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Mental Health

Five Tips for Overcoming Self-Doubt

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Your comfort zone

Some self-disclosure here—I’m a rather sensitive person and I often tend towards self-doubt, thinking something is my fault if it doesn’t go well and lots of critical voices in my head always.  With time, I’ve learned to see this as a strength since it means I’m constantly evaluating myself and pushing myself to become better.  However, often in the day to day, this self-doubt can be difficult.  And especially so in the field of social work, where decisions made often have far-reaching repercussions.

Over the years I’ve had to develop methods to help me not to linger in my own self-doubt and to feel more confident in my decision-making.  I’m guessing there are other social workers out there who have struggles with self-doubt as well, so wanted to share the methods I’ve used and continue to use today, to help feel confident and to shake off the nagging self-doubt voice.  These are applicable to non-social workers, as well so feel free to share with others you know who might find these ideas helpful.

1. Regular self-reflection.

This almost seems counter-intuitive, but I’ve found it to be very helpful. For years, I don’t think I recognized or acknowledged my struggles with self-doubt and so maybe didn’t realize I needed the extra support.  It can be helpful to talk with your supervisor about your own self-doubt so that they can help you process what is reality versus what is going on in your mind. Once you become more accustomed to those kinds of questions, you can ask them of yourself.  This will help you to be able to figure out what is the truth in the situation compared to thoughts based on self-doubt. Are there tangible things to be learned that will help you improve your practice in the future? If so, learn from the experience and move on.

2. Continued professional development.

I love learning…and have found that when I know more about myself, about the profession, about current practices, current issues, etc., the more I feel like and am a competent social worker. It’s interesting, but I feel this area has actually gotten harder to take time for as my personal life has gotten busier and required more of me.  I didn’t realize how much I craved professional development until I did take two days a few months ago and went to a conference that for me was all about professional development.  I left feeling so recharged, confident, excited…and during a timeframe when if I had not gone I probably would have felt professionally drained and would have questioned myself lots and lots.  By taking the time for professional development, one grows. And when you know you are growing, self-doubt can take a back seat.

3. Be aware of your biases.

Letting my supervisors and/or trusted colleagues know my biases and asking them to push me on certain topics based on my own self-awareness has been extremely helpful. Self-reflection leads to self-awareness.  I know most of my biases…and have been sure to share the ones I know about with my supervisors. Often this has been within the context of case-specific work. When I know I’m struggling with a decision because of my own experiences and biases I share that.

I think it’s so important to know and acknowledge my lens and share it with others, not to convince them that my lens is right, but so that they can help by asking further questions and making sure my assessment is based on all of the facts of the situation.  Having others there to help me explore means a more collective decision-making process as well, and more minds and eyes on the situation generally lead to better, more well-thought-out decisions and less self-doubt.

4. Learn from perceived mistakes and trust your gut.

I’ve been in the same general profession, a social worker in child welfare for over a decade.  I’ve seen my successes and I’ve seen my failures.  There are, sadly, cases I worked on over 10 years ago that I ran across again because of failed adoptions or failed reunification…adoptions and reunifications that I was in some capacity a part of.  And hearing about these cases breaks my heart and makes me want to crawl under a rock because of my participation in something that did not turn out to be the positive ending that I thought it would.

But, once I’m ready to pop my head back out and again go back to #1 and reflect, usually there is some wisdom gained.  Sometimes it means I realize I had a gut reaction, and the next time someone else brings me a gut reaction about a case I will push them further—will point out the importance of the decision and will ask what else can we assess so that the gut reaction isn’t just a gut.   If you are a natural self-doubter and in social work, then PLEASE, PLEASE, PLEASE, trust your gut. And then dig…you may find something concrete to support your gut.  I’m 98% sure of it.

5. Practice self-compassion.

No one is perfect. Even those who don’t struggle with self-doubt are not perfect.  As a natural self-doubter, you are also a natural self-improvement person and that is actually a sign of a true leader.  You will take the time to recognize what you need improvement in and improve it.  And when you doubt yourself and it’s not warranted, with time you will learn to treat yourself with the same compassion that you treat others with.  I’m still working on this piece, but am realizing how important it is to treat myself as I would a friend–listen, acknowledge, support, and be kind.  By doing so, I can move on and be better next time, without unnecessary guilt to hold me back.

Do you struggle with self-doubt in regards to your decision-making and/or work life in general?  How do you help to overcome it? Do you (like me) see this as a potential strength?  I’d love to hear from you so we can learn from one another!

Rachel Castillo, MSW is a licensed Advanced Practice Social Worker and has been working in the area of child welfare for over 10 years. She is the founder of www.socialworkcommunity.com, a website/blog with the goal of creating a positive community for social workers to gather, connect, and inspire one another. Rachel is also a proud mama and is always on the lookout for ways to improve her own self-care as well as encouraging those around her to do the same.

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Human Services

Is Counseling For You

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Have you been in counseling or therapy? If not, have you ever hesitated in seeing a counselor, or wondered why you felt so wary? Studies show about 20-35% of Americans having attended some form of counseling and psychotherapy compared to approximately 80% of mental health professionals.

Believing that counseling and psychotherapy could be helpful for anyone in alleviating problems, improving relationships, and developing a more positive outlook toward life, a Journal for Human Services research study explores why some people attend counseling or therapy while others do not.

Researchers, Ed Neukrug, Mike Kalkbrenner, and Sandy Griffith wondered why it was that some people seemed readily to attend counseling while others hesitate or who don’t attend often to their own detriment. Their research on attendance in counseling of helping professionals and their upcoming research on attendance in counseling of the public in general offers a thoughtful analysis which will hopefully shed some light on this important concern.

After an exhaustive review of the literature, researchers independently looked at over 60 potential barriers to attendance in counseling and eventually reduced this number down to 32 specific items. Their research found three broad areas or reasons likely to affect individuals who tend to avoid counseling and therapy. They identified these areas as “Fit,” “Stigma,” and “Value” to reflect the areas they represent.

Factor 1: Fit

Fit has to do with one’s sense of comfort with being in counseling and whether one has the ability to trust the process of counseling will be beneficial. Some typical fit questions were related to whether a potential client believed a counselor would feel comfortable with the potential client’s sexuality, disability, or other aspects of the client’s identity. Other questions in this area assessed whether a potential client believed a counselor could understand him or her, was competent enough to deal with the client’s problem and could keep the client’s concerns confidential. In addition, other “fit” questions queried whether potential clients had a bad experience with a counselor in the past and if they thought they could find a counselor near to where they lived

Factor 2: Stigma

Stigma is the feeling of shame or embarrassment some people experience when they consider entering a counseling relationship. Some of the stigma questions highlighted whether a potential client believed their friends, family, peers, colleagues, or supervisors might view them negatively if they knew the individual was in counseling. Other questions focused on how some potential clients might consider themselves weak, embarrassed, or unstable if they were in counseling. Often, those with high scores on stigma believed others would judge them, and thus, they would feel badly if they were to enter counseling.

Factor 3: Value

Value is the perceived benefit or worth one believes he or she is receiving from attendance in counseling. Potential clients who would score high in this area often believed the financial cost of counseling was not worth its benefits. Participants in this category simply could not afford counseling or they didn’t have time for it. Many participants in this category believed counseling wasn’t necessary because problems usually resolve on their own, or that counseling was simply not an effective use of their time. These individuals simply did not embrace the counseling process because the financial costs in their mind are hard to justify over meeting basic needs and/or having to take time off from work.

Although some individuals cannot find a counselor to their liking, participants worried whether counseling would be worthwhile, or they were ashamed or embarrassed about going to counseling. Most people believe that when faced with difficult life problems, counseling could be helpful.

It is hoped through research like this, people can better understand why they might be hesitant to seek a counselor and  maybe overcome some of their fears. Additionally, this research can help national organizations, in the helping fields, find ways to help clients overcome these barriers.

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Global

Turnkey: A Co-Housing Experience in an Italian Public Service for Addiction

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Turnkey is a term used in the economic field, but it also fits well in a social rehab project. The idea comes from the need to give some answers to the problem of those patients that experienced a long term therapy in an addiction rehab center for 3 or 4 years.

In the Italian welfare system, the outpatient service team -work (doctor, psychologist, educator, nurse and social worker), operating in the addiction recovery can schedule long term treatment in the residential rehab centers. In some cases, this long time permanence is something obliged, because of the serious addiction and also for the lack of different life perspectives after the recovery.

These kinds of patients need more therapeutic help in order to return to civil society in order to find  meaningful social membership. Usually, these clients have no meaningful familiar connections, no job, and no significant friendship.

In the last years, our social services system has become more careful about the use of public money. They noticed social workers more equipped to provide therapeutic interventions using a holistic approach in order to spare economic resources. Social workers are more capable to assist patients in reaching a better life condition by using their abilities toward social integration.

The Project

Five years ago, the program’s director asked for the professional team to think about a solution for the rehabilitation of the” long term patients”.

I started wondering about the meaning of poverty which is not only economics but it also the satisfaction of primary needs. It’s the lack of healthy relational bonds which weakness a lot the patients coming out of the drug addiction recovery programs.

I also noticed that this relational deficiency is a modern human condition; in the weakest social situations the loneliness is something that “destroys the mind “.

So I got an idea: I proposed to my director to start thinking about a possible apartment for a temporary co-housing for at least two patients.

He liked the project and submitted the plan to the municipalities which have the competence in the social side of rehabilitation. The municipalities agreed to the project and financed it.

For the patients in long term recovery, the rent was paid through the financing with the municipalities (an average of 6.000 Euro a year for 4 years, renewable), whereas the utilities and the others cost of the house has been in charge to the occupants.

The management of activities like the admission of the patients, the guaranteed respect of the therapeutic contract, the check of daily life and the help in the money administration, are some of my specific competences as a social worker.

In my job role, I had a significant part into find fitting persons for the project who were able to live together. I also contributed to choosing the people eligible to live in that specific therapeutic situation.

I helped the patients to organize their new life and to establish minimum rules of mutual life in the apartment. The project is strictly tied to the learning of the skills required to come back to live a regular life.

For example:

– living together is an opportunity for the patients to learn mutual respect

-cleaning the home and paying the utilities is a way to come back to daily responsibility and autonomy.

– having a good neighborhood relationship is a way to learn again to have good relationships without drug addiction to interfered an apartment, next to the main social and sanitary services of the town.

The results

Since 2011, we housed 11 clients in the apartment with an average of one year placement. We should consider that one year in a residential rehab center cost 30.000 euro each person.

Eight of them returned was able to manage a regular social life, their addiction, a job, maintain social relationships which helped them to achieve a dignified lifestyle.

Two persons are still in the co-housing situation, one of them has a regular job, and he is searching for an own house. Only one person abandoned the treatment.

This intervention is a daily challenge for our team; it gave us good results in the recovery outcomes like independence, citizenship, struggle against the stigma and improvement of personal resources.

We also have spared a significant amount of public money while offering to our clients a higher quality of life.

The creativity and the professional skills mixed together with the help of other colleagues in the multidisciplinary teamwork made this project an effective strategy to help patients overcome their circumstances.

So, I can call myself a responsible social worker, because I help to improve the personal resources in my client’s life. I was mostly inspired from the basic professional principle “start from where the client is”.

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Mental Health

Will Veteran Suicide and Mental Illness Rate Improve?

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Even in Afghanistan, I will seek pet therapy! – Rick Rogers (pictured above)

It was about 9 years ago.  I decided to put down the rifle and pick up the DSM. You see, I was an infantryman since I was age 17.  That means, since I was a child, I was literally trained to kill people.  Looking back at it, that sounds like a profound concept.

I am proud of my time in the military.  I am proud of my brothers and sisters who have ever answered the call.  But…  I am also worried.

As I said, 9 years ago, I decided to change my path.  I didn’t realize where that path would lead.  I seen multiple traumas and death happen to my fellow comrades.  I went through some trauma myself, but I still worried about others more than myself.  So, I decided to become a Mental Health Specialist in the military.

It’s been a long road going from Infantryman to Social Worker. There are a lot of learned attitudes and behaviors I had to change. Can you believe it? I literally had to learn empathy.  And that took a long time.

Just about anyone in the military knows that drinking alcohol is a part of the lifestyle. Everyone I looked up to drank and considered me a p**sy if I didn’t.  So… when I was sent to Germany back in the early 2000’s as a 19 year old kid, you better believe I drank. It was legal!

Looking back at my adventures between then and now, I don’t regret a thing. Yes, there were many embarrassing moments, and I have lost many friends along the way.  I also met some great people.  My alcohol use made my path rockier than anything else.

Many others have had this experience as well.  Between 1998 and 2008, binge drinking went from 35% to 47% of veterans, and 27% of that 47% experienced combat. 

Between 2002 and 2008, misuse of opiate prescriptions went from 2 percent to 11 percent in the military.  These prescriptions were mostly due to injuries sustained in combat, as well as the strain of carrying heavy equipment.

This concerns me. When I was young, I had a good time. Looking back, maybe it wasn’t.This might not be every veteran’s experience, but the culture encouraged substance use and discouraged getting help. There are others that would agree with me.

This could explain why 20 veterans a day on average commit suicide. This is actually down from 22 a day before the 2014 study from the VA.  However, it is a 32% increase since 2001. In 2014, veteran suicides accounted for 8.5% of U.S.’s adult suicides, and the rates were especially high among 19-29 year old compared to the older generation.

Let’s not forget about the infamy of PTSD. Up to twenty percent of veterans have suffered from this. Of course, those who suffer are more likely to admit their distress to a computer program than a battle buddy or their superior.  This, again, goes with the constant culture that causes our military to fear judgment.

These wars have been a constant the last two decades, and have cost all U.S. citizens a pretty penny. According to one report, the VA spends $59 billion a year on health care.  This number is 3 times as much as it was since before 2002.

And let’s not forget the cost this country has incurred for being in war for this long.  Well, we don’t really know an exact number.  The cost is estimated by many to be in the billions or even trillions.  This isn’t including the interest from borrowed money.

So, after looking at all these figures, I am overwhelmed.  How can I even make a dent in helping our nation’s veterans? The current administration is planning on increasing our presence in war zones.  I am expecting the rate of PTSD and suicide to increase once again.  Also, our country will continue to spend.  It seems to me that we are all participating in a death and mental illness factory.   The thing is, I didn’t even get to the physical injuries many of our combatants have suffered from.

I love our nation’s military.  I want every one of them to know that I am here to support them.  But most of all, we all need to be here to support each other.

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Mental Health

First Responders: Behind The Festive Season

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I’m a social worker. I’m a first responder spouse. With my partner, I advocate for improved mental health for first responders, including educating helping professionals to understand the culture, lifestyle, and demands of the job on both responders and their families.

I hear stories from police, paramedics, firefighters and frontline rescue responders and their family members every day. Tales of trauma, grief, and horror – and on the flip side incredible strength, resilience, courage and sacrifice.  It’s December and social media is full of excited conversations about planned gatherings and festivities for Christmas and the New Year. Those posts inspire this reminder.

In Australia, there will be barbeques and beer in sweltering heat by the pool or at the beach, a stark contrast to some of our global friends whose Christmas will be white, accompanied by outdoor play with snowmen and gift giving inside by the warmth of a log fire.

Despite the contrast in temperatures across the globe, there are those who work tirelessly behind the scenes of Christmas beer and New Year cheer. Police, paramedics, firefighters, and rescue personnel are unlikely to experience the festive season in the way most people do. They are on call to ensure the public’s continued safety, health and wellbeing. And so their festive season, regardless of location, is far more likely to include these scenarios:

  • Burglary, elderly occupant assaulted and taken to hospital
  • Multiple occasions of drug overdose at a teenage party, several individuals taken to hospital in serious condition
  • Alcohol fuelled violence, multiple serious injuries
  • Bush fire endangering properties, implement evacuation procedures
  • Car accident, children seriously injured
  • House fire, no injuries but the house is beyond repair and a family is left homeless
  • Notification of the sudden death of someone’s loved one

This is a typical “festive season” for first responders. Their families are at home – not with their loved ones as is traditional, but quietly accepting that their loved one is needed out in the community to keep others safe. Some days will simply be a bit lonely, other days will be filled with concern for their safety.

For many first responders, the festive season brings back memories of trauma past. That makes the lead in time to end December a difficult one, rather than one of anticipatory excitement. And then, of course, we have those who can no longer turn out because of physical or psychological injury. Their lives forever changed by the job. Perhaps this year they do get to sit with their families and share a meal, but at a huge emotional and financial cost inflicted by their injuries.

Finally, a harsh reality in first responder world: the first responder family members who tragically have to face this “festive” season alone. This time not by choice. Their first responder’s life either taken away by an incident on the job or by a sense of hopelessness all too common in those with psychological injuries.

The festive season of giving is a timely reminder that we as a global community are exceptionally fortunate to have first responders looking after us. Whether you’re in Australia, India, Alaska or England, these people give up their precious family time to keep us safe. Many are volunteers. They are human, just like us. Witnessing human suffering is hard at any time – but this time of year adds extra burdens.  Please drive carefully, celebrate carefully. And while we all sit in the protected bubbles of our own private Christmas and New Year celebrations- please spare a thought for all frontline responders and their families

In the spirit of the season, please acknowledge their sacrifice with a note, a smile, a thank you – so that in the midst of whatever trauma they’re dealing with, they will be reminded of the true intention of these times: goodwill, human connection, and hope.

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Mental Health

Having Difficulty Creating Worksheets and Activities for Your Clients?

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Nicole Batiste, Hub for Helper Founder – third from left

Tailoring worksheets and activities specifically for your client needs can be challenging for the best of therapists and counselors. For others, maybe you are a natural born artist moonlighting as a mental health professional dazzling clients with your creativity which helps them move one step closer to becoming their best selves.

According to the National Institute of Health, there is a direct correlation between the creative arts and health outcomes when used in a therapeutic setting. The study reports: “Use of the arts in healing does not contradict the medical view in bringing emotional, somatic, artistic, and spiritual dimensions to learning. Rather, it complements the biomedical view by focusing on not only sickness and symptoms themselves but the holistic nature of the person.”

What are my options with limited artistic abilities?

For those of us who are artistically challenged, it is imperative to identify resources and begin creating a therapeutic toolbox for practice. There is one resource that I would like to share which helps both the artistically challenged as well as the artistically gifted mental health professional.

According to its website, Hub for Helpers is an “online library for all licensed therapeutic professionals to access high-quality, interactive, low-cost materials for diverse client populations”.  Hub for Helpers also states that it hopes to lessen the burden of developing materials by providing low cost options to help mental health professionals find materials to best server the need of their clients.

Hub for Helpers was founded by Nicole Batiste, a school social worker in a Texas middle school, when she saw an overwhelming deficit in affordable, accessible, and ready to use materials for therapy. Nicole sometimes found herself spending more time planning meaningful things to do in therapy than providing direct practice.

Inspired by the response to her activities from her diverse client base, she decided to create a hub for therapeutic professionals to access numerous interactive materials conveniently. Nicole states the mission for Hub for helpers is to continuously provide top notch, affordable activities to ensure that we are indeed, “helping you help!”

How does Hub for Helpers Work?

Hub for Helpers provides a quick and easy way to access and save materials in your “My Hub” account. If you are wondering how it all works, here are the tips provided on their website:

  • We strongly recommend you sign up with us to create your personal Hub. It’s quick, easy and free!
  • Begin to browse our materials by searching by the many domains provided
  • All of our resources are multi-paged packets that guide you through each activity, if you so need it
  • Once you’ve chosen an activity, check out is easy, fast and secure.
  • You will then be able to download your resource, all of our resources are in PDF format.
  • Your resource will remain in your Hub to be used repeatedly at no cost.
  • Should you choose to become a subscriber, a $40.00 credit will be issued to you each month
  • If you are a corporate subscriber a $200.00 credit will be issued to you each month to use amongst your employees.

Hub for Helpers has provided three free activities for you to download here.

What else does Hub for Helpers do?

In addition to being an online marketplace to buy low-cost worksheets and activities, for the artistically gifted, you can also sell your creations in the Hub for Helper’s marketplace. For more information, visit https://www.hubforhelpers.com/become_a_seller/.

Sponsored Content by Hub for Helpers

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Mental Health

What is Trauma-Informed Care

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“What’s wrong with you” is typically our response to what we consider problematic behavior.  But what if we shifted our mindset in such a way that would enable us to ask a question such as “What happened to you”?

Trauma-Informed Care makes that possible.

The trauma-informed perspective is a new way of evaluating consumers’ experiences and shifts from the traditional approach of care that focuses on eliminating problematic behavior to a trauma-informed approach that focuses on getting to the root of the issues so that individuals may experience recovery in an empowering manner.

Research data reveal that trauma can – and indeed, does – happen to anyone.  As a precautionary rule, then, the trauma-informed approach requires that all administrators, clinicians and other relevant staff and volunteers interact with all consumers as though they have experienced some form of trauma throughout their lives.

Trauma occurs when an external threat overwhelms a person’s coping resources. It can result in specific signs of psychological or emotional distress, or it can affect many aspects of the person’s life over a period of time. Trauma is unique to each individual—the most violent events are not always the events that have the deepest impact.  Everyone perceives trauma differently…what may be considered traumatic to one person may not be perceived the same way to another.

Acknowledging what happened to a person will help providers generate a more accurate interpretation of a consumer’s experiences as opposed to thinking there is something wrong with them.  As such, the approach to care becomes one in which there is recognition of the multiple ways traumatic experiences impact individuals’ well-being.

It also permits the provider to focus on developing, implementing and monitoring policies, procedures and practices that promote healing and recovery. According to Steven Wiland, “Human service systems become trauma-informed by thoroughly incorporating, in all aspects of service delivery, an understanding of the prevalence and impact of trauma and the complex pathways to healing and recovery.”

The trauma-informed approach is a framework that can be adapted to meet the diverse needs of various organizational, systemic, and individual structures.  All trauma-informed systems operate under the realization of the widespread impact of trauma; there is a recognition of traumatic symptoms in people part of our organizations and systems; and a trauma-informed response that yields changes in policies, practices and procedures in order to avoid the re-traumatization of people we encounter in our organizations.

 

Traditional Approach Trauma-Informed Approach
Lack of understanding about the prevalence of trauma and its impact Recognition of the prevalence of trauma and its impact
Elimination of symptoms/problematic behavior Recovery as a primary goal
Providing solutions from an expert position Collaborating with the consumer to agree upon solutions
Providing help to the helpless – providing no choices Consumers provided with choices and have autonomy
Reactive to behavioral cues – crisis driven Proactive – prevention of retraumatization – avoiding crises

In recognition of the pervasiveness of the experience of trauma, the trauma-informed approach involves the practice of prioritizing safety, trust, empowerment, collaboration, peer support, and culture through the adoption of policies and procedures embedded with these principles.

To get you started on imagining what Trauma-Informed Care might look like for your organization, take a look at examples of the traditional approach to care versus the trauma-informed approach to care as shown below.  Then ask yourself, how do we measure up?

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