Author: Will
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Ending with a client without abandoning them
Read more: Ending with a client without abandoning themLena gives notice at her group practice on a Tuesday. Her last day is three weeks out, and she has 23 clients on her caseload. Most will be fine. They’ll meet the clinician taking over, or they’ll decide they’re ready to stop. Then there’s Gabriel, who has come every Thursday for two years, who brought…
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She takes the elevator instead of the stairs
Read more: She takes the elevator instead of the stairsNadia was six weeks postpartum when you first saw her. Thirty-one, first baby, a daughter, referred by her OB after a routine visit. No psychiatric history. Her husband came along and waited outside. She told you she wasn’t sleeping — not in the fragmented way every new parent describes, but the kind where the baby…
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When Your Suicide Prevention Hours Don’t Count
Read more: When Your Suicide Prevention Hours Don’t CountAn LICSW in Spokane gets to her October renewal with six hours of suicide prevention CE from a well-regarded ACE-approved provider. The course was good. The hours were real. The provider is accepted by boards in forty-some states. Washington isn’t one of them, for this requirement. Worth saying plainly before going further: in many states,…
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Where Your California Duty to Protect Actually Comes From
Read more: Where Your California Duty to Protect Actually Comes FromYou already know the name Tarasoff. Every California law and ethics course you’ve sat through has walked the 1976 decision, the shift from a duty to warn to a duty to protect, and the long academic argument about what the court actually meant. That history isn’t background material. The duty comes from the case law,…
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Implicit Bias in Social Work: Follow Your Gut?
Read more: Implicit Bias in Social Work: Follow Your Gut?Your brain builds associations from what it’s exposed to, repeatedly, over years. Faces with contexts. Names with outcomes. Presentations with categories. This happens without your consent and largely without your awareness, and it’s the same machinery that lets you read a room in three seconds or know a client is in trouble before he says…
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DBT for Social Workers: What is Radical Acceptance?
Read more: DBT for Social Workers: What is Radical Acceptance?Ruth sits in session fifteen, visibly exhausted. She’s learned the survival skills—the breathing exercises that help her sleep, the grounding techniques that get her through the worst spirals. And she’s still suffering. “I can manage the anxiety now,” she says. “I can get through the day without falling apart. But I’m still fighting the same…
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The Words You Choose Today Might Follow Someone for Years
Read more: The Words You Choose Today Might Follow Someone for YearsKeisha worked at a community mental health center serving a predominantly Black and Latino neighborhood. The agency’s records system came with documentation templates—dropdown menus built to keep charting consistent across providers. Most of the fields were fine. One kept bothering her. The template had a section called “Barriers to Treatment” with pre-populated checkboxes: “Lacks motivation.”…
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When Boundaries Bend: Dual Relationships in Social Work Practice
Read more: When Boundaries Bend: Dual Relationships in Social Work PracticeDr. Patel runs a thriving private practice in downtown Chicago where she rarely encounters clients outside the office. Two hundred miles away, in a rural Illinois town, social worker Maria Lopez can’t buy groceries without running into three families from her caseload. Both face boundary challenges, but their realities couldn’t be more different. That difference…
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When Your Home Becomes Your Therapy Office
Read more: When Your Home Becomes Your Therapy OfficeYou’re three minutes into a session with Isabel when your cat jumps onto your desk, knocking over your coffee mug. Behind you, your teenage daughter’s TikTok music starts blaring from upstairs. Isabel laughs and says, “Your house feels so homey—nothing like those sterile office buildings.” Your stomach drops a little because Isabel just learned you…
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When Understanding the Problem Is the Problem
Read more: When Understanding the Problem Is the ProblemSome clients come in already knowing too much. Nathaniel was 38, a high school assistant principal, and he had been to the emergency room three times in four months convinced he was having a heart attack. Each time, the workup came back clean. His physician diagnosed panic disorder and referred him to therapy. By the…