All done

Seven months ago I never thought I would still be here, finishing up my practicum materials. After having been at Cummins for so long I was nostalgic the last few days that I worked. Even though I know I am welcome to go back any time I want just to say hi, I was still walking around all day saying to myself "This is the last time I'll ...". It was the last time I would make lunch, or run group, or keep the consumers from arguing. The last time I would run to help Pam, or the last time I would learn something from Pam. I felt closer to Pam the entire time I was there than anyone else I worked with. Pam had just recently finished college as well and could relate to what I was going through. She actually acted as though she needed me, and was always happy when I was there to work.
After having ran group so many times in the past six months, it did not upset me at all that the last few days Amanda suggested I work on my learning plan instead of doing group activities. That was just less time I had to work on it at home. It also made it easier to keep up with blogs, and other items that often needed Cummins' information that I could only get from there. So my last days were spent at the desk, working on the learning plan and meeting with Amanda to be sure we had everything needed. I was surprised at how much of a role Amanda took to aid me with my learning plan. She had many materials for every item, even adding extras just in case 1-2 was not enough. Even though it was my responsibility she made sure I had everything, and helped with the things I did not have.
I knew the consumers would be sad to see me go, but that is how it always is when we end things in our lives. At least it was done on a good note, with the invitation to come back any time. This has been an unexpected, yet wonderful experience the whole way. And as everyone always says, I know I will remember my first practicum...all 320 hours of it!

Consumer Advisory Board

Cummins Mental Health Center maintains a Consumer Advisory Board (CAB) whose mission is to “establish an alliance among persons served, staff, and Cummins’ Board of Directors that results in meaningful input into policy development, decision-making, and organizational planning”. This board officially seats seven members, although not all of them are actually consumers. The board can be mixed of consumers, staff, family members, or anyone else who works towards the board’s five goals.
These goals include advocating for people affected by mental health or substance abuse disorders, assisting the staff by focusing on treatment and growth, helping consumers remove any complications keeping them from employment, education, and their goals, helping identify resources, aiding in planning, evaluation, and decision-making for the program.

Cummins' value statement reflection

Cummins Mental Health Center’s value statement is one unlike many others in that it boasts a Mission Statement, Vision Statement, and a Values Statement. The main mission of Cummins is to promote recovery and enhance quality of life through the means of behavioral health services. This means they wish to not only help consumers recover and get better from whatever brings them to Cummins, but they wish to go a step further by making consumers’ lives better than when they first came to Cummins.
Cummins maintains a vision statement similar to its mission statement with a few additions. This says communities WILL be stigma free and has visions to positively influence through leadership, advocacy, and practice. Obviously the most important of the values, respect for the dignity and worth of individuals is ranked first under Cummins’ value statement. Other values listed include responsiveness, partnership, exceeding expectations, diversity, trust, integrity, best practices, the hope of recovery, and continuous learning. These values are based on the notion that all Cummins staff will be welcoming to all consumers, no matter how unique or different than others. They will work to meet the needs of consumers and go above and beyond just their expectations, while at the same time sticking to their ethical standards and commitment to excellence.

6-29-08

6-29-08
I did not work at Cummins this day; however, I did work at home for several hours on Learning Plan activities. I have never been a very organized person, and it obviously shows. I know this unorganized habit of mine is rubbing off in other areas of my life and negatively affecting many things- that and my other horrible habit of procrastinating on everything. I know the one thing I need to do to be able to greatly improve myself and my life is to find a way to overcome these two terrible habits. In the mean time, I spent several hours sorting through 6 months worth of papers, pamphlets, and handouts that I used at some time or another while working at Cummins. Some were articles Amanda gave to me to read thinking they would be useful for my learning plan, some were items I picked up, found, or collected throughout the semester that I knew would be useful (for example the papers and handouts from LEAD), and most were the handouts and papers I used while leading group. All of this was one of the reasons I tried to make sure I finished my actual working hours earlier in the month (as you suggested Erika) so that I would have the last few weeks in the month to finish everything in the learning plan.
I also worked on the donation letter I need to write to try to get donations for Hoosier House. Amanda gave me the tax exempt forms to use and Cummins’ value and mission statements to add to the letter. This is definitely a new experience for me and I want to be sure I do it correctly. I also worked on Cummins’ value statement to write my reflection of what it means. There are a lot of items I need to write about for my learning plan, and I know I need the extra time to get it all done in time, so as not to get behind like I did the last time.

Week 3 integration question

Week 3:
Policy/macro: What Indiana Bills & Resolutions for the Spring 08 Legislative Session are of interest to you personally? What Indiana Bills & Resolutions are of interest to you professionally? Describe their significance to you, your agency, & your clients.
Many of my personal interests are the same as my professional interests since I hope to work professionally in a field that has personal interest to me. Welfare, criminal justice, and mental illness are all topics I am deeply interested in, and therefore follow more closely. Indiana Senate Bill 350 was introduced to provide for funding for community mental health centers- that of something that interests me personally, and also relates to my current practicum employment at Cummins Mental Health Center.
Indiana House Bill 1313 relates to inmate employment counseling and searches. This is more of a personal interest, although I hope one day to work with inmates, at which time may determine this to be a professional interest as well if passed. Many inmates, upon release, have no plans in place to find suitable housing, let alone suitable employment. Inmates are released with only their personal property, often not gaining any insightful education or locating useful resources. This bill would allow for inmates to begin searches, through means of (monitored) internet access, to find employment 90 days prior to their release date. I personally believe this would be a great benefit to inmates so they may be gainfully employed upon release, and not fall prey to their old ways of survival.

Week 12 Integration Question

Week 12:
HBSE/Macro: How can you determine what the formal and informal boundaries are in a community?
First I could research cultural differences to find out what is and is not appropriate. Many smaller communities have their own newspapers, often containing more items than what larger news organizations write about, such as events and small happenings. Just going out in the community could prove valuable as well by staying attentive to what others are wearing, their behaviors, manners, and other subtle signs.
Also, I could look for training on what is and is not appropriate, and search out stigma words. I can look for events going on in the local community. For example, they may have a day of the week that is a sacred day or certain days that may be celebrated for some reason.

Week 15 Integration Question

Week 15:
Practice/micro: How have you experienced successful endings? What do you already do now to help your clients experience successful endings?
In this, endings could be qualified as any ending with a client, whether it is the end of the day, end of treatment, or end of a medication. The most important ending though is the ending of treatment with a client. In this regard, here at Cummins we do not encounter as many endings as most other facilities since most of our clients are here for extended periods of time for treatment, some lasting several decades. For those who do end their treatment, many just move along to other programs that may be able to serve them better, such as the ACT team.
Cummins has procedures they use for all endings with their consumers. During discharge they utilize a discharge summary that has a plan they are supposed to follow for months after they leave. Some items may include a follow up with doc or meds, or to start other programs. They also make another treatment plan at discharge and help clients contact agencies or whatever else they need to follow up and be successful with the new treatment plan. Prior to their discharge (or ending) workers help the consumers learn coping skills or aid in beginning recovery for when they leave the program. Consumers can then become successful with medication and a better life style than when they originally sought out treatment.

Week 14 Integration Question

Week 14:
Research/micro: What are the ways you can evaluate your practice with clients?
Cummins utilizes anonymous consumer satisfaction surveys that are sent out in bubble envelopes so the workers cannot see the surveys. Each survey is done through the different departments. These surveys are done once a year to give the consumers a voice in what they do or do not like from employees.
Consumers also used to be able to read their progress notes and change what they felt was not relevant, or they could add things the consumer says they think believe should go in it. This is a practice no longer used, as it would cause dissatisfaction and controversy between consumer and employee. For example, there would be times when the employee would write that the consumer was experiencing paranoid delusions that day, but the consumer did not believe they were having any delusions and would want this taken off the record.
There are also peer review audits that are done for each worker to see if they did everything in the chart correctly. This is done at random, and not done all the time.The supervisor meets with the executive to evaluate the program and redo what needs to be updated.

6-25-08

I came in an hour late today, so when I arrived the consumers were already playing bingo. Once bingo was over Amanda informed me about a consumer who was having some difficulties recently. She wanted me to go over coping skills, warning signs, and ways to handle if he had outbursts. Amanda made a notebook for him where he could enter such things, and so that he could use the notebook as a coping skill to write in at times when he was having problems. He decided to leave early this day since because of his problems, so I only had a short 10-15 minutes to go over these things with him.

Pam taught me about how they use a progress note for consumers, called the rehabilitation services progress note. On it they list the consumer’s stressor or extraordinary event for needing the note, then any behavioral strengths the consumer exhibits. They have selections for language/motor activity including restless, slurred speech, pacing, and agitated; selections for mood/affect including euphoric, anxious, angry, apathetic, and appropriate; and selections for thought/perceptions including hallucinations, paranoid, obsessive, and delusions. Then one can select case management (CM) or Activities of Daily Living (ADL) and described items in either category such as contacted, informed, facilitated, monitored, or obtained for CM, and assisted, guided, reminded, demonstrated, directed, or trained for ADL.

Next the writer describes in detail what all happened and was gone over. This is done through PIRP: Problem, Intervention, Response, and Plan (of Action). The writer always follows this when writing these notes. Next the administrative items are filled in such as the writer’s credentials, billing codes, date of service, times, duration, consumer name and clinical record, and the consumer’s goal and objective that is being worked on.

After lunch Amanda helped me get the necessary tax information that is needed for the donation letter I had to write. She gave me information I needed to write the letter, such as Cummins’ value statement and mission statement. She left me in the back to work on the letter while she ran the rest of the groups for the day.

6-23-08

This morning Amanda was back, but Pam was not here. I ran canteen while the consumers updated me on their weekends. One consumer lives with her family and she goes out with her mother every weekend to a movie. She told me about how this weekend they “changed things up” by staying in for a movie. The consumers always ask how my son is doing so I told them about going to PBS Kids in the Park, and going fishing.

After I did the progress notes Amanda already had a worksheet for the first group (stress management/coping skills). The worksheet was titled “Getting Along with Anger”, and discussed times when the consumers get angry and things they do to cope with it. It was hard to getting the consumers to think of situations that made them angry. I had to keep giving them suggestions, and most of everything included things other people said or did to make them angry. The consumers said things like, “people talking inappropriate, people borrowing money, people insulting me or cussing at me, people expecting too much, and people telling my personal business”.

The consumers could not think of any coping skills or ways to deal with their angry situations. I started giving suggestions, then they finally starting saying when people make them angry they either “leave the room, ask them not to talk that way, just be quiet, walk away, ignore them, or tell them off”. I explained the difference between defensive and offensive ways of dealing with things, and showed how most of their suggestions were defensive.

When I just asked regular coping skills for any situation they did not know any. I gave examples of counting to 10, talking calmly and softer, or writing a nice letter. The rest of the worksheet had the consumers list things that made them angry, angrier, then angriest. They were not able to differentiate between the three, although they still listed things like “missing a doctor’s appointment, can’t decided what to wear, people saying my work or cleaning is not good enough, running out of things, jewelry breaking, and parents in general”.

This activity did not seem to go very well since the consumers were not very involved. I always have to work at getting the consumers to participate and enjoy the activities we do. I have to try to improvise when needed but also remember to include models of practice that I have learned in the classroom. For instance when a consumer complains that they cannot do the activity everyone else is doing I try to help them see what they can do. One elderly consumer has difficulties during budgeting and cannot do the multiplication that others do. She will never use that information; therefore there is no reason to make her try to learn. Instead I help her see that she can do addition problems by herself, and that she can operate the calculator on her own. The point isn’t to make them feel bad for what they cannot do, but instead to help them feel good about what they can.

For nutrition group the consumers played bingo. In this activity they are pretty self-sufficient, except for a few consumers who were not present today. This left me time to continue my project of scrubbing down the kitchen. Since I have been staying until the end of the day I have been trying to get things more organized, clean, and sanitary.

While making sure I am keeping up with my learning plan activities I discussed some of the things I still need to do with one of the case managers, Lenice. She said she had a good opportunity for me to go with her while she took a consumer to a Medicaid appointment. Amanda said it would be a good experience as well. The appointment started at 1:30pm, and we stayed for an hour. I will write about the appointment in another post since it was an activity to be included as part of my learning plan.

Once I returned I assisted in finishing the end of the day activities, such as cleaning and putting things away. I also entered the consumers’ times into the Excel program. I sat in Amanda’s office at the end of the day, discussing my hours, time sheets, and learning plan.

Amanda told me I can go work with case workers more often and also suggested some ways to write my donation letter for the learning plan. We also discussed completing the e-learning and other times I can do it at home. I updated my time sheet and made a copy for Amanda, but I also made a projected time sheet so that we all have an idea of when I should be done with my hours at Cummins. Last time I do not think everyone was prepared for how quickly my last days came, so I wanted to make sure I was prepared as well as everyone else. According to my projected time sheet, if I continue to work 3 days a week, 7 hours a day, I will have completed my hours within the next two weeks. This will leave me a few weeks to also make sure I get everything done and together for my learning plan by July 30^th.

6-19-08

Today was the last day of Amanda being gone and I know Pam is glad it is over. When I came in I went straight to running canteen and getting the progress notes going. For the first group we had a worksheet titled “Conformists”. Consumers learned a conformist is someone who usually does what he thinks others expect him to do. We discussed this, and why it is not always good to just conform to what others want. We also worked on a sheet titled “Communicating with body language”. In this we went over different ways people use body language, and all the different things some common actions mean. For example, when someone crosses their arms many people believe it means they are shutting others out, are unwilling to cooperate or participate, or could just mean they are cold. The consumers did a good job with this activity by identifying different things that each behavior could mean.

Next we went over narcotic medications for nutrition group. We discussed not only narcotic medications, but many of the scheduled drugs, such as benzos and illegal drugs like marijuana. We discussed taking medications properly, illegally, following doctor’s orders, and why people take drugs illegally, or take illegal drugs.

After lunch we had our regular walk, then cut out topics for current events. Pam led the rest of the groups for the day while I straightened the kitchen and organized the back room. I was trying to get things cleaned up for when Amanda came back. After the consumers left I worked with Pam on progress notes, discussing what each consumer that day.

My outing with a case manager on 6-23-08

Lenice told me she had a Medicaid appointment to go to with a consumer, and asked if I wanted to go with her. So I asked Amanda if she needed me, or if I could go with Lenice to complete one of my learning plan activities. Amanda said she thought it would be a good experience for me, and that I should go. The Medicaid appointment itself was not what I what curious to experience; I was more interested in just seeing how Lenice acted and handled things when she went to appointments with consumers.

When Lenice and I left for the appointment she started explaining the process to me of how applying for Medicaid. She explained that one has to first go to the office and fill out an application, and then a caseworker would set up an appointment. When one comes to the first appointment they have to bring certain documents that the caseworker uses to determine the applicant’s eligibility. She asked if I was familiar with this process at all and I told her I have been on and off Medicaid for years.

Lenice laughed and stopped there saying that I already know all about it, so she didn’t need to explain. Even though I did already know all about it, I had let her explain to me what she thought I needed to know anyway because there could always be something she says that I did not know and would have missed otherwise. I remember on my midterm evaluation Amanda said something towards the effect that I need to stop always telling people what I know, and instead be more receptive to learning what others are offering or trying to teach. If I am always showing what I know then I am not in a position to learn something new.

I have learned there is a big difference between many of the same services offered in Hendricks and Marion County. The Office of Family and Children, now called the Office of Child Services, toted a greatly different atmosphere in Hendricks County than anything I was used to in Marion County. Marion County always seems run down, dirty, and uninviting. When I walked into the Hendricks office I felt comfortable and welcome.

As soon as Lenice and I walked in we immediately went to the caseworker’s office where Lenice’s consumer was. I will call the consumer Sara to make this easier to understand. While in the office I just sat in the back out of the way since I was only there to observe. Lenice sat next to Sara and aided her by answering questions at times when she did not know the answers. Most of the questions Lenice helped with were regarding finances, medications, or medical diagnosis. When asked Sara said she was not sure what she was applying for, and was not sure about all her meds or bills.

The case worker was nicer than others I have had dealt with in Marion County, but then again she may have acted different than normal since it was not only a client in the office this time. Just as workers act different when supervisors are around, she could have been acting different since there was a case manager there, and a student to observe. This caseworker had a nice demeanor, yet did not engage with the client. She seemed to just do her job, input the information, and nothing further.

Sara had been on SSI, SS, and Medicare Part D. She was at this appointment because her benefits had been cut off and she did not know why. Lenice has different levels of involvement with each client. With Sara, I learned that she had helped her fill out the reapplication papers and had turned them in herself.

After the caseworker asked several routine questions about Sara’s finances, living situation, employment, history, etc, she asked about her medical history. Sara was not sure about her diagnosis, so they had to look at the papers from her doctors. She had depressive diagnosis disorder/bereavement, PTSD, and borderline or histrionic personality disorder. She also has been legally blind since 1966, but can see with her glasses.

Next the caseworker said she wanted to get a ‘social summary’. She asked about other medical things, such as Sara’s medications and if her diagnosis limits her. She also asked if she drives, has a degree or GED, if she is working, her last job title, if she has had vocational rehab, how she got to the appointment, and her relationship to the person who gave her a ride. Next she asked things I would expect more of a doctor to ask: if she uses recreational drugs, if she hears/sees things that are not there, if she understands all the questions she was asked today or if she needed assistance, if she has been having suicidal thoughts, what a good day is like for her, if she often leaves the house on her own, etc.

Overall, I was surprised by some of the questions that were asked. I have been to several Medicaid appointments, but have never been asked some of the things this caseworker asked. I was left wondering if it was because of the client’s medical history and diagnosis, or if it was something the caseworker asked all her clients. I also wondered if this was something just this caseworker did, or if this is part of the difference between Marion and Hendricks County offices.

Week 13 Integration question

Values & Ethics/micro or macro: Describe an ethical issue, concern or dilemma you experienced in the field. How was it resolved?

The biggest ethical issues I have encountered were actually pretty easy for me to deal with and resolve. When I first started here at Cummins I had several of the consumers try to hit on me, ask me out, and give me gifts. I did not have much prior interaction with the very first consumer who did this. I started here at the end of January, and on Valentine’s Day one consumer brought chocolates and a rose with him to group. I thought it was for one of the female consumers who everyone said like him.

During one of the breaks while I was running canteen this consumer brought the two items and said they were for me. I was confused and asked him for me? He just said yes, and I asked if he was sure. He again only said yes, and I asked why he got it for me. He said for Valentine’s Day. I just sat the two items on the desk and told him thank you, that it was nice of him. I was not sure how I was supposed to handle the situation, or if we were even allowed to take things from the consumers. I waited for Amanda to walk by so I could ask her what to do (I can’t leave canteen while it is unlocked so I had to wait for her to come back).

As soon as I saw Amanda I asked for her help. I picked up the items and told her what happened, and asked what I was supposed to do because it did not seem right to accept it. She told me we were only allowed to accept cards from the consumers and nothing more. I needed to let this consumer know that (even though she said he already knew), but make sure to try not to hurt his feelings in the process. I should tell him thank you and I appreciate the gesture, but that I could direct it more towards the fact that Cummins policy does not allow us to accept gifts from consumers instead of saying I do not want his gift.

I waited until I had a chance to talk to him alone so I would not embarrass him in front of the other consumers. I told him I appreciated the gesture, it was thoughtful and a nice gift, but that I was not allowed to accept anything from consumers. I apologized for accepting it in the first place when I did not know. I told him the only thing we were allowed to accept was cards. To try to lighten the situation I suggested one of the consumers who he should try to give it to instead…it was the female who liked him. He just laughed and said he didn’t want to encourage her. The very next time he came into canteen on a break I made sure to talk to him about other things that way he did not feel awkward around me after what had happened.

The next time this happened one of the older consumers came in, and said look what I have. He opened a jewelry box for bracelets, and there were three bracelets in there, all with price tags still attached. They were all gold bracelets with different jewels in them. All together the bracelets were worth over $900! I looked at the box and bracelets and asked the consumer why he had brought such expensive things with him to group. He said they were for me and he wanted me to keep them. I immediately informed him we are not allowed to accept gifts, that it was a company policy, and the only thing we were allowed to take from consumers was cards.

I told him I was worried about him carrying around such an expensive item though. I was afraid he might lose it or someone might steal it from him. He again said he wanted me to keep it. I explained I was not keeping for myself, but that I was going to put it in Amanda’s office so it would be safe throughout the day. I told him at the end of the day to ask Amanda for his bracelets before he left. I heard him telling people all the rest of the day about the expensive bracelets he brought with him! I am glad I put it up because he was the type of person who would have just given it to the first person who asked for it.

Another time the younger consumers and I were standing around talking. One of them just asked if he could if I would go out with him. Before I could answer the other male consumer told him he knew he couldn’t ask me out, that it would mess up our relationship and we aren’t allowed anyway. I pretty much repeated what the other consumer said, making sure not to hurt the consumer’s feelings since I could tell he did genuinely like me. He did not seem hurt, but just jokingly said it doesn’t hurt to ask! Through these situations I have learned how to handle when a consumer hits on me, or just gets too personal. I have found ways to deal with the situation while trying not to hurt the consumer’s feelings or mess up our working relationship.

Week 11 question

HBSE: How might your assessment of a client differ from that of another person on your team, such as a nurse, doctor, or teacher?

At first I thought this question meant what would be the difference in questions or in how I conducted the assessment if I were assessing a client compared to assessing a person on my team. I began by suggesting that I change the assessment questions to cater to different lifestyles or education levels.
Then I realized this asked how my assessment of a client would be different than a doctor or teacher’s assessment of a client. I know I still do not have a very broad or defined professional vocabulary compared to a nurse or doctor; therefore this would be one of the first, and most noticeable, differences in assessments. Not only would the wording be different, but also the scope and depth of the assessment. I would not be able to diagnose a client, or really even say what their condition or illness is. Many professionals would get very medical in their assessment whereas I would probably get more personal. I may not go in the same direction as another professional would, nor would I ask as much or dig as much into certain areas of the client’s life.

6-18-08

6-18-08

Wednesdays are fun for most people because we play bingo during the first group in the morning. We had 17 people today, one of our largest groups. While the consumers were playing I went around and assisted some of the people who can not see their boards very well, or who just need help keeping up. There is one female consumer who is not allowed to come very often because she is very obnoxious, loud, disrespectful, and just annoying to most people.

As a social worker we are supposed to try to be indifferent to these behaviors, especially in the mental health field. We are supposed to treat everyone the same regardless of whether they sit quietly or if they act as this consumer does- but it is hard. Especially with a room full of consumers I felt like this one particular consumer was really trying my patience, and just trying to get attention by acting out. When the bingo caller would say a number she would repeat that number, sometimes yelling it out or saying something about the number. She kept talking loudly about everything going on with her, from being in pain, to what she did the previous day, what she will do later that day, her friends, telling jokes, or anything she felt may draw attention.

She decided to be the second bingo caller, yet did not begin calling when she should have because she thought she was going to get a bingo prize for calling. I explained that she does not get one for that but she argued with me about how she was supposed to. Every time she called a number she had something to say about the number. When she called on someone who had a number she said their name differently and tried to use “ghetto talk”. I try not to let her behaviors get to me and I try not to allow my negative feelings for her to come out in my interactions with her. Its one of those kinds of things where someone makes you want to grind your teeth but you still try to smile.

After bingo we worked on a worksheet that evaluated the consumers’ fat, saturated fat, and cholesterol intake during nutrition group. Today was free lunch day so we made ice cream sundaes with all the toppings to go with lunch. It was interesting that the just thinking it was reduced sugar made the consumers not want to even try the ice cream. We also had Diet Cherry Chocolate Dr Pepper, but again just hearing the word diet made them not want to drink the soda either.

After lunch I did current events a little different than I usually do. This time I went through the paper and found articles the consumers would enjoy and read it to them. I would begin the article so they knew what it was about then I asked if they wanted me to continue with the rest of the article. I think they enjoyed this more because they were able to just listen to all the news, and were able to hear and understand everything. Most days when we do newspaper everyone grabs an article and reads it, but some people can not read very well or do not read very loud. This keeps the other consumers from being able to hear or enjoy the actual article.

For the last group of the day we just watched a movie about people reentering into society who have abused drugs or alcohol. It was lecture style where the consumers were able to learn about substance abuse, support groups, and what it is like afterward. We discussed things about the video afterward that the consumers thought were interesting or wanted to point out, such as key points the lecturer wanted people to remember. Some of these were Work on the moment, take it one day at a time, and you must rearrange your priorities.

This was a long and stressful day for Pam and me both. In the morning we had a room full of consumers, and it just seemed like everyone wanted or needed something. I know Pam is feeling stressed and overworked from having to fulfill two different full time jobs at the same time. She is definitely ready for Amanda to come back!

6-17-08

6-17-08

Although Tuesdays are not my usual days to work, I came in because Amanda is gone at a conference. I like working when Amanda is gone just because I feel I get more responsibilities and am usually in charge of more things. When Amanda is here I feel I always have to ask which activities to do, and what she wants me to do next. I still feel like a new student just following her around. When she is gone I often have a choice of which activities to do, and I lead the group most all of the day unless I need something from Pam. I feel like I work harder and am treated like an employee. I also actually feel needed when Pam is in charge, whereas when I work with Amanda I feel like I am just in her way.

As I usually start the day I ran canteen, made the sign in sheet, and started progress notes. The first group I facilitated was about self care skills. We went over a paper together as a group about doing laundry. I would pose each question to the group and everyone would give different answers about how they did things. The first question was when doing laundry how do you sort your clothes into piles? Each person had different ways of doing their laundry, sorting by whites, darks, colors, towels, sheets, and even lights, blacks, delicates, etc. Then we talked about the proper was to do a load of laundry and whether to use hot, warm, or cold water.

When I first started here at Hoosier House I did not have a good perspective on the consumers’ abilities to do what most people consider ordinary daily activities. I quickly learned that I took most people’s daily skills for granted, just assuming that they were able to do things I was used to. I learned how running canteen is considered a way for the consumers to learn daily living skills like money management, or how sticking to the posted schedule helps them learn time management skills. Prior to starting here I would have just assumed the consumers would know how to start a load of laundry, but at this point I know not to assume anything. When I asked the consumers how or where they learned to do laundry many said from the directions on the back of the detergent bottle.

For nutrition group we did a quiz style worksheet about the consumers’ eating habits, and whether they make healthy choices with their food intake. I was able to discuss with the consumers how to make healthy choices when given different opportunities, and how to stay aware of their nutrition and health with daily eating habits.

Next was lunch, then current events where we read newspaper articles. Pam ran the last group of the day while I cleaned up the kitchen and got thing ready for the consumers to go home. I am still not completely used to staying until 4:00 everyday, but I like feeling like I put I a full day’s work. I also like that by working two extra hours a day I am going from 15 hours per week to 21 hours. I feel like I am able to gain a lot more knowledge from Pam than any other employee here, maybe because she just finished school last year and can relate a lot better to me and my role here. During lunch and at other times I like sitting and discussing things she has done, seen, and experienced. She gives me her perspectives on the clients and other things throughout Cummins or our profession.

6-12-08

Today we started with the activity I picked out Wednesday afternoon, a worksheet titled Me, Myself Esteem and I. There were three different categories on the paper; one about their heredity and genes, one about their environment growing up and current, and one about their choices. I gave each consumer an index card for each question and we did the activity together on the board. For heredity and genes we went over (and they wrote on their cards) things about them they were born with. For example, some people wrote their gender, hair/eye color, disabilities, talents, life roles (mother, sister, daughter, etc). This was hard for many of the consumers, and most only wrote certain things that I suggested like the examples above.

On the next card we went over things about their environments during childhood, while growing up, up until now. I again started giving examples of things they could write about, such as if they grew up on a farm, in the suburbs, in the city, during a war, extremely religious, in a religious environment, with a big family, poor, always doing sports, etc. They wrote about their interests, hobbies, favorite activities, and how their lives were and are. This was the one category that most people kept going on and kept finding more to write about.

The last category was about the negative and positive choices the consumer thinks they have made in their lives. We went over positive and negative coping skills, and other things in their lives that contribute to those choices. Each consumer listed a few of both kinds of coping skills, and what they can do to change the negative to positive. Some listed things like smoking, eating junk food, and spending too much money shopping as negative coping skills, and journaling, exercising, and talking to people as positive coping skills.

For nutrition group the consumers played nutrition bingo. The consumers seem to always like bingo, as long as we do not play every day, and enjoy it more when we play various different kinds of bingo. I still always have to make sure to watch out for the prizes since so many consumers still think they can just take what they want without winning.

After lunch we had current events where I cut out newspaper articles so each consumer could pick out an article to read. I always let each consumer take turns reading theirs, and thank them afterward, then I read all the leftover articles out loud. By now I know which consumers like to read which kind of articles, and what each is more interested in. Some like to read only the weather or movie listings, while others like to read gossip about celebrities. No one really likes to read about international matters or sports (unless it’s the Colts).

I let Pam take over after that for the last group of the day while I had a consumer help me sanitize and scrub down the kitchen. The kitchen is obviously used on a daily basis, but is not often cleaned. It may not have been very educational for me, but it felt so much better knowing when I opened a cabinet I would no longer be sticking my hand in a pile of gunk.

One of the regular case workers had a consumer who regularly came in every two weeks when she got paid to go over her bills and make sure things are all paid. The case worker had an appointment to go to and asked if I could assist the consumer when she came in. She left a few things to make sure to do, such as look over all the check to make sure they are written correctly, and make sure everything is written down in the checkbook. The consumer did pretty well on her own, and only need a little direction at times, or my assistance realizing when she made mistakes on the checks she wrote.

This was the first time I was able to work one-on-one with a consumer, especially one who was not a Hoosier House member. I enjoyed being able to assist someone, and feeling needed. I felt like I was her case worker, and that my presence was actually beneficial to her. This gave me a bit of a different experience because even though I was there to assist her, I knew I needed to allow the consumer to try to do everything by herself instead of standing over her shoulder doing it for her, or instructing her. If I had done that she would not have learned anything and the whole point is for her to learn to do things on her own.

6-11-08

At the beginning of the day I was again greeted by consumers during canteen time. I knew this day was going to be different than most regular days since the younger consumers were not in attendance. They often are obnoxious and distracting to the other consumers, so without them there I knew everyone else would actually participate. I began my usual routine of writing progress notes, then organizing for bingo since it was Wednesday, but Amanda first gave us a crossword to work on. I used the board to explain how to complete a crossword because many people had never done one before.

The consumers often have a hard time dealing with the slightest bit of change. So when Amanda handed me new bingo cards to use that had new questions and phrases for the consumers to read out loud, I worried how they would react, and/or if they would even participate or enjoy it.

Instead of 5x5, the cards were accidentally printed 5x4. We ended up cutting it down to 4x4, which interested the consumers more since it gave them more chances to win. Sometimes the consumers will call for bingo, other times, like today, I called.

Bingo is usually pretty easy, but the consumers had problems getting used to this board. Each square has a number and a question or phrase on it. When the number is called the consumer reads and answers the question. These cards had phrases such as “A person who I look up to and would always take advice from”. The consumers did not understand they needed to think of and name someone who fit that quality, they just read the phrase and kept going.

I also have the task of playing security guard to the bingo prizes when they are out. There was a regular couple who used to call every week and decided they both got prizes every time for calling, that they had first pick over the prizes, and could take as many prizes as they wanted. We had to change the rules that only winners received prizes; however, many people still try to just take a prize off the table when they see one they like.

Next was nutrition group, where we went over the 5 food groups. We discussed the vitamins, recommended serving, and serving sizes. I have tried to remember since my midterm to use the worksheets more, and improvise to extend them. After we read descriptions of each food group I had the consumers do short math with me of how many cups or teaspoons they would have to eat to meet the daily servings for various kinds of foods. For example, for fruits and veggies, one needs four servings a day. Each serving size is ½ cup. I asked the consumers to figure out how many cups they would need to consume in one day, which the answer was two.

After I cut out interesting newspaper articles and everyone chose one to read out loud. I have come over time to know which kind of articles each consumer likes, and that they each have extremely different tastes. One person likes to read the weather, another liked news about famous people, another likes the “odd” articles, etc.

For the last group of the day Amanda asked if I would rather watch a video about Clozaril or Schizophrenia. I chose Schizophrenia because I would rather learn as much as possible about diagnosis than medications. I asked the consumers to write three things about the video which they would like to discuss afterward. The video was actually some what boring for most of the consumers, discussing more general things about the disorder that most all of the consumers already knew.

After the video I wanted to do something different to include the consumers and actually get them thinking about schizophrenia. I gave them a hypothetical situation where I was a patient and did not know anything about schizophrenia or what it was. I asked the consumers to describe to me symptoms someone with schizophrenia may have or present. They actually got into role playing where they acted like a doctor and I was the first time patient. The consumers took turns asking questions a doc would ask, such as “Have you felt like hurting yourself or others recently” ?, “Do you hear voices, see things, or smell things that are not there”?, “Do you feel like others are out to get you”?, etc.

This was a fun activity because the consumers had a chance to show how much they actually knew, and to feel for once like they were the experts. Everyone got into describing symptoms, and said when we were done that they would enjoy doing it again.

I stayed late to make up hours for missing Monday, and this was the first time I stayed the entire day. After the consumers left I had time to organize several things around Hoosier House that were in need, such as the back room with bingo prizes and all the videos. I also went through an activity binder to find activities for the next day.

6-1-08/ 6-5-08

6-5-08 This has been my first full week back to work since school ended. Even though I had about two weeks off, as soon as I walked in the door on May 28^th I got right back in the groove of things. I had a large welcome from every one of the consumers, and could tell they were excited to see that I was still there. June 2nd started a new week, and a new beginning, where I wanted to prove I would improve and do better than I had before. I have always worked M, W, and Th from 9am-2pm, but since it is the summer now and my son is out of school I offered to change my hours or days for whatever would be best for Amanda. In another week she will be going to a conference for four days, so I offered to work each of those days to assist Pam while she was gone.

Every morning when I come in to Hoosier House I run canteen. Canteen gives me a chance to talk with the consumers and get updates on their lives outside of Cummins. They tell me about their outings, families, and lives. Through this I can do a quick appraisal of how the rest of their day may go; someone may be in a bad mood, may be having elevated symptoms of their disorder, may be dealing with a recent tragedy, or just needs more praise and attention through the day. I learn to adjust the way I deal with each individual based on these quick assessments.

One female consumer is very shy so when I first see her I always give her a big greeting to make her feel welcomed, and I know I can always carry a conversation with her outside of group, yet she does not like to read out loud or be called upon during group. Another consumer always comes in to talk to me the days he is there. He seems to keep claiming elevated symptoms of medical problems, yet never shows signs during group. His own doctors have said they do not believe he has the problems he claims, yet he still tells us when he is having attacks. The very first time I heard this from him I became extremely concerned and did not know how to handle it, so I discussed it with Amanda. Now I know his behaviors so I just humor him at times while trying to still inform him I did not witness any signs of it because I do not want to add to his delusions

Most of my days seem routine since I have the same consumers, and do the same activities. At times I try to incorporate different activities, but they are not always welcomed by the consumers. They are so used to their routine and do not like deterring from it. Thursdays are Amanda’s administrative days so Pam runs group. This previous Thursday Pam was late so Amanda gave me a book of activities and asked me to pick which one I wanted to do. I chose one where the consumers had the letters of the alphabet listed and had to write one good thing about themselves that started with each letter.

They all had obvious problems with this, many not knowing words for each letter, or feeling apprehensive about writing good things about themselves. After they were done they turned the pages over and took turns trading papers with everyone else in the room. Each person had to write one good thing about everyone else. This was a little easier, yet some consumers complained about not having good things to write about certain other consumers. Some wrote generic comments such as they are nice, or they merely repeated what someone else had already written. I still enjoy trying to get them to participate in new activities, and to get them to learn new things about themselves. I guess it just takes time, and a little more work on my part to get them involved and comfortable with the idea.

In retrospect, I see the need for continual blogging/journaling during the week, as it is easy to forget simple interactions and educational experiences in one week's time. As I try to recall a full day's work for each day of a week's worth of work, it all seems to flow into a jumbled memory. It is hard to write about individual encounters or certain incidents in as much needed detail when it is a full week after it happened. I need to work on making a regular schedule to blog, and to figure out better how to go about it. I think writing daily would be too much, although waiting an entire week becomes too general and in my opinion does not explain my experience well enough.

I also am having a problem with how much or how far I can write about people or experiences in group. I know I cannot name names, but when it comes to a person's disorder or things that happened, I am not sure how much detail I can write without breaking confidentiality. I know this blog is an educational tool to write about my experiences at my practicum, but I must consider that this is a public venue. So how much is too much?

I also need to just write directly in my blog instead of keeping it in a file, then adding it later. I think it is good that I realize and discuss certain things that I need to work on that way I do not fall into my same old habits and get behind.I know I still have many things I need to work on to become the excellent student and social worker that I wish to become.

A New Beginning

5-22-08- I figure since I am starting a new chapter in my practicum that I should sum up my experience thus far, then come back every week and reflect on my experience as I am supposed to. Just to avoid confusion, if I discuss people at my practicum I will make up an initial for each person to refer to them by.

So when I first began my practicum I wasn’t scared as most other students were, nor was I worried if I would do alright. I was, however, apprehensive as to whether I would have a good experience, or whether I would learn enough or what I needed at Cummins. I was confident in my interactions with my clients, but I was not sure how I would be perceived by my supervisor or coworkers.

The first week I felt more like a guest than an employee, where I participated in the consumer activities like bingo. I quickly began to build relationships with the consumers, careful to make sure they saw me as an employee/intern rather than a friend. I think this has been one of my biggest challenges in the field as I am used to always befriending everyone I meet. I definitely learned the difference between the role of a social worker and a friend.

I felt like an assistant, where I just followed my supervisor, Amanda, around, doing little things and running canteen. Over time I learned how she did paperwork, and procedures that were used for different situations. There was a daily schedule of activities that we always followed because if we deterred even a little the consumers were quick to remind us what we were supposed to be doing. I knew they came to Hoosier House to have structure during their day, but I did not realize how much they depended on that same structure.

It was not until Amanda had surgery and was off for two weeks that I really stepped up and became more productive. Pam, a case manager, was in charge during this time, but usually had me run things so she could work on her cases. During that time I began filling out the morning paperwork, and was in charge of making sure everyone completed it. I always ran canteen every time it was open, and I began making lunch every day for the consumers. Although I was provided the materials and activities for group, I actually ran group every day.

I saw the difference in how my role changed during those two weeks, and I saw the difference in how the consumers saw me. At first I was just the intern, a helper, but then I turned into a leader, the group supervisor. They looked up to me, and came to me for things.

I also was able to start telling the difference between the consumers’ regular actions and behaviors, and those that were a result of their illnesses or disorders. I was learning what severe mental illness each person had based on their actions and behaviors, and I could tell when someone’s behavior was a result of their disorder. I began learning more about mental illnesses, and all the different presenting symptoms they have.

Once Amanda came back I actually felt awkward because I was not sure how to be. Before she left I was just a helper, but while she was gone I became the leader. When she was around I was used to just following her direction, but by then I was used to taking charge and running everything. We soon got back in a groove where I still ran things, and she just gave me the paperwork for the activities.

In all this time I saw myself become a practicing social worker. I was in situations that seemed oddly familiar, then realized it was because I already learned what to do from my coursework. I remember learning about identifying a consumer's goals and objectives in S231, but I just thought it was part of procedure and I would not use it in my real practice. However, while working with a case manager at Cummins I found out they use this exact system with their clients. The paperwork I fill out every morning for them identifies the goal and objective that each consumer is working on while at Hoosier House.

There have been so many individual situations I have experienced at Cummins that have just reinforced my learning at IUPUI. So far, this practicum has been a valuable learning experience, and I look forward to learning even more in the coming weeks.

Week 8 integration question

Week 8:
HBSE/micro: What theories of development would be useful for you to know about in your field placement?

Erickson’s psychosocial stage’s of development, in which a person consecutively passes through eight stages in life, where each stage builds onto the next stage. In each stage, the person must master new challenges, or they therefore become “stuck” in that stage, presenting problems later in life.

Pavlov “classical conditioning”, with his dogs in conditioning them to change their behaviors with changing stimuli and behavior modification techniques

Carl Rogers’ client-centered therapy, as many say this is the beginning of the strengths perspective, and

Joseph Wolpe’s Systematic desensitization

Week 6 integration question

Week 6:
Practice/micro: When is a client’s right to self-determination not the priority?

If they are at harm to their self or others. The NASW Code of Ethics says “Social workers may limit clients' right to self-determination when, in the social workers' professional judgment, clients' actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others” (NASW, 2007, 1.02). If a client informs me they are planning to hurt another person, or themselves, it is my duty and job to step in and intervene to ensure it does not happen, regardless of the client’s right to self-determination.

National Association of Social Workers. (2007). Code of Ethics, 1.02. Retrieved January 6, 2007 from http://www.socialworkers.org/pubs/code/code.asp

Week 5 integration question

Week 5:
Policy/macro: What was your experience at LEAD? What was most valuable? How could your learning experience have been improved?

The first couple hours at LEAD were boring to me because I had no initial interest in policy. It seemed to me like a sales pitch where they were trying to get us interested in their product- in this case the product was policy and legislation.

When we had a choice of groups, I chose the discrimination group, hoping to learn something new, and hoping to actually be interested. I was surprised by the group started, but loved the way it went. This actually felt like the presenters were talking to us, telling us their thoughts and beliefs, and giving us an idea of their lives. This short group about discrimination was the best part of LEAD. I learned a gay man’s perspective on bills that are aimed towards GLBT, yet somehow affect everyone. He also showed us how many things that are thought to only affect GLBTs could affect anyone.

Taking a tour of the Statehouse for the scavenger hunt was interesting, and a good idea. I had to look around the Statehouse and would not otherwise have done it. I did, however, expect more from LEAD. I would have had a better experience if more had been done at the Statehouse, or the presenters found a better way to show how policy and legislation affected us and was part of our life.

Week 4 integration question

Week 4:Practice/micro: How does your personality reflect and influence how you work with clients and coworkers?

I am very outgoing, and sensitive, as well as extremely positive when I work with other people. By using these skills or traits I try to draw out these same feelings from the client or my coworkers. This can lead to building trust, and then a helping relationship. When I am able to keep people thinking positive, or in positive moods, it opens more room for change, development, or just a pleasant environment.

Another feature of my personality is the caring, empathetic, intuitive, and helping side that picks up on other people’s feelings and moods. Whether it is a friend, coworker, client, family, or a stranger, I am good at reading people around me. This allows me to do a quick assessment of what the person in front of me needs, and what personal tools and knowledge I should use in my interaction with him or her.

Thursday April 3

4th (and last) day of camp
Today I came in and everyone was already putting up the volleyball net. We played volleyball in the morning, then I got out things for the boys to draw. I asked each of them to draw a scene or character from their favorite tv show. One of the boys was upset that J was not there yet so he decided to draw a picture of his feelings. Everyone either drew or played games until lunch.

For the group activity I asked each of the boys to write down 5 things they learned this week. Many of them said they learned new things about their friends. One kid said he learned about art (since we had been in the art room).
The kid who called 911 said he learned not to "do stupid things", not to get angry over little stuff, not to steal, that he can do better, and that he can draw more than he thought.
The boy who drew his feelings said he learned not to cuss, not to fight, how to control his feelings, to be nice, and that his friend ("brother") looks up to him.
Another kid said he learned how to interact with his brother better, how to be nicer to his brother, and how to include his brother.

I feel like I learned a great deal more than all of them. I learned about each kid individually, as well as more about adolescent boys in general. Everything I have done in my practicum has been with older adults until now, and I learned how differently these groups act. I do have younger brothers that I help and interact with, but I learned there is a large difference in a relationship with a sibling or someone I know personally, and with a client. When one of these boys asked to do my hair, I automatically said I don't care. But one of the other adults told him that he needed to remember his boundaries. I am glad she stepped in and said something because I would not have otherwise said anything, or thought that this was too much. When another kid asked for a hug later on I did not know what to do because if doing my hair was crossing boundaries then hugging me had to be crossing boundaries. I told him he should hug the kid he thought of as a brother.

I find my biggest dilemma as a social worker is always trying to figure out where that boundary line is. How close is too close...how friendly is too much?

Wedneday, April 2

3rd day of Camp
This day started out like the rest, but by now we knew we were not going to get anymore kids. When I came in J and the kids were already having what seemed to be a serious discussion, which I found out later was very serious. It seemed the previous day (Tuesday) one of the kids decided at the end of the day to go to the office and call 911. He dialed it, hung up, and left like nothing happened. Of course the cops came to the school, the school called J, J called the boys. The kids all denied it, but luckily the office had a camera so they saw who did it.
So in the morning J was disciplining the boy about doing this, and it seems the previous summer he had done the same thing in another group. We tried to figure out what motivated him to do it, but he just said it would be fun. I tried to get him to realize that when he has the cops coming there for nothing it keeps them from going to a real emergency somewhere else. I asked how it would make him feel if he was hurt and needed an ambulance, but they didn't come because someone else had called and pranked 911. I also let the other boys each go around and tell him how they felt about what he did so that he knew what effect he had on everyone else.
We asked the other boys what they thought the punishment should be for his actions. Most said write sentences while another said stand in the corner. I could see this question reflected the kind of punishments they receive at home.
J and I came up with him having to write sentences, as well as write a short essay about what he did, why he did it, and what effect it had on others. He was not allowed to participate in activities the rest of the day, except when we did group activities. He also was not allowed to go anywhere without an adult with him.
Later that day I had a chance to talk to him alone (which is something I like to do with everyone I work with). I asked him if he could repeat the sentence he was writing without looking at it, but he couldn't. I asked if he knew what the use was of him writing that sentence, except just for punishment, but he didn't know. The sentence said something along the lines of "I will accept responsibility for my actions, and I will behave and follow the rules". I explained to him that he should first write the sentences individually instead of writing "I" down the line, then "will" down the line, etc. This way he would be able to remember the sentence later on when it became significant.
It is obvious why he should remember to behave and follow the rule, but I asked if he knew what being responsible for your actions meant, and he didn't. I explained that it meant he needed to admit what he does, even if it is hard to do that. I said taking responsibility means to tell others when he has done things and not let someone else be blamed, even if he is scared of getting in trouble. I asked if he was scared of getting in trouble for calling 911 and he said yes.
I then asked if he thought J ever got scared like that, and he of course said he thought J never got scared. I explained that that is what being a man is- even when you are scared still take responsibility, you still stand up for what is right. I knew that all the boys looked up to J and thought he was a big, strong man who was not scared of anything. Most kids think adults are perfect and that they have to be perfect too. I told him even J messed up sometimes, but he always took responsibility for what he did no matter if he was scared or not.
He seemed to really listen to what I was telling him, and really catch on to the concept. I asked him further if his best friend had been blamed for calling 911 and was sitting right there writing the sentences all day while he played, if he would accept responsibility and tell on himself. He said he probably would not because he would be too scared. I thanked him for being honest and asked if he would be willing to work on that.

By the third day the kids were getting restless and bored of doing the same activities everyday, so I found one of the custodians and asked if we could have access to the gym equipment. She took me to the principal to ask, and he said we could take out 5-12 items from the closet and keep it with us until the last day. The kids were ecstatic when they got to pick out things to do. We got out a volleyball net, bowling ball and pins, jump ropes, dodgeballs, and a few other things.

After lunch the group activity was another paper that had questions of: I feel (angry, scared, sad, etc) when..., my favorite (toy, color, food) is..., when i think of (black, orange, red, green, etc) I think of..., what is something (sharp, smooth, sour, sweet, warm, etc).... There were 44 questions total. Some things they wrote were:
I feel happy when I win, with my mom, have a good day.
The scariest thing in the world is when I'm in trouble, my mom, going to juvie.
Today I feel happy, pissed, sad, okay.
Rain makes me feel sleepy, tired, dark, good.
When I grown up I want to be a football player, pro soccer player, fireman, army man.

The rest of the day was pretty fun playing a larger variety of games.

Tuesday, April 1

2nd day of spring break camp
This day I came in I little more prepared, and at least had an idea of what we would do. I hoped more kids would show up this second day. The day before we only had 4 kids and since another group leader came to help, we ended up having 4 kids and 4 adults! This day started out like the previous day, the kids wrote their individual goals for the day, then went to the gym. We played the same games as the day before, with the exception that they boys wanted to go to the stage more and play games. 3 of the boys were drawn more to sports but one seemed to just have too much of an imagination for that. He brought some of his own small toys to play with and kept making up his own games. He had so much energy though and couldn't stay still no matter what we were doing. For him, everything was to the extreme.
After lunch J had another group activity for the boys, this time we played a game I cannot remember the name. We had a card with a word on it that we were trying to get our group to guess. the card had 5 other words on it that we could not use as clues. We only had 1 minutes to get our group to guess as many words as we could. It was fun using team work in this game. After that we went back to the gym and did the same things- play basketball, kickball, and football.

March 31-April 4

So last week was Spring Break for all of Hendrick's County and Wayne Township schools. Of course that meant my son was off school, but also that meant the kids who usually go to Cummins for the after school program were out all week too. Cummins offered a spring break camp for all their adolescent after school kids M-Th from 9am- 2:30pm. The guy who runs this program, J, asked for my help during the week since they expected a lot of kids, and I was happy to get experience doing something else, and to help.
When I showed up on Monday there was no one there, and I thought I was in the wrong place. I ran home to get something (it was at McClelland school, right by my house), and when I came back J, 4 kids, and another woman were there. I found out the other woman was there to help just like I was. I wondered where the other kids were because we were expecting close to 20 kids for the week. J asked each of the kids what their goal was for the week, and what they wanted to learn while they were there. One kid wanted to learn to get along with his younger brother better since they always fought. Another wanted to learn to deal with his anger better.
After we did short introductions J told the boys (all the kids were males) they could go to the gym to blow off some energy. One of the boys seemed to not be able to sit still, he kept getting up, moving around, and playing with anything around him. J came prepared with games, activities, and different balls. We played football, basketball, kickball, and other games. The gym had a stage so one of the kids (the one who couldn't sit still) went up there and came up with creative things to play.
After we had lunch J had an activity titled "This is me". It had 3 pages of questions like "the things I do best...", "If I had one wish...", "When I grow up I want to...", "The best thing about me is...", "what makes me the angriest is...", " and "Of all the thing I have done, I am proudest of...". I learned quite a lot about each kid through their answers to these questions.
Two of the kids that attended were foster kids living in the same house. They had obviously known each other for quite a while and almost considered each other brothers. one of the boys had just been adopted and once this happened he began calling his foster parent "mom". I thought this was a great break-through for him, but unfortunately it had negative effects on the other boy who was still only a foster kid. I could see it hurt their relationship and made the foster kid jealous. He tried making fun of the adopted kid for calling her mom, but the adopted kid was very adamant in how much he looked up to his adopted mother. In all his work he always referred to her as is hero, as someone he wanted to do things for, and someone he looked up to.
After this we went back to the gym and played basketball again, team kickball, and other things mainly just to pass the time. I knew the rest of the week would be a great learning experience, and a lot of fun!

Weeks of March 3-13, 2008

I am behind on my blogs so I am writing about things I wanted to share that have happened. Please remember if this gets confusing that I am talking about the weeks of March 3 through March 13, and I will try to be as exact as I can about the days.

Up until this point I have slowly started helping more with supervision of the group and running activities. My supervisor, Amanda, had to take two weeks off work for medical reasons starting around February 28th, so one of the case managers who runs Hoosier House on Thursdays, Pam, took over Hoosier House. Before Amanda left she made packets for both of us on what to do, how to do it, and everything we needed to get it done! I don't know how she keeps track of everything she does, but she seems to always be prepared for everything! While she was gone Amanda wanted me to start the progress notes every morning (they are done for everyone everyday) and enter the consumers' daily times into the computer.

When each consumer begins at Cummins they sit with their case managers, therapists, doctors, and/or whoever else is needed to develop their treatment plan. The treatment plan includes all the goals and objectives the consumer will work towards while at Cummins, everything they are expected to accomplish, and how long the consumer will need services. Every day at Hoosier House the consumers are working on one of the goals and objectives on their plans (it is the same one everyday). So in the morning on the progress note I fill in the consumer's name, their consumer ID number, and which goal and objective they are working on (i.e. Goal 2, Objective 1). The consumer writes an individual goal for that day on the note as well (anything from be nicer, learn something new, to practice daily skills or learn how to balance my checkbook). Before the consumer leaves that day they go back to the note and write whether they achieved their goal, and they sign it. Then the supervisor fills in different things about their behavior, appearance, mood, attitude, and other things from a checklist on the page.

For billing purposes each consumer must also sign in every morning what time they got there, and every time they leave they must also sign out. Sometimes they leave to go see the nurse for medicine, or they have appointments with their therapists or the job coach. Each of these people bill for the short time the consumer is with them so we have to make sure insurance is not being double billed. A consumer cannot be at the nurse's office for 15 minutes getting a shot and be in Hoosier House at the same time, so we have to be exact about these things. When the consumer leaves for the day they sign their time out as well. Some consumers come everyday, some only come a few days or one day a week. It all depends on what their treatment plan says they need, and what insurance will pay for. Most of the people there have Medicaid (otherwise it would be EXTREMELY expensive to pay out of pocket!).

Long story short, I am in charge of all this. At the same time I run canteen in the morning. Canteen is like a small snack bar with sodas, chips, snacks, fruit, etc. that the consumers pay for. The proceeds from this buys more snacks, food for free lunch Wednesday, and food for regular lunch (lunch costs $2.00). You wouldn't otherwise think about it, but canteen helps teach budgeting and money-management , as well as problem-solving skills.

I figured I would describe alot of this in detail because I know so many of my peers are in practicums where they do nothing like this, and are curious about these kind of details in my kind of setting. We all are writing about our experiences with the clients, but not about the little things. We have to remember that as social workers so much of our work is paperwork. The mandatory paperwork and documentation is different at every business. I know some out there may not even do progress notes, or deal yet with the goals and objectives we have learned about. When I first dealt with this in the workplace I was so excited to actually see what I was learning from school being directly applied on the job! Here's a quote that I heard once that everyone should remember when it comes to the hours and hours of paperwork and documentation necessary in social work and all health care fields, "If it's not written down, then it did not happen". Remember, everything has to be documented!

Week 2 integration question

I know I have already wrote about this shortly before, but I am trying to go back through and answer all the integration questions up-to-date, so I answered this more thoroughly:

How could doing research for classes impact your relationship with your clients?

When I first thought about this question I realized it could be understood a few different ways, and each could provoke vastly differing answers.

The first way I interpreted this question was to suggest that I was just doing any kind of research at the library for a class, and how the information I found in my research would come into play with my relationship with my clients.

The next way I interpreted this question was to suggest that I would do direct research on or with my clients, and how this would impact our relationship afterward. I believe the question is meant this second way.

Now that I had an idea of what the question meant, I first thought that doing direct research on or with my clients would actual hinder our relationship. I thought my doing the research would change their perception or idea of me.

The other day I had my mid-point visit at my practicum with my supervisor and Erika. We got to talking about my learning plan and different things I can do to improve it. Something was brought up about me maybe doing a mock eco-map or genogram with my clients. The more we talked about it the more I realized it would be good for my clients as well as myself to do direct research like that. This would help me connect more personally, as well as help the client realize more about themselves. So, in the end I say that doing direct research with my clients could improve our relationship.

3-18-08 integration question

What are the time frames needed for developing a treatment planning your agency from the time that the client enters your program. Who dictates that policy?

Cummins policies on clinical documentation timelines are:
1st appointment- Intake assessment, CSDS data sheets, Bio-psychosocial assessment, diagnostic impression, integrated clinical summary, and preliminary service plan

The Individualized Service Plan needs to be completed by the client's 6th visit. The plan will dictate the goals and objectives of each client, and will determine how long the client will need services.

The Director of County Operations and Cummins corporate staff dictate these policies.

3-16-08

I keep logging in to write about something that happened at work, then I start thinking about all the reflection questions and other experiences I have not wrote about that i need to catch up on, and I get overwhelmed then log out. So what I am going to do is try to at least stay current, and catch up on other experiences as I can. I will try to keep it from getting confusing as much as I can so please bear with me...

I'm not sure if I have explained much about what I do, but I work in Hoosier House at Cummins. We have adults with severe mental illnesses who otherwise would sit at home all day by themselves. They come to Hoosier House to have some structure in their day, and to learn a variety of Adult Daily Living (ADL) Skills. Each day we structure their time with a morning group, nutrition group, lunch, and two afternoon groups. Besides the nutrition group, all the groups vary each day, from social skills, budgeting, current events, coping skills, stress management skills, self care skills (hygiene), recovery lifestyle, exercise, etc.

The actual description published in the Hoosier House pamphlet says:

“Hoosier House is a Psychosocial Program for consumers of mental health services in Hendricks County. Hoosier House provides members with daily opportunities to engage in meaningful work that directly benefits all members. The work provides members the opportunity to focus on strengths, self-determination, and personal empowerment, develop adult daily living skills, and further knowledge. Hoosier House has a goal to concentrate on the recovery of the members and help members to reach their individual potentials through education, ADL skills, and social skills groups.”

One of the big differences between what I do and what many other people do is that the clients I work with (we call them consumers) will be my clients all semester while most everyone else will only work with their clients temporarily, or for a somewhat short period of time. Some people only see their clients a few times total, or maybe work with them for a couple weeks. I will see my clients everyday for the entire course of my practicum.

2-27-08

So I am loving my job at Cummins! I am learning new things every day, and starting to pick up on the signs of each mental illness. It has always been hard for me to separate people's behaviors and say THAT is from the mental illness. If someone acts out or different I never attribute it to a mental illness. Now I am starting to see at times when people act out it is not that they are intentionally wanting to do it, but instead that it is caused by their mental illness.

I am done with my first month of my practicum. My 1st week (Jan. 29-Feb. 1) I had 16:30 hours, second week (Feb. 3-8) 14:30 hours, third week (Feb. 10-15) 7:00 hours, and fourth week ( Feb. 17-22) 17:15 hours. For my first month at my practicum I had a total of 55 hours, 15 minutes.

"How could doing research for classes impact your relationship with your clients?"
This would depend on what kind of research I was doing. I have built great relationships with the consumers (we call them consumers not clients) at Cummins. Unlike most of my peers' practicums, I work with the same group of adults everyday. Most of my peers meet and work with clients, then do not see them again at all, or if they do see them it is very little. In those conditions it is hard to build any relationship, especially one based on trust and respect.

I have a day group of adults with mental illnesses who I work with. I actually think if I were to do direct research involving any of the consumers at my facility that they would love to volunteer. They all love to feel involved, needed, and helpful. I think doing research for class would only improve my relationship with the consumers.

links to LEAD pics and video

Here is a link to the rest of my pictures from LEAD day at the Statehouse. There are the pictures for our scavenger hunt, pics of statues outside, and pics of some of the marchers.

http://s167.photobucket.com/albums/u152/js57gifts/LEAD%20day%20at%20Indiana%20Statehouse/

Here is a link to a short video I took of the marchers outside the Statehouse.

http://www.youtube.com/user/js57gifts

LEAD Day at the Statehouse 2-6-08

Here are some of the pictures from LEAD at the Statehouse on February 6, 2008 for Group 4 (Jennifer Martin, Bryan Overbey, & Jennifer Schaefer). I really liked the idea of doing this scavenger hunt instead of just sitting and listening to more people talk, then leave. Prior to this day I had never been to the Statehouse. I learned a great deal about the Statehouse and Indiana's government and legislature from participating in the scavenger hunt with my group members. I would imagine several if not most of the other LEAD participants most likely did not venture to the second or third floors of the Statehouse or go to different offices in the building to meet important government figures. I am grateful for the experience. I have several more pictures, but these are the ones from the actual scavenger hunt. I will post another blog with the rest of the pictures, and the cool video I got of people rallying outside in the march.

My first day

So today, 1-30-08, was my first day on the job. I am now an intern at Cummins Mental Health Center in Avon. I am working with Hoosier House, an adult group that meets every day (M-F). All the adults have some sort of SMI (Severe Mental Illness), such as bipolar, schizophrenia, dissociative identity disorder, etc.

After my interview I thought it was going to be a real professional job, in a professional setting like a therapist's office. I really thought I would not like it but knew that even if I disliked it, it would make for a good experience anyway.

I found out today that the group is more laid back than I thought it would be, and I like it so far. I played bingo with the group members today to get to know each other. Everything they do needs to be therapeutic so we played "Social Bingo". The bingo card has questions on it, like "What is your favorite childhood memory?" or "What is your best accomplishment?". Each question had a different number on it as a regular bingo card does, and when a number was called, you read and answered the question for everyone to hear you.

Everyone included me right off the bat, and they were all friendly. There are so many things my supervisor is responsible for and part of my job will be to help her with it all. I am so excited to jump in and get started on everything!