It's all worth it

Today was probably the highlight of my professional life, thus far. My days at the Perinatal clinic are the busiest and most emotionally draining of any of my days. I'm the only person there who provides mental health services - all their other people are drug and alcohol counselors. Because 80% of the clients are dual diagnosis (which means they have co-occurring psychiatric diagnoses and drug/alcohol addictions), I'm a hot commodity. The only people I see are the ones who REALLY need help. I lead a co-occurring group therapy group but individually do mostly crisis interventions and short-term patch-em-up-and-get-them-to-someone-who-can-see-them-long-term work. I have only two clients that I see on a weekly basis, because they are in such tenuous positions that they really need a lot of help.

This morning, the clinic head came into my group and warned me that there was a big issue with one of my clients and that she had her in her office until I got out of group and that I'd need to clear my schedule for the rest of the morning. This is a client whose history is full of the stuff nightmares are made of and who has a long list of diagnoses. So I fully expected that I was about to have to have her involuntarily admitted. Instead, I found out that she had made the huge decision to get out of her environment. She'd finally absorbed a lot of what we'd been working on in therapy the last two months and was willing to act on it. I spent the rest of the morning working with her on establishing a plan for her safety, helping her figure out her options and making connections with family she hasn't talked to in years and seeing if they were willing to help her, getting her connected with mental health and addiction services in her new place, and prepping her for getting her stuff. Meanwhile, the clinic director had marshalled our staff to help this girl get her stuff and her kids and had the sherriff's department accompany her to get her stuff. She was on a bus and headed to her new life just after lunch. The change in this girl over a 2-month period absolutely blows my mind.

As if that weren't enough, I found out later that I'd missed a really great group in the afternoon. I guess the girls were talking about finding hope and were asked to tell what gave them hope. So my other regular client said that I gave her hope, because I was the first person in her life who acted like she was a person and not "just an addict or a whacko or a f---up." This is a girl who has probably the worst history I've ever heard, and after hearing it and looking at her symptoms and making her diagnosis, I was shocked anyone could come out of what she'd come out of and *only* have the short list of diagnoses she has.

So yeah, it was a day that stands out amongst good days. It definitely reminded me why community mental health is a good place to practice psychology. The cases are so complex and the illnesses are so severe, but when there are successes, they are awesome ones!

To top it all off, then I came home to the cutest face in the whole world. She jumped out of the kitchen to "scare" me and then doubled over laughing.



Scaring us is one of her new favorite things to do. She makes this position with her hands and calls them her scary hands. It's hilarious, because it just looks like she's making a c shape with her hands, but she thinks it is scary to us. It causes her all kinds of delight!