Conserving Spoons

A little bit of using self in Social Work.

Two weeks ago I fell at my Field Placement. I was walking down the hall (using my cane, not my rollator – my first mistake!) and all of a sudden my muscles decided that it was time to take a lunch break without me. I fell backwards, scared all of the staff who were around me and came rushing to my aid, and I required four people to help lift me off the floor and get me into a chair.

Pictured: an accurate representation of how I looked when I fell down at Field Placement.

Unfortunately, my muscle strength didn’t return, I couldn’t stand from the chair, and I had to go to the Emergency Room for a bit for safe keeping. Fortunately, everyone who I work with at my field placement site is brilliant, compassionate, and trauma informed. This meant that instead of being embarrassed, or worried about stigma, that I was able to instead concentrate on getting better, and meeting with my medical team.

Dr. Hackenbush has always provided me with excellent care.

Among being neurologically special, I have two auto-immune conditions that pose the most amount of complications in my life: Rheumatoid Arthritis & Fibromyalgia (which, for me, is actually co-morbid and secondary to the Rheumatoid Arthritis).

While RA isn’t rare in males, Fibromyalgia is, which (according to my math) makes me some kind of unicorn. It took ten months, lots of doctors, a biopsy, an EMG, literally dozens upon dozens of blood tests, a trip to the Mayo Clinic in Minnesota, and finally a local rheumatologist (working with a fairly advanced medical team of primary care providers, neurologists, physical therapists, nutritionists, etc.) to get me to a final diagnosis. If I were a woman it would have taken four years and two months longer; so I’m acutely aware of my male privilege here; to say nothing of the fact that I was able to even fly out to the Mayo Clinic.

Both of these conditions effect every area of my life. Rheumatoid Arthritis attacks my joints, nerves, and muscles. When I have an acute flare up I am the equivalent of a giant newborn who can’t walk, and who can barely sit up. Both of these conditions also cause fatigue. Fibromyalgia also causes intense pain. Fibromyalgia also has this awful thing called “Fibrofog.” Generally, it’s how my cup of coffee winds up in the linen closet.

Because of this, I have had to become an expert in conserving my energy properly, so that when I’m with my clients I’m at my peak game (this is an ethical imperative). What this means is that I have had to become an expert at time management, and conserving spoons. If you’re not familiar with The Spoon Theory, please take a quick read (it’s okay, I’ll wait).

A large part in being successful in managing my spoons, is making use of a variety of tools, tech, and assistive devices:

Tom Bihn’s Maker’s Bag
I use a bag by Tom Bihn called the “Maker’s Bag.” The main reason for this (outside of the fact that I’m vocationally trained as a sewist and fiber artist, and as soon as I found out that there was a bag geared toward people like me I wen’t “cool!”) is that there are a ton of rings that you can tether (literally) all of your belongings to. This means that no matter how “foggy” I am, I’m not losing my wallet, my bus pass, or any of my every-day-carry. This of course then lowers my anxiety (which can escalate from 0 to 100 in about .03 seconds if I can’t find my wallet, which used to happen regularly before I got this bag…usually as I was trying to get out of the door just on time). Everything is connected to this bag. My keys are tethered to this bag with a tether long enough to reach my door while I’m still wearing the bag. My wallet is tethered to this bag. My crochet hooks are tethered to this bag. My life is more or less tethered to this incredible bag. When I kick the bucket at 120, I’m having this bag buried with me so I can make sure I’m still this put together in the afterlife.

NovaJoy Vibe Wide Rolling Walker
Affectionately named Zappy, my walker is one of my main mobility aids. I do have a prescription for a wheelchair that I’m waiting on; but I prefer my walker for a variety of reasons. First, I feel more comfortable and active with it. Secondly, by continuing to walk (when I can, so not during acute flareups where I just sort of flop around like a Magikarp), I ensure that I don’t lose muscle strength. That said, when I am weak, it provides support, and when I lose all energy, I always have a seat with me. My walker is pretty tricked out. It has a light, a cane holder, a cup holder, and storage in the bottom. This may seem silly, until you realize that as someone who can have a rapid drop in energy and/or muscle strength, it provides me with both a safe and comfortable spot to rest, or to wait for an Uber to pick me up and help me get home. I don’t expect a cure from two incurable chronic conditions, which is why when people ask me when I’ll be “healthy” and not need my walker, I just sort of stare at them.

The Miracle Cube Timer by Datexx
I use a Miracle Cube Timer to help me get my work done. What I do is set it for 15 minutes, and then “sprint” (so focus only one one task and one task only, such as writing my case notes). While the timer is going I don’t allow myself to do anything else. Once it beeps, I flip it over to the 5 minute side, and give myself a five minute break. I’ve found that this has helped me manage my time at work more efficiently. I have one cube on my desk at field, and one cube on my desk at home. Research papers, reports, case notes get done in record time (though it does take some self-discipline to develop this skill).

Unfuck Your Habitat
Unfuck Your Habitat (UFYH) is one of the best resources I have ever encountered for anyone who is either disorganized, or faces challenges keeping their habitats unfucked due to chronic disease, illness, or mental health challenges. There’s a book, website, tumblr, and app…and I use all of them. It’s the only reason that my counseling space looks impeccable, the only reason I can function in my home office, and the only reason my bedroom hasn’t been listed as a national disaster site.

Remember The Milk
If I don’t write it down, the odds of it happening are slim to none. But I also have to be very cognizant of how much weight I’m carrying with me at any time. I use Remember The Milk as my main go to organizer for tasks. This saves me from having to carry a large to-do notebook. I have it installed on every computer I use at work (and at field placement). It’s on my iPhone and on my Apple Watch. It can send me multiple reminders hours, days, and even weeks in advance of when something is due. This means no matter how “foggy’ I am, I remember to get things done (so long as I plan in advance, since I never know when an acute flareup may strike). I obviously don’t enter client names or any PHI into it, but it’s great for things like “remember to case note;” “pick up flyers for clients,” “check your task list from your supervisor!” etc.

Evercontact is an application that will automatically update your address book based on your contacts signature lines. I have limited energy, and limited time. But I’m also in a field where networking is absolutely crucial to providing services to my clients. By having Evercontact update my address book (instead of me doing it manually) I save quite a bit of time. I get notifications on updates multiple times a week (sometimes even multiple times a day).

Evernote is one of my lifesavers. I just cannot physically carry notebooks and binders with me everywhere anymore. This is where Evernote comes in to save the day. It is *literally* my everything binder. I have video clips saved there, audio clips, word docs, PDFs, notes scribbled on the back of envelopes, post-its, whiteboards and blackboards…all stored digitally, almost all searchable thanks to Evernote’s incredible handwriting OCR. I cannot praise them enough…if they were HIPAA compliant, they’d be *literally* one of the only things that a Social Worker would need…but even without being HIPAA compliant, they’re damn near perfect. Evernote is quite literally my brain’s backup device.

My iPhone & Apple Watch
My friend was kind enough to gift me an Apple Watch, which I mainly appreciate for it’s SOS feature (it provides me with a great deal of comfort knowing that I can hold the side button, have my watch call 911, and at the same time have it text my emergency contacts, including my supervisor). The Apple Watch has been useful in numerous other ways as well. I have an app on the watch that records sound at the touch of a button and then transcribes it (great for taking important notes, especially when I’m foggy). It also keeps me on track (by having my schedule on my wrist, and not having to remember to look at my phone or my calendar), reminds me to check my blood sugar, monitors my heart rate, and reminds me to remain active (among many other things). It also syncs with Remember the Milk & Evernote, which is incredibly helpful.

My iPhone has more or less replaced my daily computer. I find that an iPad is too heavy for me to hold in the long term, and after a day at sitting at desks and typing (which can be painful at times, especially when my hands and wrists lock up) that I rely on my iPhone for pretty much everything. Emails, television (i.e. Netflix & Hulu). Facebook. Even blogging.

Final Thoughts
I haven’t been paid by any of these companies. I haven’t received services in exchange for recommending these products. There are just – hands down – some of the tools that I have used to conserve my spoons, manage my energy, help my health, and remain in the MSW program (with a 3.687 GPA). They have allowed me to continue to work as a counselor, remain in my field placement, and continue forward toward graduating so that I can have my Social Work practice.

I look forward to sharing other tools and tricks in the future. I think it’s important – for true self care – that we recognize our barriers, roadblocks, and differences…and then find ways around, over, under, and through them. We ask our clients to be honest with us, and to share the most intimate parts of their lives with us…the least we can do to honor this, is to be honest with ourselves.

Social Work, Safety & Internet Presence: My Lessons Learned in 2017

I had one of the senior counselors that I work with at field placement ask about my website the other day, and how one goes about setting up a digital presence. It lead me to think about the journey that my digital identity has taken over the past year (and what I’ve learned from it).

When I first started as an MSW student at the UBSSW, they shared with us a great infographic entitled the Social Worker’s Guide to Social Media (which I highly recommend). After reading the infographic, and doing a bit more research, I created a second Facebook profile, and a second website to function as my ‘professional’ presence. I separated out my “work friends” (who were really colleagues) from my “personal friends,” and any classmates who I became friends with were added to the new profile (since they would be future colleagues).

I have been running a personal website/blog since I was 13, so it was a bit of work to tease the two out, and to determine what would get posted where: where do I talk about what?

When I started my clinical field placement I found that one of the rules at the counseling center was that we could not have an accessible Social Media presence: clients could not be able to find us online. I grumbled to myself (a bit) in my head, not because I disagreed…but because my digital presence was (and is!) part of my Social Work practice: I have been a regular participant in #MacroSW twitter chats, I have used hundreds of public posts to share information relevant to the profession of Social Work on my new Facebook profile. I interact in a number of groups to promote the values of Social Work and to discuss policy. I also grumbled a bit because I knew that it would mean making a third website (and how many domains can one person own and maintain?).

However, it was actually a blessing in disguise. Outside of my field placement, I work with survivors of violence at a confidential location (we literally don’t have an address, and we’re better protected than 12 Grimmauld Place). As part of my work, I provide counsel to people who are escaping both violence and torture.

I did not realize how absolutely perilous it could be for someone to associate me with my work, until one of our clients (who’s under our protection) came into the office and said he was worried the person that he was escaping would shoot up our location with a machine gun if they found out he was there. Since then I have had at least a few incidents a week where I was incredibly grateful to have worked to slowly remove any social media presence that could link me to my Social Work practice (I’ve been working slowly in order to avoid the Streisand Effect).

Just last week I was searching an apartment with a police officer behind me (one of us had Kevlar and a weapon, and it wasn’t me). I was on point for reasons clear to no one. But Social Workers (and Social Work Students) go into the same locations that police do all the time: we just don’t get the backup or protective garments, and if we’re lucky, we have a 90’s Nokia and our name on a whiteboard back in the office…and sometimes (like last week) we even get a police officer (who will stand a few feet behind us).

It could be absolutely perilous to be followed (digitally or in person) by someone who makes the connection about who I am, what I do, and where I work: not only for me, but for my clients who are seeking safety.

This means that (today) I have a spectrum of presence on the internet: I have my main website, which isn’t in English, has me listed as living in another country, and – likely – would be very hard for the average person searching for me to find. This is where my “personal” self finds its digital home. There is nothing I say here that I would be somehow embarrassed to have on the front page of the New York Times…but it’s very personal, and we have to be very careful about the use of self in Social Work. Additionally, I don’t think anyone in the Social Work profession ls terribly interested in my retro 8-bit gaming, Pokémon, or Dungeons & Dragons (which I write about a lot).

I have my “professional” website, which has me listed as working in another profession entirely (one that I happen to be vocationally trained in, like some of my heroes were); the website, the Instagram, the social media, the twitter, are all red herrings that let me have what I call my “travel” persona (something I developed when I worked for a government agency in another country many years ago): I can go anywhere, and introduce myself, and my ‘travel story’ will match what they can find about me online…because I don’t always want people to know too much about me. It is entirely neutral, entirely boring, entirely safe…and I can talk about it for hours ad nauseum. It also hosts the email I use professionally when not at work, or when traveling, and it is the user name that I register on many sites (since I never want SocialWorkDesk to be associated with my name)…the front end of this websites protects me (what people see is a person who works in a very neutral field), the back end allows me to function and to work via email.

I then have this website, which is my professional voice, which allows me to participate in the Social Work community safely, and anonymously: my clients can’t find me through this website; and I can – in one place – discuss issues that I find important, digitally advocate on the Macro level, discuss the profession (warts included), and not have it come up with my name (which I find essential to my safety and the safety of my clients).

This isn’t the kind of thing they teach you in Social Work School…it’s the kind of thing that you develop on your own, as you go…but it is incredibly important that Social Workers (and Social Work students) give serious thought to how they intend to work digitally. I cannot imagine the setup I have now changing (because I always want the option of anonymity, and to work in some of the more…critical areas…of Social Work, and so I am disinclined to pierce the veil…especially after how much work it took to get here).


Every Wednesday my mentor and I have supervision at my field placement. This time is – and I hesitate to use this word, but it’s the best one I have – a sacred time, and I truly treasure it.

The notion of supervision in Social Work can be confusing to those outside of our profession: it doesn’t mean that my supervisor is in my session watching me interact with client (that’s observation). Rather, supervision is where (at least in my current setting, because it varies by practice, agency, setting, and individuals involved) my mentor and I sit down for an uninterrupted hour, and get to share in each other’s presence, where we close out my case notes for the past week (since I am functioning under my supervisors clinical license, he must sign off on all of my work). It’s where we discuss case conceptualization, where we talk about struggles that I am having free from judgement. It is where new ideas and concepts are bounced around, and where I can ask for help that I wouldn’t necessarily interrupt his day for during the regular week. It’s for bi-directional feedback.

Generally my feedback is incredibly positive; two weeks ago I was given feedback by my mentor (after the staff meeting) on something I needed to improve on. However, I wasn’t left ‘high and dry’: my mentor reminded me that he was my greatest advocate, and that he was there to work with me on what it was that I needed to improve. He checked in with me all of this week, and during our weekly session he made sure to find out if this week was a better week than last (which it was). On top of that, we’ve been doing satisfaction surveys of our clients, which – while anonymous, are linked to clinician – and my clients are in the “extremely satisfied” or “very satisfied” categories, so I felt much more confident walking out of supervision this week, than I did last week…not only because I did better as a colleague and Social Worker, but because I knew my clients were doing better as well.

The important part, though, through all of this, was that when presented with negative criticism, I was willing to listen, and willing to change: because at the end of the day, the goal is being a better clinician, a better colleague, a better co-worker…and even if I didn’t agree with that negative criticism; I didn’t want others to have that perception of me (whatever it was) so I worked to change my behavior, so I could – in turn – change the behavior of others.

Supervision is important, it is ongoing, and it is important we pay attention to what we like in our supervisors, because at some point (very soon) we ourselves will be providing (and yet still receiving) supervision…and we want to be the supervisors that we have enjoyed and learned from most.

36 Steps in in 12 Hours: Meeting Our Clients Where They Are

While I am working to complete my Master’s of Social Work (MSW) I am also completing my CASAC (Credentialed Alcohol & Substance Abuse Counselor) credential alongside it as well.

For one of my classes, The Nature and Treatment of Alcohol and Other Drug Problems, we are required to go to three 12-step meetings. This is not the first time I’ve been required to go to 12-step meetings, and I always find them empowering, and interesting, and insightful (for a lot of reasons).

A few Thursdays ago I went to 3 twelve-step meetings in 12 hours…so I had 36 steps under my belt by the days end: I went to a morning AA meeting, an afternoon AA meeting, and an evening NA meeting (and truth be told, I always prefer the NA meetings to the AA meetings…I’m not sure why yet, something for me to meditate on and explore within myself).

We often say (or are often taught) that we have to “meet our clients where they are, not where we want them to be.” But how many of us actually follow that advice?

What I found so interesting is that at almost every 12-step meeting I’ve gone to there has been a similar theme, and one that I think is telling (or should be) to my fellow counselors:

“My counselor doesn’t get it,” “my counselor doesn’t listen to me,” “my counselor wants to talk about past issues…and all I want to do is move forward.”

This – to me – is a failure of meeting our clients where they are. When I have a session with a client, the questions I ask have to be carefully constructed…and I can’t ask them because they interest me…I have to ask questions because they’re beneficial to or are of interest to my client.

This justified negativity toward counselors doesn’t spring from the Big Book or Basic Text, it’s not endemic to AA or NA, or to 12-step programs or literature…so if you’re an addictions counselor and you’re looking for someone to blame, you’ll have to do some inner reflection.

While we (as counselors) can look at a client’s past and find useful threads, and meaningful connections to trauma, if our clients are looking forward to their bright future, we can’t allow ourselves to be anchors holding them back – or worse, dragging them back – to their past…instead, we have to be Solutions-Focused, allowing them to pragmatically reach the goals that they set for themselves, so we can remain helpful, and relevant to them…otherwise we just become a stumbling block on their path to recovery.

Always remember: Just for today!

This is your quick reminder…

This is your quick reminder that it’s okay to take some time for you. You’re doing the best you can, and that’s okay…in fact it’s great, and it’s awesome! I hope you’re having a great day, but if you aren’t, there are people who love and adore you…and work isn’t everything: it doesn’t define who you are as a person, it’s just one of many many many parts of who you are…and even if today was a bad day, you’ve survived every bad day until now, and you’ll get through this one too. Go have a cup of coffee or tea, sit for a few minutes, enjoy it…breathe in the aroma, and take some time for you. Take a couple of deep breathes, relax your shoulders, clear your mind…and when you’re ready, get back to work…the world needs you.

Adults Have Kids (or The Wisdom of Not Always Being Placed Where We Want)

I am not a kid person. I general I dislike having to deal with any children that are not my Godson, or any of my adopted nieces and nephews. In fact, when I adopted my cat they said “you need to be warned, she doesn’t like loud noises or children” and my response was “perfect, we’ll get along just fine!”

Entering the MSW program in my 30’s I had a relatively good idea of where and what I wanted my future Social Work practice to look like (or at least I thought I did: it’s expanded tremendously as I went through my program, though the general idea has largely stayed the same).

So last year, for my first field placement, I indicated on my placement request form that I was looking for an adult population, in a clinical setting…and my Field Placement office met me half way: I would have one day a week doing Solutions-Focused Brief Therapy at a Family Solutions Center (so adults would be involved…but so would their children…).

I said “Okay…”

Then the other shoe fell: I would be spending my other day a week doing School Social Work.

I was (initially) a little disappointed. I was super excited at having the opportunity to do some clinical work…but…School Social Work? Children? Teachers? Parents? PTA? Soccer Moms (and Dads)? Why would I – a soon to be Social Worker working with adult clients – need to do any of that? How was that at all relevant to my future practice!?

Because. Adults. Have. Children. You. Doorknob (I say to myself, now…older and wiser…)!

…and sometimes it is absolutely critical that we learn how to interact with populations that we are uncomfortable or dislike working with, because our clients (and our code of ethics) require us to do so…and it was one of the world’s most amazing experiences.

I learned Theraplay and I learned how to work with children and their families. I learned how to work with parents and guardians. I learned how to interact with CPS. I learned how to liaise between administrators, teachers, parents, and students. I learned about the incredible developing minds of Kindergartners, First, and Second Graders…and how they can explode cartons of chocolate milk with only their eyes (sort of like…Darth Vader). I learned how to elicit information (and the truth) from unwilling children, and how to play games while at the same time conducting counselling sessions. I learned how to effectively advocate for my students’ needs. I learned a lot about myself. I also learned about the incredibly important role of public schools within a community, and why I think they need to be protected and cherished at all costs.

Now, as I complete the last 8 months of my MSW program, and I am in the Field Placement of my dreams, and I interact and work with adults as a Domestic Violence Counselor as part of my day job, I am extraordinarily thankful that my first field placement forced me to grow and stretch my boundaries as a Social Worker…because while day-to-day I get to work with my “ideal” populations, I also know that if I need to work with children I can, and because I had this incredible experience, with incredible mentorship, guidance, and supervision, I know I can do so effectively. 

My first field placement gave me the gift of expanding my toolkit, which can only benefit my clients…so if I client tells me that they’re having concerns at home…and they’re an adult…and they have children, I can have them bring their kids into the office and I know that I have the training and the experience to work with that client and their family as a whole…and I would have never had that if I had my “ideal” field placement for my foundation year.

…I also wouldn’t be working as a Domestic Violence Counselor either with my incredible team at my incredible place of employment…so if you’re a student working your way through an MSW program, work with your Field Placement Office…and trust them (at least a little bit)…they may not give you what you want your first go round, but odds are they may give you what you need.


Permission to Nuke The Whales

One of the traps that I think some of my clients (and even myself, to be honest) can get caught up in is that generally we want to do the right thing, and that sometimes we want to do the right thing so much that it becomes deleterious to our overall well-being and daily functioning. I think this is especially true if one has a chronic disease, disability, condition, or illness.

For instance, if you have a disability that makes lifting and moving difficult, and you really want to recycle…but the act of recycling causes your kitchen to fill up with plastic bottles because you don’t have the physical strength or energy (or spoons) to bring the bags down on recycling day once a week (or once every other week)…and then you find yourself constantly falling over bags of recycling in your kitchen, then is recycling really your best option? In this case I advise my clients to give themselves permission to nuke the whales and throw the bottles out with their regular garbage.

Sometimes depression makes it hard to clean up the litter box. Who wants to use disposable litter trays? They’re bad for the Earth, it’s wasteful, you’re throwing out aluminum or plastic each week…all of that’s true. That said, a kitty litter box that’s overflowing is bad for a client’s health, can contribute to a greater feeling of depression (due to the smell/mess/’failure’ to take care of something), and the kitty won’t be happy either. So what’s better in this case? Personally, I think giving yourself permission to nuke the whales and go for the disposable kitty litter trays.

Reduce, Reuse, Recycle…always sound advice. Paper plates, plastic forks, spoons, and knives: who needs em? Just more petroleum based products in our landfills. However, if your chronic illness, disability, depression, mental illness has you living with a kitchen sink full of dishes all the time (which can bring with it bacteria, mold, or vermin)…and it’s easier to just throw out paper plates, plastic forks, spoons, and knives…and those disposable plates and utensils are what makes it possible for a client to have a clean living space (and feel better)…then it’s time to nuke the whales and stock up on disposable plastics.

There is a time and a place for environmental activism…there’s also a time and a place to remember that clients have every right to put themselves first, and it’s one of our goals – I believe – as Social Workers, to remind clients that they are allowed to take care of themselves first, that they are allowed to put their needs first, and that we can work together to help them find other ways of taking care of the environment (and even offsetting their adaptations/restrictions) so that nuking the whales can become a win-win situation…because our clients aren’t going to be healthy (or successful) if their own environments (remember PIE) aren’t inhabitable, let alone be able to worry or do anything about Mother Earth.

*Social Work Desk does not advocate nuking actual whales. Please do not do this. Looking at you, 45 & Kim Jong-un.

Sunday Paperwork Catchup & Doing The Best You Can

Today is a paperwork catch up day: lots of paperwork to scan in and shred, some assignments to get done or get started on, and lots of writing to do! There’s also a fair amount of home office clean up to get done as well (fortunately, the folks at UFYH have made that a bit easier for everyone).

I was also hoping to get some volunteer work in this weekend, but that’s just not going to be possible (since the laws of physics still apply to me) so I’m going to remind myself that the only thing I can expect from myself is to “do the best I can” and so long as that standard is met, I get to be cool with myself.

Now, time to get cracking on the home office clean up, so I have the space to actually get my paperwork done…and then I’ll probably order a pizza…because social work students survive on a healthy dosage of carbohydrates and cheese.