they moved our former assessment person up to step in for her while I took his assessment job. Since at our agency the policy is that men counsel men, and women counsel women, my co-worker (the original assessment guy who's now counseling women) won't be counseling women for long. Our director doesn't like it. She insists on separation of the clients by sex. So...I'll not be spending a whole lot more time in the assessment department. Sadly, the guy who's doing the women's counseling now, by the end of summer, will be back doing assessments again when my supervisor deems me ready to take over the women's groups. Sound confusing? It is...it's like we're playing musical chairs. Unfortunately, the man I work with seems to be the one who's going to end up with one chair short when the music stops. He's a good friend of mine and I understand his frustration with the whole thing. He's actually thinking about quitting. He doesn't want to go back to doing assessments again.

__________________________________________

God! You're bringing back memories, TERA. Or should I say ... flashbacks!
Please remember to take care of your own mental and physical health. Situations such as the one you're in erode it.

Quote from bababob

__________________________________________

God! You're bringing back memories, TERA. Or should I say ... flashbacks!
Please remember to take care of your own mental and physical health. Situations such as the one you're in erode it.

You're right to remind me to take care of my physical and mental health. I need to. There are days that I'm exhausted...not just physically but mentally and emotionally. "They say" that one develops a professional "detachment" but I'm new....I haven't really developed that yet. Though I appear that way on the outside, inside, I feel...and it's draining. I'll never get used to men crying. I see a lot of that in my office. And for some reason, when women cry it doesn't have the same effect...but when men do it, it really gets to me. Not in a bad way, or anything. What I mean is, I know how hard it is for men to open up- to show emotion like that, and so when they do, I know they're really hurting. I feel their pain. It's intense. Today I worked on assessment with a man who was fine all the way through it until we got to parts of the assessment that have to do with family issues. He was solid as a rock until we touched on family stuff. He broke down in tears (which he desperately tried to hold back) when he described being alienated from his daughter, and how recently she almost died in a car accident and still he's being kept from seeing her because his ex won't let him see her until he gets help for his addiction. It really tore me up to hear him describe that.

Does one ever really "get used to" this stuff so that it no longer has an emotional impact? I wonder.

My boss just informed me (today) that as of next week I'll be doing art therapy with the men's groups. That should be interesting!

A man goes into a Doctor's and say's every time i do this it hurt's(bending his arm behind his back) the Doctor say's well stop doing it.

My attitude towards work has always been the same (or it was, since I have not worked in the traditional sense for over 15 years!)..

"If a jobs worth doing, its worth doing right"..

Don't do a bad job just to hit an unrealistic target.

Do your best, and have pride in your work, and if they dont like it, then tell them were to shove it!

Quote from haahoo

My attitude towards work has always been the same (or it was, since I have not worked in the traditional sense for over 15 years!)..

"If a jobs worth doing, its worth doing right"..

Don't do a bad job just to hit an unrealistic target.

Do your best, and have pride in your work, and if they dont like it, then tell them were to shove it!

Thanks Haahoo. I like that advice. All of it ...except maybe the "if they don't like it tell them where to shove it" part...lol! I did tell him how I felt, though. It just wasn't quite framed the same way.

Quote from TERA

Thanks Haahoo. I like that advice. All of it ...except maybe the "if they don't like it tell them where to shove it" part...lol! I did tell him how I felt, though. It just wasn't quite framed the same way.

haha! yes, well, we all have our own unique style and you obviously have a better way of putting things to suit your style much better!

What I was getting at, of course, was that I have in the past informed bosses that they have a choice, if they like the standard of my work, and they want me to increase the rate at which I do it, then the standard will inevitably suffer and I will not allow that as it is the high standard that creates the demand, lowering the standard to meet the increased demand will reduce the demand and more importantly reduce my feeling of pride in my work, something that I am not under any circumstances prepared to compromise..

Hence, I'd rather they sacked me as a man who does a good job, than as a man who does a crap one because of the pressure he is under!

I can relate to the situation you are in, as I was in the same position in my last job.

What made me most angry, was that I was in this position simply because there was a high demand for my work, which was, due to the high quality of it!

My other workmates did not have such pressures on them, they were shit at their jobs, so no one wanted more work from them!