Mental Health Affairs

I am field instructor for graduate and undergraduate student in social work going for their bachelors and masters degrees. I am also a professor of social work in a university. As a field instructor, I am the point person in the field where social work students at the university level go to their placement or “internship” where they learn social work practice skills from working with real clients.

Due to my position as a supervisor in a mental health clinic, my students, at my site, learned how to practice in a mental health setting. The bachelors students learn case management, and the masters students learn how to practice psychotherapy and have their own caseloads with clients with various diagnoses. As their supervisor, I teach my interns how to be good therapists.

Being a good therapist is sort of a loaded sentence isn’t it? What is a good therapist? I think most of us would agree treating the whole person and seeing people as individuals is a step in the right direction. That person centered approach that situates diagnosis right where it belongs. Balancing a diagnostic clinical approach with empathy, support, and all of those good things is a step further. My focus, however, as their field instructor, isn’t to micromanage their ripening skill set, or tell them how to practice. Sure, I will guide, model, and lead, but telling a therapist how to practice is walking down the path to the same narrow focus the medicalization of mental health did to the system of care.

Today, one of my former students updated me on his present work situation. He said he continues to feel unsupported by the agency higher ups and feels alone in doing the work he does as a mental health therapist in a clinic. He asked me: “Max, what keep you moving forward?” Aside from grinning and bearing the entry level nonsense and plight of the worker who sets out against a learning curve, I told him the truth. Reinforcing I kept all this in mind, and the long term goal ahead, I said keep it all in perspective. Our work matters, and our impact matters. More importantly, how do we keep all this in mind and be successful in putting theory into practice?

In the mental health profession, this is so hard to do. As a field instructor, my main goal is to support my interns in how to survive the system of care. Setting out as an entry level social worker and working within the limits of an agency is my primary concern when monitoring the success and ability of my interns to succeed. Everyday, we mental health therapists expend our valuable energy to alter, augment, and improve the quality and level of care we can provide our clients with limited resources, time, and support.

Maybe this is my focus because I have a very systems approach at the root of understanding of how care operates in this country. But I also believe the job of the classroom, as a professor, is to supply the theory and knowledge for their students to implement in their placements. As a professor, I stop at nothing to explain clinical approaches to different theories of psychotherapy, differentiate between the abstraction and practice, and supply examples through role play and discussion. However, as a field instructor, my job is to take this work in the classroom, and direct its application the in the field. Point out weak points in practice, support reflection, and above all, explain how all of this learning and growth plays out in each students long term plan for practicing as a future mental health practitioner.

Without the right support, or the right people around us, no skill, no technique and no theory will save our jobs. Even worse, our clients will no longer benefit from out help when we get walked out of the agency because our political clout evaporated over a non clinical issue or contestation of our judgement because we get a new boss or team member that has a personal issue with our character. Please don’t get me wrong. I am no cynic, but I know and believe too much in my interns abilities to allow anything other than their innate skills shine in the face of systems issues and agency politics in mental health settings