[acb-hsp] Workaholism

[Baracco, Andrew W]

Hi Carmella,

As usual, I can relate to everything you have said.  I work in a setting
where you do not choose your clients. Sometimes it is a lot like working
on an assembly line.  And we currently have a program leader who does
what he can to stimulate a competitive atmosphere.  In 2005, he hired
some new staff to work on a new grant funded program.  These people were
truly on fire, working a lot of time off the clock, etc. I would come in
on Monday morning and find voicemail messages stamped on Saturday at 10
PM. Who in their right mind is working on Saturday night?  People were
chided for wanting to take vacation time that they had earned, being
told that if they couldn't arrange coverage, they couldn't get the time
off.  
Last year, he secured yet another grant for another new program. This
program featured hiring several vets who had been homeless to be what I
call "Barefoot counselors". The usual qualifications were watered down
in favor of an "It takes one to know one" mentality.  These people were
recently homeless themselves, and many were still living in VA sponsored
housing programs.  They were hired on 4 year terms, which means that
their jobs are only quaranteed for 4 years. Our program leader dangles
the possibility of permanent employment in front of them like a carrot,
even though he has no idea if this is even possible, but these people,
who see a government job as the holy grail will do anything to please.
Because of my years of employment, I am pretty much bullet proof in
terms of job security, but am shunned to a degree because I do not buy
into this mind set.  It is interesting to note that those folks who were
so on fire in 2005 are now completely burned out, and have fallen out of
favor with leadership. It is truly sad when you have worked so hard to
get where you are, only to find that you are regarded as little more
than a robot working on an assembly line.

Andy


-----Original Message-----
From: acb-hsp-bounces at acb.org [mailto:acb-hsp-bounces at acb.org] On Behalf
Of Carmella D Broome
Sent: Wednesday, October 03, 2012 7:24 PM
To: Discussion list for ACB human service professionals
Subject: Re: [acb-hsp] Workaholism

The sipping point.  That was funny.
I think workaholism is alive and well in the  helping professions. Most
community MHCs are overloaded.  Caseloads are huge and  the demands on
the clinician can be ridiculous.  That's why so many people get out of
that setting sooner or later.  They  know they're not providing the
level of care 
they want to.  They know the stress is getting to them. They   know
dreading 
going to work is not how they should feel.  Those getting a private
practice started may  put in some long hours becoming established.
Those in rural areas or with  sought after specializations  might have a
very hard time 
turning anyone away because they know  needs will not be met.   Those
are 
all tough situations.   There are plenty of other settings where  the 
clinician is pushed to overextend him/herself. There are just as many
where providers choose to do this, though.  It makes me concerned for
all involved.

Why do we push so hard?  What are we trying to prove and who are we
trying 
to prove it to?     Is it about us more than about our clients?    Why
the 
need to be the world's best most dedicated therapist?  I get kind of
tired of  the  mental health professional hero martyr complex.  We're
allowed to be human and should be human, not superhuman.

Handle  your job that way if you want, but don't  look down on me if I 
don't.   Everyone has  different  energy levels and  we all differ in
terms 
of how much stress we can, or want to,  deal with.  Some therapists are
dealing with their own physical or  emotional limitations or have other
family obligations or other interests that are  very important to them.
We all know what  feels healthy and balanced and when we're there vs
when we're not.

I often get the feeling that, in order to show yourself to be a  "truly
committed"  mental health professional, one must  basically demonstrate
this commitment by being a workaholic.  If its not about  commitment,
its about how many hours you have to  work a week to make ends meet
financially, whether or not  you are  truly able to handle such a large
caseload well and whether or not  you may not be as good a therapist to
your clients.  If you don't/one doesn't, work  extra, sacrifice blocked
off time, and  doesn't 
"give til it hurts,"   dedication level is suspect and there's  subtle
guilt 
or pressure from colleagues  or supervisors to do more.

I know people that work  12 hour days on a regular basis, never take
vacations,  are always doing some related professional something or
other 
when   they're not at work, and   literally seem  to eat, sleep, and
breathe 
this stuff.  They're going to talk about how hard they work, too, and
how "that's just what you have to do when you go  into this kind of
work." 
They're proud of their stamina, their dedication, their   willingness to

extend themselves just a little more to save one more person, to
intervene even though they were hungry and exhausted and had to  cancel
other plans.

I've  seen interns in  situations where its almost like they're put
through some  kind of therapy hazing experience to see if they can hack
it.  They're given nightmare cases. New professionals are afraid to say
"No" as more and more is put on them.  They're afraid to say "I don't
think I can see that many people in a row without a break," or "I don't
know if I should take on that case," or "No,  I can't work this weekend
due to family obligations." 
"I'd rather not drive six hours each way to  go to that conference after
working all week."  "I've had the after hours phone for a month straight
and I need a couple  days without it."

Some people take on absolutely any and every case that comes their way. 
Not only do they not have time for so many clients, but they also  can't
possibly be  skilled enough to address every possible  therapeutic need.
I don't care how gifted, skilled, talented, or spiritually called to
this work you are, that's just not possible. Of course,  many people
seem to want to get certified in every niche and specialization known to
God and man and spend all their extra time and money  pursuing  extra
credentials.  I wonder why. Why the need to know how to help every  type
of client when there are others around who  have specializations  and
are appropriate referrals?  Why 
try and be thoroughly competent in every  treatment modality?   That's
just 
not possible. Do some people think no one could do therapy  as well as
they can? It seems that way sometimes.

I understand if you're the only provider in a very rural area.  Beyond
that, though, there's just no reason to try to know everything about
everything. 
I'm all about knowing which populations I don't  want to/am not
qualified to, work with or what I don't specialize in and having a
network of other medical and mental health people to refer to.  I trust
these folks and am 
comfortable with them and   know that referrals I make are in good
hands. 
Granted, there are plenty of therapists, or enough of them, near where I
am to do this. I know that's not always the case. It may  be even less
the case if you're working with low income clients without insurance and
such.

I know people who regularly  stay late to see  clients who need to be
seen that day.  They  come in early for the same reason.  They  come in
on days off to see clients or to do paperwork.  They make sure those
around them know they  did these things, too. If someone chooses to work
marathon days, opens up  additional hours beyond their usual schedule
for clients,  spends weekends doing paperwork, gives out their personal
phone number, and takes on new  cases  even though they don't know how
they'll fit everyone in, that's their choice.  If they think they can't
leave their clients long enough to take a vacation  and  work extra
before and after doing so, then that's their right.  I personally don't
want  to  be the kind of therapist 
who's clients are truly that dependent on me all the time.   Back up for

managing crisis situations should be sufficient. I think it is a little
egotistical to think we can't  step away from our clients for five
minutes 
without someone having a major life crisis.   Are we  making them  that
way 
to meet our own needs?   Are we helping them or enabling them or what?
If 
someone is that unstable, they need a higher level of care involving a
treatment team, not just one therapist.

Maybe  some people can just be that steady, have that much energy,  can
truly be able to care for themselves and their clients, and they truly
do want to spend so much time on  career goals.  That's  up to them.  I
don't want to judge, but I do get concerned for them and for their
clients. I'm skeptical of how long people can do this well.  I also
resent the implication that anyone who doesn't do these things the same
way is  not thought to be as dedicated or passionate about their work.

Personally, I've realized knowing my limits is crucial to professional
and personal survival. I think it is ethically irresponsible to
overextend ourselves.  Clients deserve our full attention and  being
overwhelmed by a caseload that is too large is  a recipe for something
important to get overlooked or for  service to be compromised somehow,
even if it  is just because a person is distracted or tired or simply
too busy with too many other people to take  appropriate action.  This
work, to me, is about quality vs quantity. I'm not trying to break any
records for how many sessions I can  cram into a week before collapsing.
I'm not  competing with 
anyone to  see   who had the most severe crisis case or   most difficult

case this week,  and how much extra time was taken  beyond the time
alotted for the session.  I'm not going to be guilt ridden if I didn't
take on 10 new pro bono cases or if  I charged a client for deciding
not to attend a session without an important reason.

I  also think it can be hypocritical to  preach self care to our
clients, and to talk with them about "shoulds" and boundaries and
differentiation, and then not  put those things in place for ourselves.
None of us can see every client with every issue at any time of day no
matter how many hours we've already worked that week.  None of us are so
special that we can't refer, delegate, or say "No" if its more than we
can or should take on.  We need to  practice  the balance we preach and
not be martyrs to our profession. We need personal lives, hobbies, and
to make  time for pursuits outside of work.

This doesn't mean we aren't dedicated.  It means we want to  do our
jobs well and  be able to continue in the profession for  a long time.
This is not a sprint; its a  marathon and pacing seems very important.
Use up all your energy too soon and you just fall behind and drop out
sooner rather than maintaining a  pace that is  consistent and
reasonable. We all need to stretch and grow and challenge ourselves, but
we need to be wise minded about this, too.  Join professional orgs and
take part in meaningful 
committees or other groups.   Read and take  CEU courses and  other
classes 
that interest you.   Take extra time now and then for particular clients
if 
you choose to do so for particular reasons, but   do so because you
really 
do want to and freely choose to.

Counseling is draining work.   If we're not careful and self-aware,
we'll 
all be burned out, vicariously traumatized, compassion fatigued,
resentful that we've let our jobs drain the life out of us, and of no
use to anyone, including ourselves.  And as we  so often tell our
clients, if those things happen, they're due to our own choices entered
into for whatever subconscious or  psychologically complicated reasons.

Climbing down from soap box now.

Carmella Broome EdS LPC LMFT
Crossroads Counseling Center, Lexington SC
http://CounselorCarmella.WordPress.com
Author of Carmella's Quest:  Taking On College Sight Unseen (Red Letter
Press 2009) http://CarmellasQuest.LiveJournal.com


Carmella Broome EdS LPC LMFT
Crossroads Counseling Center, Lexington SC
http://CounselorCarmella.WordPress.com
Author of Carmella's Quest:  Taking On College Sight Unseen (Red Letter 
Press 2009)
http://CarmellasQuest.LiveJournal.com 

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