thepathNY

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Should you stay or should you go?

April brings showers, visions of spring, and the beginning of the end of your field year experience. What are the benefits to staying or saying good bye? Here are some things to consider as you begin the process of winding down your field experience.

“Should I stay or should I go…” ~ The Clash

Termination
Go: While it may seem counterintuitive to begin with the end in mind, this is precisely what fieldwork students should be thinking. A large part of the learning process during the internship experience is learning how to terminate with your clients. Clients will (and should) move on. Knowing how to say goodbye and prepare them for either your departure is just as important as the very first session.

Stay: Even if you decide to stay, termination is one of those phases of treatment that is inevitable and unavoidable. Stay tuned for tips on how to terminate with clients.

New Faces, New Spaces
Go: Experience a different environment, coworkers, supervisors, client population. Building and growing your skill set is an important part of your career. You can use the end of your internship to explore a different side of yourself while practicing and enhancing your skills as a counselor.

Stay: If you decide to stay, be sure to make clear your new role as a professional. Perhaps there are new responsibilities you can add or change so that you are not continuing in the same role that you were in as an intern.

Taking Time Off
Go: If you’re graduating and completing internship concurrently, it might be a good time to take a much needed break. Processing doesn’t stop just because there’s no professor after you for that reflection journal. Taking a break allows you to process your whole experience and the experience of being a graduate. Journal, dream, meet and greet other professionals. You can still be productive in your career outside of the office.

Stay: If you decide to stay, be sure that you’re building in self-care and discuss new work schedule options with your agency.

“If I go there will be trouble…”

Staying On

They love you and they want you to stay. Congratulations! Use the “Stay” strategies above to really define yourself as a professional counselor in your new role. Seek opportunities to grow within your position. You’re in a prime position to help new interns acclimate to the fieldwork experience. Utilize your skills, share what you know, and please do not forget to schedule your first vacation!

“If I stay there will be double…”

Saying Goodbye

Remember to always give a clear ending date and remind your supervisors and colleagues at least two weeks before you end. Treat it like a job, put in your notice and make time to wrap up loose ends before you depart. Maintain the partnership once the internship comes to an end. Connect on your social media and professional networks. YOu can stay up to date with them and they with you. As you job hunt, they may even endorse some of your skills. It never hurts.


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…it’s been a while

I’ve had a hiatus from this blog for a while but I’ve been busy (I swear!)   Here’s what I’ve been up to during my “silent” time:

  • Started a job with Project Hope
  • Guest blogged for Counseling Internships – this is an amazing resource for students.  
  • Working on communications for ACA NY
  • Ramping up counseling services at the Offices of Dr. DeMarco
  • Prepping a free workshop through Meet Up (stay tuned!)
  • Drafting new content for the second half of the Internship series

Lots more to come.  Stay tuned.  

It’s good to be back.


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Work the Cube: multidimensional cultural competency

I am looking at you,
You at him,
Kabir asks, how to solve
This puzzle —
You, he and I?

Kabir
(Philosopher, 1440-1518)


 

I’m trying to write a post about my multicultural experience during my internship and I’m finding that I don’t know where to begin.  This is not surprising.  I think it’s fairly common “not to know where to begin” when dealing with these issues of culture, the -isms, and clients.

I walked into the agency armed with my Multiculturalism in Counseling Resources and an abstract understanding of what might take place in the room.  I also walked in feeling worried that I might say something silly, or worse yet, insulting.  I’d had many classes that provoked thought, required self-reflective journaling and processing, demanded experiential activities, and imbued the theories of identify formation and multicultural counseling competencies – but putting it all together in a new environment with real clients was something entirely more challenging.

The key thing I made myself remember during my internship was that it’s a learning experience.  As a mental health counseling intern, I was there to grow, to contribute, to practice the skills and begin to make the transition from theory to practice.  Becoming a culturally competent counselor follows a similar path.

A few weeks into the internship, I returned to the Cube (see below).   I’d had an array of clients at that point – many with cultural norms, religious beliefs, and race, class, and educational experiences that differed from my own.  The Cube served the same purposes then as it does for me now.

The Cube reminds me of the interlocking components that lead to the development of cultural competence.  Using the Cube, I can determine which component (skills, awareness, knowledge) I need to focus on, for which group, and at what level.  Working the Cube reminds me that acquiring cultural competency is an ongoing and proactive process.

So, while honing your interviewing skills, learning the fine art of identifying discrepancies and mastering interventions, take some time to Work the Cube and flex that cultural competency muscle.  As counseling goes global and our society continues to evolve (Counseling Today, Aug 2012) we need to be equipped to deal with with clients and colleagues from all walks of life.

A multidimensional model of developing cultural competence (Sue, 2001)

An edited version of this blog appears on CounselingInternships.com


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Was it something I said?

Sometimes, interacting with clients feels a little like speed-dating. We meet, we chat for a bit, and suddenly I find myself wondering and worrying about whether or not they’ll call me again. Did they find our session helpful enough for round two? Am I the type of counselor they can see themselves with?

After a first meeting or particularly difficult session, a client cancellation or no-show prompts me to rewind back through the session in slow motion, searching for clues that might answer that persistent nagging question: “Was it something I said?”

I’m embarrassed that a missed session can so quickly bring down my carefully constructed fort of self-confidence.   The cancellation/ no-show kicks up those still too-fresh grad school feelings of self-doubt and uncertainty.  At best, I feel a little rejected.  At worst, I fear I’ve scared them away from counseling altogether.

I had to face this recently when Calm Client missed not one, but two sessions in a row.  Complete no-shows.  No call, no text, no pigeon carrying a calligraphic notice.  So, I did the normal thing and placed a phone call.  No answering machine and no client.  Then I did the abnormal thing and conjured up the last session (and the one before that) for a mental re-run.  By the time I was done  – none of it yielding any clues – the second week had come and again, a no-show.  Well, I thought, I’ve really done it now.  I called again but this time the number was no longer in service. I must have scared Calm Client right out of the state!

The following week, I was shocked to see Calm Client was waiting for me, a full 15 min before the scheduled session. The wave of relief that Calm Client was a) physically fine and b) present was overwhelming.  I felt greedy to know what had caused the no-shows and I prayed it had nothing to do with me.  The explanation was one of the best I could have ever hoped to hear.  Calm Client had landed a new job and the change in schedule caused the missed sessions.  Calm Client meant to call, but had not.  And my second call attempt failed due to a change in phone service.  The words from Carly’s song came to mind, “You’re so vain…” and yes, I did think that the no-show was about me. It wasn’t.

My take home lessons:

1. The cancellation/ no-show might not be about you.

2. Self-confidence is still a weak spot. As a new professional, it’s easy to fall into the mindset that perhaps you did something wrong or that you’re not very good.  Keep building that brick house of self-confidence.

3. The cancellation might indeed be because of you…and now how do you prevent those negative feelings from causing you to run screaming from the profession?

While I work on the internal aspect of cancellations, I’m trying to take a proactive approach to managing cancellations.

Client Responsibility – When I meet with clients for the first time I stress the importance of calling in at least 24 hrs before the session if they cannot make it.  Not only does it put some of the responsibility on the client but it serves as a way for me to check in on the client. I’m far less likely to feel anxious and get lost in the world of self-doubt if I can hear the client’s voice (their tone can tell you quite a bit) and provide a positive statement like: “I’m sorry we will not meet today but I look forward to seeing you next week.”

Assigning Homework – I don’t do this in every session, but sometimes a well-timed homework assignment can give clients that extra push to make it next week.  Sometimes something as simple as, “You mentioned XX during the session and perhaps next week you can tell me more about it,” can provide the impetus for a client to return.

Charge a Fee – I’m not in private practice so I can’t implement this for my clients but some private practitioners and agencies will charge a fee for a no-show or cancellation less than 24-48 hours before the session.  It’s not about beating the client over the head with fees but rather making it very clear that counseling services are indeed a service and a missed session without prior notification may cause a counselor to miss providing that service to another paying client.  Charging a no-show or late cancellation fee certainly makes one reconsider blowing off the counselor for that re-run of any-old reality show.

End it with Positivity – Therapy can be tough. Anyone who has ever been a client can tell you there are days that you want to just melt into the couch and be done with the whole thing.  I make it a point to leave some time at the end of a hard session to summarize and pull together pieces for the client, to acknowledge the difficulties faced during the session, and to appreciate the courage it took to engage fully. It instills a sense of accomplishment for sifting through the issues and as a reminder that therapy is a process and it’s not always easy but sticking with it can yield life changing results.

How do others proactively (or retroactively) deal with clients that cancel, don’t show, or simply never return?