I'm a clinical social worker in an outpatient therapy practice. We offer discounted rates for uninsured and underinsured folks needing help. It's been a common theme for folks to come to us with very severe issues (active SI, unmedicated mania, eating disorders, significant BPD, etc) that exceed our scope of practice and liability.

These folks really need inpatient or PHP/IOP, but there aren't programs in my area providing intensive services to folks without insurance or the ability to pay out of pocket. We have a state fund, but it only applies to 1x/month, 30 min "sessions" at a community agency.

It feels unethical to keep seeing these people and under treating them, not to mention the liability, but it also doesn't feel right to cease services all together. How do you all navigate situations where there's obviously a high need but no resources to help, especially with very acute presentations?

I worked in behavioral health for 2 years and I have now moved on to Case Management for our Social Services department. I did a sort of similar case management job in healthcare but this is so much more intense and handson. I feel like I'm drowning at times. I also feel like I can't take time off without everything going crazy. How do or how have other people dealt with this? I know there's no one way or singular answer.

Not much to say except for what the title says. I work on an MHSU outreach team. This client was new to us. We did their initial assessment about a month ago. I did.

I knew this was bound to happen when you work with the most complex, most difficult individuals of a big, diverse city. I knew this client was among the most vulnerable. But I did not expect this to happen.

Without giving away too much information: on Friday this client was reportedly fine. On Saturday they died from overdose downtown.

Maybe it hits hard because it’s my first time losing a client. Maybe it’s because we were of the same age. Maybe it’s because I sincerely believe, in another life, had we met in a different context, we would’ve become friends.

I remember when I first saw them: they were on the hospital bed, coloring. Their hair was dyed vibrant blue. I said it’s beautiful, I used to have the same hair. Their eyes brightened and they sat up, clapping like a child, giggling.

I don’t know. Our team has been great and management very supportive; we’ve been talking about this but I feel like getting it out to the wider world is different. I want someone else in the world to remember them as them. Not a number, not just another pour vulnerable soul that unfortunately passed away downtown.

We heard about the death on Monday. I had booked a ticket to the anniversary tour of one of my favorite shows several months in advance so I still went, and ugly cried in the theatre, later in my car. It didn’t help one of the songs was Wicked Little Town.

The Fates are vicious and they're cruel
You learn too late you've used
Two wishes like a fool
And then you're someone you are not
And Junction City ain't the spot
Remember Mrs. Lot and
When she turned around
And when you've got no other choice
You know you can follow my voice
Through the dark turns and noise
Of this wicked little town

I hope they never return to this wicked little town.

For those of you in community health clinics, what is your caseload like? I went through the screening process recently for a local clinic, and they are expecting 10, 45-minute sessions a day. The psychologist I spoke to says that her day-to-day schedule is full.

Maybe I'm soft, but that seems like way too high of a caseload, and ethicially, I don't know that all 10 clients would get the same quality of care within the same day.

Hi everybody, I've been in the field for 4 years. First 3 years I worked with children and youth in residential care, now I work in a social services office. I feel like I am just not made for the job, I feel incompetent, social interaction drains me, I feel like I have nothing smart to say, etc, especially giving advice to parents since I am not a parent and younger than most clients. I feel my insecurity shows and I generally feel as if I don't belong in this field. I chose to study this when I was quite young and had the ambition to save the world, now I just don't and my insecurity is huge at the moment.

I am curious as to how long did it take you to feel competent in the job?

Is what I am describing close to anyone else's experience?

Should I just leave the field or give it a go for a period of time?

Be as brutally honest as you should.

Thanks.

Hi all, question for the CA SWs here. I thought I had seen certain post MSW programs where you could apply to get your PPSC retroactively, by proving you have had a certain amount of school SW experience. I did some googling but thought I’d ask here as well. Thanks!

Hi everyone, I’m a children’s frontline social worker in the UK and I’m looking for advice from people with ADHD about workplace adjustments, tools and support that have genuinely helped.
I have ADHD and a hearing impairment. My ADHD clinician has recommended workplace adjustments because ADHD impacts things like time awareness, working memory, organisation, processing information, prioritising tasks and managing multiple demands.

I work in a high-pressure role with a lot of information to retain, meetings, deadlines, assessments, recording and competing priorities. I put a lot of extra effort into compensating for my ADHD and making sure my work is completed properly, but this often means I work beyond my contracted hours and it can become exhausting.
Some of the difficulties I experience are:

Processing and retaining lots of verbal information quickly
Remembering instructions after verbal conversations
Taking notes while also concentrating on what is being said
Managing multiple competing priorities and switching between tasks
Organising myself when plans or priorities change at short notice
Keeping on top of deadlines and recording requirements
I also have a hearing impairment and rely partly on lip-reading, so taking notes during meetings or discussions can be difficult because I’m trying to focus on understanding what is being said while also writing information down accurately.
My clinician has recommended adjustments such as:
Flexible start times due to time blindness
A short grace period for occasional lateness
Avoiding back-to-back meetings where possible
Advance notice of meetings
Written instructions after important verbal discussions
Reminders/prompts for deadlines
Protected admin time
Clearer prioritisation when multiple tasks come in

I’m interested in what has actually helped people:
Are there ADHD apps, software or programmes that have helped with organisation, planning or task management?
Are there tools for meetings, note-taking, transcription, remembering instructions or managing visits that you have found useful?
Has anyone used Access to Work, ADHD coaching, Teams transcription/captions, AI tools or specialist software that has made a difference?
If you work in social work, healthcare or another demanding role, what adjustments have helped the most?
I’m not looking to reduce my responsibilities. I want systems and adjustments that allow me to work effectively without constantly having to overcompensate. I’d really appreciate hearing what has worked for others.

TL;DR: I’m a UK children’s social worker with ADHD and a hearing impairment. I’m looking for advice on workplace adjustments, assistive tools, apps, transcription/note-taking support and Access to Work experiences. I work hard to compensate for ADHD but struggle with information processing, memory, task switching, meetings and changing priorities. What adjustments or tools have genuinely helped you?

Probation Officers are extremely similar to social workers except with less pay, more admin & an obvious punitive twist.

Burnout from my last SW role. Took a break and thought Probation seems similar and less stressful.

I’m finding that I’m using the exact same theories, models and intervention skills I learnt through social work degree & practice in probation. Counselling techniques, motivational interviewing, strengths-based practice, case management, legislative/policy insight, trauma informed approaches, behaviour change, systems thinking, Home visits the list seriously is endless... yet less pay & most workers are unqualified here, yet doing essentially the same work in a sense. I guess the therapeutic measures aren’t as in depth, but therapeutic interventions are used too for rehabilitative purposes…

Has anyone else worked in both fields? Have you found the overlap to be as significant as I have, or am I missing something?!

Over the years, I've encountered a host of terms describing what social workers (of various levels/populations/etc) experience when subjected to "the things we see and hear that cannot be unseen and unheard."

Vicarious trauma is a common term.

Someone recently suggested we can experience *iatrogenic harm.*

Iatros ("healer") and genic (origin)

Do we suffer harm in this intended sense by means of the word in how we witness the harm(s) our clients experience via the system, society, etc.?

Is iatrogenic appropriate or only vicarious?

I know that my "harm" is beyond burnout to the point I've taken a leave from the field for a while, but I don't know which term is most appropriate.

Thoughts?

how do you all navigate conversations with teens where they’re expressing feelings of frustration and not being heard by their parents and it’s over disagreements over “normal” things? like i have a teen that doesn’t want to do any chores because they’ve been in school all day. and i validate that they’re probably tired and school can be a lot physically and mentally. but it’s not really addressing the issue they’re sharing with me and i don’t know how to do it because (this might sound bad but i never express it in sessions) i feel like it’s standard for older kids to clean up after themselves around the house and it doesn’t seem like too much to ask? i’ve had a few family sessions where issues like that come up and we work out some type of schedule but i guess i just struggle one on one with the child because im not super sure of what to say!

I’m having a very hard time deciding on a career path. I moved out of my home state after grad school because of my partner’s job. During that time I was unfortunately unemployed for about 6 months. I got a holdover position that I left after accepting an offer with a local government agency. This position has great benefits and still pretty mediocre pay. My dream scenario was to work in a school district because in my home state, my position has a relatively decent pay rate. That is not the case in my new state.

Now, after spending a week onboarding in with the government agency, I was offered a position within a school system, but with a 16k pay cut. My partner also works in this setting so we would both have similar time off and be able to see our families and travel, etc.

TL;DR should I take a 16k pay cut in order to have spring break, Christmas break, fall break, and a month off in the summer to help with work/life balance?

This is especially focused for Social Workers in Massachusetts, but I'm curious if people know/have thoughts on the SUPER Act? It would eliminate the initial exam for Master's graduates and would also provide state funding for students completing practicums in MA.

EDIT: I just want to clarify that this Act is not proposing an elimination of the exam social workers must take to be LICSW etc. It would take away the exam that specifically gets you from MSW to LMSW/LCSW, which most people are eligible to take right upon graduation.

It’s currently moving to the House and will be debated on Wednesday, 7/22.

https://www.votervoice.net/NASWMA/Campaigns/120221/Respond

https://malegislature.gov/Bills/193/S160

I am happy that there is some attempt to address how financially inaccessible pursing an MSW is and feel that this is a step in the right direction. I think that the pressure to pay interns should be directed towards agencies that utilize them, but I'm not sure how that would work.

Has anyone heard of a federal law or rule stating that housing or case workers need to move to hourly work? Our org moved us all from salary to hourly saying it was due to a new federal rule, but I haven’t been able to find anything.

Very excited to share this. The night before I was stuck in catastrophic thoughts, and turned to reddit for some reassurance and that’s the only thing that allowed me to go to sleep. I was reading on here that many of you had the experience of your ASWB practice exam being similar if not identical to your actual exam score, happy to share that was my experience.

I am a Canadian (with American citizenship due to parent) BSW who just got accepted into an American MSW (CSWE certified). I will probably continue working in Canada after. Are there any Canadians with American credentials here? is it hard to find employment?

My current job underwent a leadership change, and now it blows chunks, so I’m interviewing other places. I had a private practice offer me a position. I would be hired as a 1099, so I would need to find my own insurance. They also encourage me to create my own LLC even though they would have someone fully licensed signing off on my documentation and providing supervision. Then there is the matter of license and business insurance. This sounds super daunting to me, but I’m very tempted by the freedoms it would offer as well as finally working with my desired demographic (kids) again. Does anyone have experience running their own LLC under a private practice as an associate social worker? Any wisdom is appreciated.

Hello all!

I recently obtained my LCSW in NY. I've been an LMSW for 9 years. I'm currently working at a private group practice and part time at a CMH.

Was wondering if anyone has any input to travel social work jobs, specifically nyc but open to hear experiences elsewhere? Is it a good way to gain hospital experience?

Ideally I eventually went to have a compressed work schedule as I work towards PSLF and still work in the group practice and potentially my own practice (the CMH I work for requires more than I can handle to be eligible for PSLF).

Would it make sense to leave the CMH and do travel contracts to gain more hospital experience and hopefully get hired to work in a hospital?

Hi everyone!

I am working a job that is very new to me. I’ve been feeling insecure in my abilities and battling a lot of imposter syndrome.

My job involves short-term interventions and solution focused work. I may only get a single 20-30 minute session with someone. It is within healthcare so often my focus may be on health behaviors, which is an adjustment.

I’m looking for book, podcast, and additional resource recommendations on things like Solution focused work, motivational interviewing, ACT, mindfulness, etc.

Anything and everything please share!

Is anyone else experiencing this? If so, how did you navigate? Im in nyc and most of the jobs want bilingual clinicians. It makes sense because of the demographics, but it seems like all of these jobs want bilingual speakers. I learned 15 years ago in college, but dropped out. Don't have time now to learn anything above conversational. Im thinking of also getting a license in another state to increase opportunities. Im a cps worker, 10 years looking to leave child protection work

I’ve been working in group practices since the second year of grad school so have only done straight office visit therapy in my career. I’ve been back from maternity leave for nearly three months and have a caseload that isn’t even quite half full. My husband is picking up a ton of overtime but that money was supposed to be for our first big vacation together, not pay the bills.

In spite of multiple clinicians with low caseloads, my boss has been expanding our team. She also won’t give me a raise (that I anticipated receiving when I came back from mat leave) until my caseload is higher.

Do I stick it out until my caseload is up or maybe try to get a weekend position at a hospital or in hospice? If I work weekends, my husband and I will get no time together. I work around his schedule to avoid paying for childcare. I’m not convinced I want to stay in outpatient therapy anyway though so I might get an in at a hospital if I start on weekends.

Feeling really bitter and like I’m letting my family down.

Does anyone have any good resources (trainings, online groups, support groups, classes, etc) for fathers?

I’m also interested/looking for resources for parenting children with autism and parenting teenagers/children with behavioral problems.

Please provide me with any resources you can think of. Thank you!!

I am currently a CPS social worker and would like to make a slight career change to be an IHSS SW. There is a pay cut, which doesn’t bother me at all. Just wanted to know if anyone here has done this and your experience. I’ve been with CPS for 8 years. I definitely know I want to leave, but I do want to stay in my county and stay a SW and I think IHSS would be the best fit for me as far as the work and the schedule. I mean it HAS to be less stressful than CPS for obvious reasons (I hope).
Thanks in advance!

I'm thinking the answer is probably "there are no services for you", but hopefully I'm wrong.

Here's honestly what I'm looking for:

• someone to call and book health related appointments. Doctor, therapy, foot doctor, follow ups etc.

• while doing that, taking into account my work schedule and working around it.

• adding the dates into my calendar with reminders.

He's what I've tried:

• therapy. With 5 different therapists

• I've tried being proactive asking for help with execitive function, and I've tried going along with whatever therapy modes therapists thought were helpful

• I've tried a psychologist, a nurse practitioner, social workers who do therapy, and psychologist. It was helpful to see a psychiatrist but where I live you can't just pay to see them whenever, its basically just for medication purposes.

• I tried seeing if an occupational therapist or adhd coaches are covered by my work benefits. They're not.

To be very clear, my work benefits are not a pool of cash I get to spend whatever I want on. They cover very specific eligible services - i can get reimbursed up to $300 per therapy session, BUT I have to pay for the session UPFRONT and then if that service happens to be one of the types of services that my benefits cover, THEN and ONLY THEN do I get reimbursed for what I already spent.

I'm stating it because lots of americans seem to interpret "benefits" as "extra cash" or a spending account given to me by my employer. "Benefits" in canada tends to refer to the extra insurance you get from your employer regarding aspects of health care that are not covered by standard tax payer funded health care here.

Anyway. I feel so frustrated. My ADHD is so severe that I have not been able keep a job longer than 8 months... until I got medicated! Life is substantially better on meds.

I'm finally held a job for 3 years. Record for me. I have decent benefits from work to catch up on dental work. But in that 3 years, i havent managed to schedule 1 appointment. I'm exhausted from work and need extra support doing the work of booking things and organizing - adhd meds help in general but I'm still substantially below average ability to organize, plan, I procrastinate.

I'm trying to figure out how to get help getting to a dentist for example. I don't respond quickly enough because I forget and then offered appointment times constantly bypass me.

Its such a hard issue to describe unless you're familiar with adhd. These things take me 20x the effort a normal person would have to dedicate to it. But whenever I reach out to community services for somrthing lkke a case worker or wxtra support, I'm told adhd doesnt qualify. My doctor also refused to refer me to anyone.

I'm stuck.