Getting Pepper Sprayed is no bueno.

I thought I had left most of the dangerous occupational hazards behind when I left the ambulance. And I certainly didn't think that I would encounter these hazards in graduate school. Yet, yesterday I was pepper sprayed by one of my clients. It wasn't a direct hit, nor was it fully intentional. It was a middle school aged kid making some very bad decisions. I have no doubt that there was not malicious intent. Another student brought a canister of pepper spray to school disguised as a pen, and he thought it would be funny to discharge it about 5 feet away from me in my direction. Almost immediately everyone in the room, including myself started coughing. We evacuated the room, but my asthma was already severely flared up. 1 ambulance ride, CPAP, Continuous A&A, solumedrol, and sub Q epi later... I finally got to come home and rest. What a day.

Teaching... sucks.

I've hit that point in my MSW internship where I just dread going... I've been told it happens. But here I am, on a Sunday evening, near tears because I just don't want to go tomorrow. The biggest things that I can focus on that I've learned right now are 1. That I do not want to work with middle school age kids. 2. That I do not want to work in a school environment, and 3. That I HATE teaching.

Not very strength based... very anti social-workey. But here I am.

The last 2 times I've taught, the class got rowdy and totally out of control. I had no idea how to handle it, and actually had to excuse myself to the bathroom once because I was about to cry in front of the kids. I don't feel like I have a lot of support in that department. L., the just recently graduated MSW there is one of the teachers, and she has no idea how to handle the classroom, because she is SO strength based, that she can't consequence. And J. (my task supervisor), a veteran teacher with this demographic while having the best intentions, has a "figure it out yourself" teaching approach for me, that is just not working! I have NO training on how to teach, and I'm expected to teach for 1.5 hours.... and I have not been able to hold their attention for 1.5 hours yet.

I am supposed to teach an A.R.T. Lesson tomorrow (there are words like respect, team work, caring, etc. that I have to develop a lesson around). I decided to do a bully prevention lesson, and incorporate those words into what I'm doing. It's a great lesson - I start with an empathy game, followed by reading an excerpt from "Dear Bully", some other stuff, and finally empathy activity by listening to music and talking about what the musician is talking about. I got a phone call saying J. is not going to be there... so once again, I have no support for my lesson... and the more I look at things, the more I'm losing confidence that it will be a good lesson.

I know I need to go in with confidence blazing... but I just don't have any.

Mandatory Reporting

I'm feeling a little disenchanted with social work after today.

I did my first mandatory report to DHS today. One of my clients has been absent for the last two days, allegedly home sick. But when he returned today, he had an obvious physical injury - that was NOT caused by what the guardian claimed.

The client told us this story about getting high and drunk with his cousins and guardians over the weekend, and blacked out. When he awoke he had the injury, not sure how it occurred. He spoke of being encouraged to use OTC's recreationally by his guardian, who also further enabled him by purchasing him booze.

DHS said they would look at it in the morning and see if it warranted a caseworker.

My supervisor then told me about 2 kids he reported on last year who directly said that their mother was physically abusing them, and they had visible signs of abuse. DHS did nothing.

What's the point of reporting if nothing happens? I know the system is broken, but can I really make a change on a micro level if the macro and mezzo levels of the system aren't doing their part??

Manifestation of Microaggressions

Yesterday morning, I was getting ready to go to the farmers market. The plan was to drive there, leave my room mate with the car, and bike home. As I was loading my bike into the car, I had Amos on the leash (but not holding it very tight), and a man with a pit bull walked by. Now I have reason to suspect that this pit bull is used as a fighting dog. I have seen it around the neighborhood on numerous occasions, and it always has new cuts and injuries. Anyhow, Amos pulled free of me, and ran over to greet/play with the dog. The dog attacked him. Amos naturally fought back. The owner was screaming all sorts of profanities at me, including calling me a f-ing c u next tuesday. Between my dog being attacked and being called abhorrent names, I saw red and screamed back at the guy telling him that he shouldn't even have a pit bull in Denver - as they are ILLEGAL. I got Amos's leash and we walked briskly in the other direction.

The entire day I was fuming partially at the dog owner, partially at the situation, and partially at my reaction to the owner. The owner was latino, and obviously of lesser education and lower socio-economic background than myself. Would he have been screaming at me if I were not white and privileged? Would I have screamed at him if he were from the same background as myself? I was sickened by myself and how I kept going over the racial stereotypes - and found myself laughing later that day when I drove by a beat up rusted out 2 door sports car, with a latina woman driving - the car had a bumper sticker with the outline of a pit bull head and it said "if it ain't pit it it ain't shit". It embodied the stereotype of I had been fuming about all day. Which of course leads me to question, is it people of power that force minorities into that stereotype?

When the end of the day came, I decided that I would have screamed at the dog owner no matter what his race or class because I have absolutely zero tolerance for animal mistreatment, nor do I have any tolerance for being called a c u next tuesday.

Multi cultural is making me think... about everything I do, think and say. Oh yeah, and Amos is ok.

Who Let The Crazies In???

I entered my MSW program with the assumption/expectation that I was going to be surrounded by mature, emotionally stable and developed people. The biggest lesson that I learned during the first week of classes was that this was not necessarily true. There is great diversity of emotional and social development among students and faculty alike.

In a small discussion with some people in my "Social Work Practice Lab" (which is basically an intro to clinical class), I divulged that I was, and have been in therapy. It was pertinent to the conversation and it's not something I'm ashamed of, nor did I divulge WHY I'm in therapy. One of my classmates took my openness as an invitation to deluge all her issues to me. Initially, I was just thinking "woah, this woman has boundary issues", but then later she accosted me about my weight - wanting me to commiserate with her on weight loss, and her very Americanized weight management views (which I'm simply not willing to do). When I refused very politely but firmly to engage in that conversation, she told me I was in denial about my weight, and nastily retorted "I hope you have a nice weekend" and stormed off.

My professor for History of Social Welfare class is another person who will force me to maintain my center. In addition to teaching, she is heavily involved with Shapedown - a program for overweight kids and their families at The Children's Hospital. As a former client of Shapdown, I have unbelievably strong oppositional feelings towards the program. I developed bulimia during that program, and it would not surprise me to hear that I was not the only kid who developed an eating disorder during that program. It was apparent to me that my professor has, at the very least, disordered restrictive eating.

Its an interesting revelation that observation of other people's psychological states allowed me to more clearly understand where I am in my own process. The more I understand about myself and where I am, the better I think I'm going to be able to listen with compassion and empathy, and work with people through their own processes.

Oppression

I've always hated the word. Through the first week of my MSW readings, I have encountered it more often than I thought possible - were talking nearly every line in some readings. My initial reaction contained a lot of guilt and resistance. Am I in for 2 years of forced self flagellation due to my class race and culture?
As I continued into the readings, intermittently shouting rants at my dog (as he was the only one who would listen) I began to realize that I was thinking critically! Hold the reins there a sec... They tricked me! Before I knew it I was redefining "oppression" to myself, identifying both the oppressor and the oppressed within myself. I became aware of the emerging concept that this was not to be an experience of degradation and remorse but to lead me to better understand my origins, and those of others: you can not adequately understand client systems without first understanding the oppressed and oppressor within yourself.

Foundation Internship

After being lead to believe that I had landed the internship at the Y, I received an email late on Friday, very curtly informing me that I " was not selected for the Y internship". It was one sentence. No salutation, no explanation, no thank you for expressing interest. To make matters worse, there was absolutely nothing I could do about not having an internship (which is supposed to begin on Sept. 18) over the weekend. I managed not to fall into a spiral of panic only by spiraling into depression. All I wanted to do all weekend was sleep.


This week began with a rush of exchanging e mails with my field coordinator, and the human resources dept at Excelsior (my job), and phone calls to a new list of agencies with potential internships. I was able to secure a fall back option for internship at Excelsior. I really do not want to do this, because my responsibilities as a first year intern would be nearly identical to what I do now. As I plan to continue to work there on a fill in basis throughout grad school, I don't want to do the SAME job, and not get paid for it. Plus, I know how to do my job. The whole point of internship is to do something new. As I've heard back from more and more agencies this week, I'm finding all internship positions are filled. Crapola.


There is however one placement that still has an open spot. It's with the Rocky Mountain MS Foundation Adult Day Program. They offer a multitude of classes for adults with MS, and some with brain injury (did not specify if it was anoxic brain injury or traumatic brain injury). My responsibilities there would include facilitating classes, running group therapy, and psycho-social support. From what I understand there is a lot of flexibility in the internship for me to design my own curriculum. This is a definite "pro" for the agency - as it maps on to my Hampshire background. What concerns me is that they focus so much on people with disabilities, and an older demographic. I'm not sure if this demographic is one that I want to work with. I'm trying to separate my fear of something new (I'm accustomed to working with at risk youth), and my reservations for working with a population that might not be all there - I've found I'm just better with a higher functioning demographic - at least in youth.

Perhaps this level of ambivalence and trepidation is a good indication that I should accept this placement? It could be a phenomenal learning experience.

Aurora teens work to find ways to handle bullying

We were on the news on Tuesday!

Dan Evans, country singer and also former participant of The Biggest Loser came to visit our facility on Tuesday. It's anti-bullying week, and he talked to them about bullying and what they can do about it. At the facility we run strong anti-bullying campaigns, and this time we got some news attention.

One of my favorite kiddos, (and quite possibly the worlds shortest basketball team captain (coming in at towering 4'9")) did an interview with Dan Evans, which was televised. C. was a former bully (and has the most horrendous past I've ever heard), who has now become one of the strongest roll models and leaders. She's such a cool kid.

I couldn't find the full clip of her, so sad...

Aurora teens work to find ways to handle bullying

Evil Bitch Monster From Hell

I have this client whom I shall call the evil bitch monster from Hell. Now I know that this is the antithesis of therapeutic. I'm way past therapeutic with this little shit.
A little bit of background is in order. The evil bitch monster from hell entered the facility about four years ago. She has some mild mental retardation a dysfunctional family and was molested once by her step brother. She has more attention from staff, family, mentors and special programming just for her. She is the most self entitled little snot I've ever met. Also she is incredibly assaultive but there's nothing we can do about it even though she's 18, because the court has declared her incompetent (which shes not). She even threatens "I can hit you and there's nothing you can do about it". It's infuriating.

This evening she was not following directives, and trying to do unnecessary laundry 20 minutes after her bedtime. I told her no, and that she needs to work on her time management. The evil bitch monster from hell started screaming in my face and posturing at me. She eventually went up to the intervention unit where she demanded that I give her a hug. When I refused, explaining to her that I would not hug her after the way that shed been treating me, and that when she was having better behavior I would be happy to give her a hug, she sat down in the middle of the hall and started screaming. I just walked out. (it would be different I this was not a daily attention seeking occurrence). Later, my co-worker D.V. Called and told me that she spent the next 45 minutes crawling between and around his legs. She then started licking his shoe. Gross.
She's fricking 18 and DECIDES to do this for attention.

Matching socks

This morning I let my extremely low functioning client with severe paranoid schizophrenia into the storage closet to pick out clean clothes to change into after showering.
As always, she ceremoniously opened each drawer one at a time, methodically riffled through each in turn, and closed them. By the end she has a collection or garments that you're not sure how she's going to formulate an outfit (yet she always manages to come out fully dressed).
Then she goes to the sock drawer, where all the socks are singles. She stares pensively at the socks for several moments and then picks a sock out. She then will very slowly pick up other socks and hold the two together, seemingly to carefully consider the combination, discarding the second sock into the drawer until she has found a combination that suits her - albeit not usually matching.

Prostitution for 400 please

The other day we had a phase group for a client (phases are the clients progress in therapy). When a client is applying for their phase II, they must complete a series of tasks including writing their life stories, making a road map of how they've gotten to where they are, facilitate a therapeutic group about their primary issue to their peers, and presenting/defending their phase to their treatment team.
This clients primary issues are prostitution and abuse(which of course go hand and hand). She read her life story, which depicted a traumatized child who was raised transiently in motel rooms, pretending to be asleep while her mother serviced her Johns in the next bed over. A child who was molested by her uncle at age 5 and was prostituting by age 12, and arrested for it at 13.
We then played 'prostitution jeopardy' which while was entertaining and educational, prompted some disturbing commentary and discussion from our hypersexualized kiddos. The comment that stands out to me the most was 'I hate it when men abuse me. I don't even really like it when they rape me". Even after eight months here those comments floor me. Their childhoods were so starkly different from mine that I don't know if I will understand the normalcy of this lifestyle for these girls.

Masks

In one of the units at work, a select group of clients who have displayed progress in their own treatment and have had good behavior are part of a leadership group

There is an upcoming art show being put on by the recreation department. Our leadership group was asked to make something to contribute to the show.

On Tuesday night, I took six of the clients in the leadership program, we stayed up late and decorated these masks. I put out all of the arts and crafts supplies that I could find in the cottage ranging from tissue paper and glue, sequins, paint, and markers.

Each of the clients decorated a mask. The creativity that ensued took my breath away. Each mask is such a statement of the emotional space that the girl was in that evening. Some of the masks brought tears to my eyes, while others made me laugh outright.

This mask, while a little difficult to see in the picture is all women's faces - from all sorts of magazines. There are women of every size, color, and culture that could be found in our limited magazine stash. This is one of the two that spoke to me the most.

Such a cool project. These are the moments that I positively love my job. I get to watch kids be kids, and let their creative juices flow, and watch them laugh, and be 'normal'... if only for an hour.

Toothpaste

I never want to see toothpaste again.

This evening, one of my client's (who was recently diagnosed with Aspergers) was having difficulty following staff directives (to go get in the shower), and became emotionally dysregulated with escalated behaviors. She proceeded to walk into the bathroom without asking permission, and filled up the center of a toiled paper roll with a concoction of shampoo, conditioner, body wash (about 2 tablespoons of each), and an ENTIRE tube of toothpaste. Add a little water, give it a good stir.... and then start flinging it about the bathroom. While she was at it, it seemed prudent to soak all of the toilet paper on said roll with the toothpaste soup, and fling giant spit-wadesque masses at the walls... the ceiling... and of course at me.

As frustrated as I was.... I couldn't help but be thankful for the minty freshness, and not mind the smearing of it over every surface in the bathroom, when my clients have been known to liberally finger paint with their own excrement and menstrual blood.

When I got home, I discovered tooth paste in area's tooth paste ought not go. I just may have to brave through the taste and start brushing my teeth with baking soda.

Graduate School!

Last week, I was accepted as a foundation year student in The University of Denver Graduate School of Social Work!

GIGGITY!

Nutrition

I have to pat myself on the back a little bit. Since I've been working at my facility, I've been talking to the director about the correlation of nutrition and behavior. They're finally re-evaluating some of the nutrition and wellness issues. They're re-evaluating the contents of the vending machine and are pricing out more healthy options. The cafeteria is going to start sending veggies to the units for clients to snack on. We already get fresh fruit. It's a small start, but it's being talked about, and I'm thrilled!

I'm old!

Ugh... I took a 15 year old client to the hospital the other night for vomiting blood, and all the nurses (and even the doc) kept assuming that I was her mother. I would have been 12 when she was born....

Do I really look that old?!

Gang Activity

I learned about a new (new to me) gang tonight at work. After searching the client's school folders, I was showing a co-worker

this sexually inappropriate, slightly creepy drawing I confiscated from one of the folders. She immediately expressed concern that it was gang related... The Juggalos (or Juggalette feminine). Huh... never heard of it.

The Jugglos were initially started at an ICP concert when one of the musicians referred to the crowd as Juggalos... and it stuck. There have been violent acts ranging from homicide to arson

associated with the Juggalos, and due to this activity they have been classified as a gang in Utah, Pennsylvania, Arizona, and California. Though "studies have shown" that the violence has no relation to ICP's music, this is why ICP paraphernalia is not allowed in schools... I always wondered that.

Additionally my co-worker filled me in that Juggalo's "worship" the hatchet man, and carry hatchets as their preferred weapons (rather than guns). They consider themselves to be societal outcasts, and to be a family. Several of them will paint their faces like ICP.

Therapy Dog

I had a meeting today with my potential new boss, who is the therapist that runs the Canine Healers at Excelsior. In addition to Interviewing for the open position for Group Living Counselor in Edge Point, I expressed my interest in animal assisted therapy, and my desire to 1. Train Amos to be a therapy dog, and 2. to specialize in animal assisted therapy. She told me to look at TDI (Therapy Dogs International), or Delta, which are the two most recognized certifications for therapy dogs.

I was looking at the behavior requirements for TDI, and I'm feeling a little bit discouraged that Amos will be able to become a therapy dog. There are several things he can do, but several he just can't.

1. Greeting people and sitting politely for petting. Amos is just too exuberant, and happy to see everybody. I've worked with him with this...
2. The dog will welcome being groomed and examined and will permit a stranger such as a vet, groomer or friend of the owner to do so. Yeah right... ain't gonna happen. Amos is TERRIFIED of being groomed, and totally flips his shit every time he sees the brush, unless I have him in a small enclosed room (such as the bathroom), and am giving him treats every 30 seconds and am speaking sweetly to him... and even then its a bit of a struggle.
3. Coming when called.... needs some work. He's just inconsistent, which I know is my fault, as I'm inconsistent as well.

These are the one's that I'm worried about. I keep telling myself manners can be learned.... It just might be a bit of a process.... Le sigh.

Group Ideas

Part of my quarterly goal is to start to plan and facilitate groups for my clients. (This will become easier if I get the position I just expressed interest in in ONE unit). I already have several ideas.

Nutrition Group

This idea is still in rudimentary form...

I want to make a handout with nutrition information

Carbohydrates - The difference between good and bad carbs. Whole grain foods are rich in vitamins, minerals, fiber, and phytochemicals. When grains are refined the bran and germ portions are remove, and the endosperm is all that remains. 25-90% of the nutrients are removed!

What are whole grain foods? Brown and wild rice, popcorn, corn, whole wheat, oatmeal etc.

Aim for 3 grains and starches a day!

Proteins - Build, repair, and maintain all of your body tissues. If you don't eat enough carbs, proteins are broken down to use for energy. When this happens, protein is unavailable to maintain muscle, and you lose musce mass. Protein makes a meal feel more satisfying and sits in your stomach longer. It gives us an energy boost, and slightly elevates the metabolic rate.

Sources of proteins include: meat, chicken, fish, eggs, nuts and beans.

Fats - Not all fats are bad! Monounsataurated fats, Polyunsaturated fats, Omega-3's, and Trans fats. Talk about what cholesterol is, and which fats you should chose to maintain cholesterol.

Fruits and Veggies - Still working on this one

Aim for 3 veggies and 3 fruits a day!

Dairy (or dairy substitute)

Calcium and Vitamin D - Vital for bone growth and maintenance .

2-3 Servings a day

The Nutrition/Mood connection - Multiple studies have shown that a balanced died has a direct effect on mood and psychological function. A diet rich in fruits and vegetables, nuts, whole grains, and lean proteins will provide your body the nutrients it needs to function properly, and ultimately make you a happier person!

I then want to have some sort of activity. Right now my idea is to bring in paper plates (that you can draw on), and markers, and have each of the clients draw out a balanced meal that they would enjoy eating.

Some fun facts about suicide

Yesterday, I had to attend a Depression and Suicide prevention inservice for work... some parts of my job can be so incredibly uplifting. There were several interesting facts I learned that I had previously not known.

• More Americans die by suicide than by homicide.
• 93% of all suicides are completed by persons with an Axis I diagnosis
• Suicide is the leading cause of death for persons with Bipolar Disorder
• 15% of persons with Major Depressive Disorder will take their own lives, at a cost of $8 billion dollars to the U.S. economy per year.
• 15% of persons with Schizophrenia die by suicide
• 5-7% of persons with Borderline Personality Disorder die by suicide
• 50% of completed suicides met with a mental health provider at some time in their life
• 17% will be in treatment with a mental health provider at the time of their suicide
• Limitations on inpatient services, shortened lengths-of-stay and premature discharge have shifted the risk of suicide malpractice to outpatient providers
• Graduate schools preparing practitioners for the mental health field provide little in the way of formal course work in suicide risk assessment and risk management
• Mental health care providers are not immune to the myths, misperceptions, stigma and taboos associated with suicide. They may be reluctant to deal with the subject in an honest and helpful fashion.
• The well intended, but uninformed acts of caring professional communities are no substitute for specific knowledge about suicidal behavior, ignorance can not be an excuse for poor practice.
• Studies have repeatedly shown 85% of suicides are premeditated and approximately 90% of persons who take their own lives communicate their intentions to someone they know, frequently a health care provider.
• Suicide malpractice claims are the leading cause of suits against all mental health practitioners, including psychiatrists, psychologists, social workers, and nurses.

It really made me think of the ignorant attitude of EMS providers towards psychiatric patients. It is upsetting that many EMS providers are not even well intended - they willingly buy into the stigma and taboo of psychiatric disorders and suicide, dismissing them as medical concerns. I have even heard providers call these patients "a waste of oxygen". 911 is often the first line of help for patients with suicidal ideation. They are asking for help - a task that can be exceedingly difficult to do when in that state of mind. I wish they would receive the degree of respect that they deserve.

Reminiscing on my days in EMS makes me incredibly thankful that I shifted my career.