It was an emotionally challenging day at work today. Patient number one was getting ready to discharge today. Treatment was successfully completed. Vivitrol administered. Prescriptions filled out. Doctor seen. IOP set up. Then, as she waited for her parents to pick her up I received a call telling me her probation officer was in the lobby with an arrest warrant. An arrest warrant for a possession charge. I went to the female building and braced her for the events that would be shortly unfolding. I had her call her parents. I copied two sets of discharge paperwork including completion certificate. I got two envelops and place a copy of each set of paperwork in each. I packed one envelop with her things since her parents will be coming to pick her stuff up then I walked her over to the lobby with another set of paperwork to give to the probation officer as proof that she successfully completed an inpatient program and received the Vivitrol injection. They handcuffed her and shackled her which I personally thought was "overkill" for the charge. I talked her threw the ordeal and walked with them to the car.
I work in a profession where 90% of the patients I encounter have some sort of legal involvement as a result of substance abuse. I speak with more probation/parole officers, judges, attorneys and DA's than I could ever count in all different counties/cities throughout the state of Pennsylvania. Honestly, I feel like I am an attorney myself at times. Advocating for people is very much like an attorney. You should see the arguments I prepare to get patients more inpatient time from insurance companies. This profession is not for the faint of heart and one better know how to speak and write because one does a hell of a lot of it everyday. Whatever happened to the days where a patient laid on a couch talking while the therapist listened and never said a word. Yeah. That kind of therapy does not exist anymore. Today, therapy is advocating, teaching. doing case management while helping someone cope with their substance abuse, mental health, legal and family issues. It is about finding someone a safe place to live dealing with DHS or CYS workers conducting family session and teaching family education. It is about court continuous, visitation, trauma, educational and employment issues. It is about paying an overdue bill or applying for food stamps. It is about finding peer or recovery support. It is about every part of a patient's emotional, physical and spiritual health.
I believe a good counselor can balance it all and still have compassion and empathy. So many counselors burn out or get jaded in this field because the success rate is low and the relapse rate is high and the work is exhausting both mentally and physically. I personally believe it is the best profession in the world. Maybe that is why I am still working at it years later to the point where some of my coworkers who have not been in the field very long ask me how I manage to still be doing this type of work when in fact they are burning out. The only answer I can come up with is the love I have for the work and the fact that some people have gone through terrible things and if they survive the perils of their existence and land at my door step then I am going to help them with my best effort. I firmly believe in HOPE.