Well, it’s officially turning into autumn up here in the Northern US, and I’m on day 430 of my sobriety. The Fall semester is in full swing and I’m entering my third week (third, already?!) of my practicum experience. I’m working at a drug & alcohol treatment facility for low-income clients, many of whom are coming through our doors having already gone through treatment before. Many have complex trauma, years of chronic and severe substance abuse, legal problems, or multiple mental illness diagnoses. Many see this place as their last hope, while others see it as just another item on their checklist to mark “done” so they can get back to their lives.
Last Friday I observed a mental health intake for a man who is now my first official client ever. He’s about 10 years my senior and has been through treatment for drug abuse more than 10 times. He has several severe and persistent mental illness conditions — bipolar disorder, paranoid schizophrenia, panic disorder, and probably PTSD — as well as a traumatic brain injury from a suicide attempt almost a decade ago. He was calm and mostly cooperative during the intake, though a bit fidgety, and appeared to be motivated to change his life for good, for his son. I am nervous, anxious, and terrified of having him as my first client — not because I believe he will be a bad client, but because I’m finally at the point where I am expected to know what I’m doing and know how to help this man. Thank god for supervision.
Speaking of supervision, I met with my supervisor one-on-one after the intake on Friday and informed him that I would be taking on the client as my own starting this week. He congratulated me and called me brave for diving in head-first. As we chatted about my fears and expectations, I mentioned that I worried about my clients’ ability to connect with me or feel comfortable with me since my background, personal experiences and culture are so different from most of theirs. Me, a nearly-30-year-old white female who has a cushy white-collar job, two loving (albeit divorced) parents, and no history of abuse or neglect or severe trauma. I wondered if perhaps this fear of disconnect was mostly in my head… but, my supervisor nodded and acknowledged the inherent difficulty in connecting and creating an alliance with someone who is so vastly different from yourself in so many ways.
And then, he said something that made me laugh a little to myself, but also feel very self-aware and proud: “Of course, I assume you’re not homeless and that you’ve got a roof over your head, and I assume that you’re not an addict or that you’ve ever had problems with drugs or alcohol, so there’s definitely some challenges there when it comes to connecting with clients.”
I laughed to myself because, well, I have had problems with drugs & alcohol. I’m 1+ year sober now and I’ve been able to fully integrate sobriety into my life and my sense of self, but really the biggest thing that separates me from my clients in that regard is the fact that I was fortunate enough to never get into legal trouble because of my drinking, and I somehow managed to find what worked for me in order to get clean and stay that way. I am proof that on some basic level, it is entirely possible. I have depression that rears it’s ugly head at the least opportune times, and I have anxiety that follows me everywhere I go. I am sober, despite these things. I am sober, and I believe that anyone who is given the right type of support and the right set of tools can get & stay sober, as well.
But that’s just me — perhaps the overly-optimistic side of me. I know sobriety is shitty and tough and heart-wrenching work, and that’s before you factor in other major problems like mental illness or homelessness or violence or abuse. I know it is a huge, back-breaking uphill battle for most of the clients who walk through the doors of my agency. But at least in some small way, I stand with them as a bit of living proof that every hill has an apex, and it’s such a beautiful sight once you get there.
2 thoughts on “Reaching the Apex”
Just like sobriety, your first step in case management can be the most difficult. It’s good you sought out the supervisor because having that one-on-one is critical. For me, my fears (basically am I doing everything I can and everything right to help this person) were a big hurdle. While I speak for myself, it wouldn’t surprise me if everyone has those fears in the beginning. You think you’re prepared but you’ll soon find out you’re not. Things changed in an instant. It’s just the nature of the business. But in the back of mind, I always remember the one client I did help (who now has five years of sobriety). That is what kept me going. We can’t help them all, but those few we do help mean everything.