Saturday, April 25, 2009

Saturday morning alpha-bits

So I had thought I would make an attempt to start my garden today, as the forecast said it would be near 80 degrees today. However, I ended up switching a shift to be on-call today instead of tomorrow (I have a bridal shower to go to tomorrow for my husband's cousin). I was imagining myself being outside today, covered in dirt, as my pager goes, "do-da-DA-DO-do". However, at least right now, mother nature is putting a stop to all of it, as it's raining and appears to be ready to really thunderstorm. Maybe tomorrow after the shower?

I continue job hunting, though it seems to be in vain. During my most recent job pursuit, I have continued to send out copies of my resume, mostly via email and mostly though Careerbuilder.com. So far, I have gotten zero responses. Back when I first was finishing grad school and job hunting I only sent hard copies of my resume, now most jobs you find online say you can fax or email a resume. I can't help but wondering does it really get to the intended viewer? Do they really check all those emails? But I guess a hard copy can just as easily be pushed aside or filed in the circular bin. I know it's a tough economy and my resume is competing with probably a 100 others for one job, people with more experience than I. It's still extremely disheartening.

I also can't help to wonder when I send an email through Careerbuilder, what are they actually sending to the potential employer? I use Careerbuilder for free, but they have upgraded resume packages that obviously they want you to buy. Do they trick you into thinking you need to buy the upgrade after two years of no responses to sending your resume the standard way? Are they really sending employers a giant picture of a clown face? I know my resume isn't flawless, but there are times I have applied for jobs for which I am definitely over qualified and still didn't get a call. I just don't get it.

Maybe God is trying to tell me to stay where I am at. Even though there are many reasons I don't want to. Maybe it's part of the bigger plan. Sigh.

As a follow up to my last blog, I spoke with the counselor from the crisis program who took back myclient who had been hospitalized, the one whose mother said I "wasn't effective." I now realize those were probably the words of the progress note writer, not a direct quote from the mom. The crisis counselor said that mom thought the client didn't want to talk to me because I seemed too young and too close to her age. I had to laugh at this. I wonder how old they think I am? I am going to be 30 this year, I have been out of grad school for 5 years, but I often still get labeled as fresh out of school, or even a student. In a society obsessed with eternal youth, I have often viewed looking younger than my age as a blessing; however, a friend of mine pointed out that it can be a curse too, that people don't take you seriously. And I definitely see that side of the coin too. It probably doesn't help that I am also short, soft-spoken, and frequently laugh or smile nervously. These are probably why the handful of job interviews I have been on in the past year or so haven't lead to follow-up interviews or offers. Who wants to hire a big kid? If only I could use my child-like qualities to my ultimate advantage...hmmm...what would that be?

Wednesday, April 15, 2009

The definition of "effective"

Recently I have been thinking about the term "effective therapist" and trying to figure out what this means.

About a month ago, I teenage girl with whom I had been working working was psychiatrically hospitalized for threatening suicide and trying to run away. I had been working with her for about three months with little progress. She was a transfer from another therapist who left the agency (as is common where I work), and I had just been working on engaging with the client. I would arrive at her home and, week after week, she wouldn't want to talk. I happened to look at her chart and see a note written while she was in the hospital (we have staff who specifically contact the hospitals), and it said "mother is requesting a new counselor, feels current counselor is not effective. Plan: discuss complaint about counselor with supervisor."

I have often thought it and felt possibly clients have made comments to imply it, but I had never seen it written out so bluntly: "counselor (me) is not effective." Before this, I had already talked to my supervisor and the plan was for the client to go back through the crisis counseling program (and thus to another counselor) anyway, but I have to admit to read that took me aback and humbled me greatly. I knew this was a client and a family I hadn't made a great connection with, hadn't really helped to make any progress, so in many ways it didn't surprise me. (I also knew this family tends to look for external sources of their problems, rather than really looking at how multiple issues within their family just might be the reason this girl is having problems). But, overall, it really made me take a look at my own skills and think, what makes a therapist effective?

When I first started working in the field, a veteran therapist wisely told me [regarding working with kids] "you are just walking besides them on their journey." And I truly got that idea, deep down. Another therapist told me, "you might be the only positive adult in their life, and anything you do with a kid is therapeutic." So the days I was sitting playing tic tac toe or Uno I remembered that, that just being there was therapuetic. But was it effective?

The term "effective" seems to be up for interpretation. In everyday terms it means something like "getting the job done." I suppose it goes back to what is the goal of counseling/therapy, the job we are to do. And with kids, that is tricky. It often depends on who is saying the kid needs therapy, and usually that person is hardly ever the kid. Usually it's a parent, sometimes it's their school or family doctor, sometimes it's a by-product of a legal issue or crisis situation and not necessarily the kid or family's choice. Sometimes a parent just wants their son or daughter to "have someone to talk to", maybe because they are dealing with changes, losses, difficult times. Generally these parents feel anything I do is helpful and supportive. I play games or draw or just talk with the kid, hopefully they learn to trust me and talk to me about whatever...if it's how they miss their grandma, great, but if it's how they love their puppy, great too! Just get them talking, I heard someone else say once.

However, then there are cases where parents (or teachers, etc.) are looking for change, and looking for it NOW! These are cases where there's been a problem for awhile, and it's gotten bigger and bigger and more out of control. These are the kicks flipping desks or joining gangs and we are trying to intervene, but it's a little late. For these kids, if change doesn't happen in 2 or 3 sessions, or 2 or 3 months, then "counseling isn't working" and often they quit. Yet another wise co-worker told me to think of it this way, "if the child has been having emotional and behavioral problems for X number of years, it's probably going to take at least X number of years to correct, if not more. So we have to help them with baby steps, little miracles." But parents who are stressed want big miracles. I can understand this. We live in a world of instant gratification, pop a pill for this and that, quick fixes. I never promise big miracles.

I heard recently on the John Tesh Radio show "Intelligence for your Life" (which I often listen to on the way home from work and highly recommend, it's very interesting and helpful! http://www.tesh.com/) that animal trainers don't blame themselves when an animal doesn't correctly perform a trick, that behavior is behavior, and they just work on continuing to train them. I think, I can know all kinds of facts about psychology, behavior, therapy, interventions, and execute them perfectly under ideal circumstances and it still may not make a huge difference. Sometimes I feel like I fight losing battles daily against the bigger influences of society, socioeconomic hardship, genetics, generations of dysfunction and substance abuse. When I look at it that way, it makes it seem pretty impossible, and depressing! How on earth could a person be an "effective therapist" dealing with all of that??

Back to the story of my client, I decided that the most accurate way to state what was going on with her was that therapy was not effective; therapy, which included me as the therapist, but also includes her as the unwilling 16 year old who is not invested in therapy, an overwhelmed mother looking for medication and a therapist to erase years of bad parenting and unstable family circumstances.

So, maybe effectiveness isn't something about me, my skills, or personality; maybe it's an interaction of all the things I bring to the table and what the client brings. Maybe all I can do is try my best, try to encourage my clients to try their best, and hope for little miracles.

Monday, April 13, 2009

Ah, the holidays...

I remember as a kid, holidays seemed so magical. I waited in excited anticipation for Santa, the Easter Bunny...what would they bring me this year?



Then came the fateful day when I found the present hidden in my parents' closet, the one tagged "To: Kara, From: Santa". Could this be?? In order to find out, I used some fierce detective work; secretly wiggling out teeth for the Toothfairy, leaving it under my pillow without telling my parents. No quarter. I wrote letters to Santa and stuck them in the front window so they could magically fly away to the North Pole (ala "Santa Claus: The Movie"), but didn't mention anything to mom or dad. The letters stayed (until I mentioned to mom or dad that I had written a letter, then suddenly they were gone.) It was true. Holidays would never be the same.



And ever since, holidays have increasingly lost their luster. And as my brother and I grew from young children to adolescents, holidays evolved from larger gatherings with my mother's aunts and cousins or my uncle and his family, to gatherings of simply my mom, dad, and brother. It was hard because all of my grandparents were deceased, and I know on the holidays my parents would miss them, especially my mom, as she often was depressed come holiday time.

As I have become an adult, holidays have seemed to become times mixed with stress; the stress of rushing up and down interstates and splitting time between families, ultimately short-changing someone; the tension of awkwardness and forced conversations, the endless monotony of eating. Initially, my husband's very loud, very boisterous, very Italian family was a nice change from my quiet and dull family holidays. But even as his extended family grows larger and larger, his father's side still insists on having large get-togethers that include all of his aunts and uncles and cousins and cousin's spouses/significant others and children. This all-day event of eating not just lunch, but lunch and dinner (leftovers), followed by playing poker has grown rather stale and boring. Every recent holiday I have felt the post-holiday let-down, the sigh of "well it's all over now" and the disappointment of "that's it?" Perhaps my expectations are too high. As I have said before, I am often guilty of not enjoying the moment.

My hope is that when my husband and I have our own children that the spirit and joy of holidays will be renewed, that I will feel refreshed and reinvigorated and excited to celebrate with my own little ones, and that we can create our own family holiday traditions to make it feel special and magical for them.

Saturday, April 11, 2009

Marriage...

As promised earlier this week, I was going to write a post reflecting on my two years of marriage. Finally today I have a little free time to relax and reflect.

It seems ages ago, that fateful day when we met. We met at work. I never thought I would seriously date someone with whom I worked. One summer long ago my high school boyfriend and I had worked in the same factory; since then I had had crushes on co-workers and even went on one or two dates with co-workers, but that was during the time I worked at Sears, not at a full-time, professional job.

So there I was, fresh out of grad school, my second week of work. I didn't have any clients yet, I was in my office reading manuals and really pretty bored. I had met all of my other co-workers during my first week except this guy whose office was across the hall from mine, my new boss told me he was on vacation. So when this mystery guy finally appeared, he was busy and I got glimpses of him taking clients in and out of his office. Tall. Dark hair. Dark eyes. Hmmm. I was interested.

I can't remember now if it was that first day or the next when I boldly and uncharacteristically went over to his office, knocked on the door, and introduced myself. We talked briefly, and I remember him being friendly but surprisingly open and rather blunt. I left his office feeling off balance, like "what just happened?"and "who does this guy think he is?" I wasn't sure if I really liked him or really didn't. I just knew he was different than most any other guy I had ever met.

A friendship developed. We started talking more and more, and then spending time together outside of the office. But I had recently been blown off by another guy who I had been seeing off and on over the past year, and was still focused on that person and those feelings. I opened up to Michael about that guy and realized it was time to let go of that whole emotional baggage and move on. Maybe it was so I could move on to him.

We took a long walk on a humid summer night and talked about so many different things. Some where along the way we admitted growing feelings for each other...and well, the rest is history. Or actually, more accurately, the present.

That was nearly five years ago. Now it is hard to imagine a time we weren't together. I notice sometimes starting to take for granted that I have someone to go to bed with, wake up with, laugh with, cry with, and just share life with. But as I sit and recall the early days of our relationship, a reminder of the time when our lives weren't intertwined, I realize the beauty and blessings of being married. I am guilty of not enjoying every day and thanking God for every day I have been given with my husband, but as I look back, I see how much we've grown, how we've become more understanding, more tolerant. We challenge each other often, we differ, we disagree, but through this is always growth. And of course there is room to grow even more.

Here's to many, many more.

Tuesday, April 7, 2009

This past week

Ah, it's been a long, mixed up week. Here's a synopsis of all of the things going on since I last wrote....

*Work--chart audits = stress!! But, thank goodness, the audit was not as bad as I thought it would be. I imagined a workplace full of tension and stress and it seemed fairly normal. But the rest of the week I was dealing with a few client crises and chronically annoying situations that I just need to suck it up and deal with once and for all! However, one night after work I did go out for dinner with some co-workers to Rock Bottom. We vented and exchanged stories about my supervisor (who is unanimously voted as the worst boss in history!) I tried some kind of wheat ale and realized fancy beer isn't my thing (I like an occasional Corona or Bud Lite or Blue Moon.) Either way it was nice to socialize with co-workers, who I am around all the time but we are all so busy it's hard to take time to enjoy each other's company!

*Our Anniversary--Tuesday was my 2nd wedding anniversary. I had planned to write a whole blog reflecting on two years of marriage, and I still plan to, just haven't gotten to it yet. My husband and I went out the weekend before, so the actual anniversary wasn't much of anything special, we both worked late shifts. I had hoped when I got home from work that perhaps my husband might have gotten me flowers (I bought him some candy and a small present), but alas there were none. Flowers are so cliched but don't they just make your day??

*My Mom--For the past few weeks my mom has been undergoing various medical tests. She passed out a few weeks ago and was feeling dizzy, so her doctor wanted to find out why. Now, to explain, my mom is 60 and is in pretty poor overall health. She has a combination of mental and physical health problems so intertwined it's difficult to say what her primary problem is. She's got depression, anxiety, an eating disorder, all of which have lead to ulcers in her stomach and esophagus, leading to acid reflux and more problems eating and digesting food. These problems have been going on as long as I can remember. Over my lifetime, she had a few surgeries to repair the opening of her stomach, which was scarred and irritated, and back in 2003 they removed a majority of her stomach because it was so scarred. I love my mom, but over my entire lifetime I have never really seen her take good care of herself and am accepting that she isn't going to start now. My husband and I went to visit her and my dad this past weekend, and I can't help but starting to emotionally detach from her. This situation has been weighing heavily on my mind, and I feel guilty for feeling this way.

Oh yeah, and it snowed again, and it's April! At least today felt more like spring. But I was spending it at work.