Risky social work business

Sometimes I wish I could direct people to my blog when they ask how things are going at my new job. I become exhausted at times while trying to explain why it’s great, why it’s stressful, why it’s hard, why it’s fun… It’s helpful talking it out with some people, but sometimes I don’t even know how to start. How can I summarize all I’ve shared on here? And honestly I feel like there is so much about the new job that I haven’t even addressed in this blog yet.

One thing that has been a huge adjustment in my new position is how much is at stake each day. Or at least how much it feels like there is at stake.

For one thing, I have never done so many suicide assessments in such a short period of time. And it’s terrifying.

Each time I leave work after speaking with a child who is expressing that they want to die or want to hurt themselves, I feel empty and sad. It stays with me all night and often for days after. When one of my current clients was absent from school a full week after he shared his suicidal thoughts, my initial reaction was fear that something terrible had happened.

Another of my clients viewed the suicide assessment as a challenge and spent a large portion of the time we talked trying to make sure I knew that he could kill himself if he wanted to. So I spent that night reviewing all the possible ways he was hurting himself while I stared at my bedroom ceiling.

As you can see, this is all very healthy and not at all stress-inducing.

This week I met with a mother who told me that her son (the second of the two clients described above) had made cuts in his arm with a knife over the weekend and that two days earlier, he had bolted out the door while threatening to jump in front of a train and promising he would never return. I gave her a lot of phone numbers and suggestions of what she could say in-the-moment and encouraged her to err on the side of caution with calling for help and called my supervisor and prepared to talk with the student again and ultimately… felt useless.

This happened after a very relaxing weekend where I successfully (though clearly temporarily) let go of some of this stress and convinced myself that I was competent and able to meet the expectations of my new job. Not that this is about me. But it is.

It’s not about me because it’s about these students’ lives and their mental health. But it is about me because it is my job to be prepared for these situations and help as much as is possible.

So here are some things I am doing to help myself and hopefully help these students, too:

1. Re-reading the articles I have related to suicide assessment that I marked as useful from graduate school and elsewhere. This is one that I find useful when considering how to explore suicide with a kid who is not in immediate danger: “‘Who Would Find You?’: A Question for Working with Suicidal Children and Adolescents”

2. Listening to the second relaxation recording on this website. We did it during a training I attended and I weirdly like it even though I usually don’t respond well to that kind of thing.

3. Writing out a practice “script” before a suicide assessment (when possible) where I note things I want to bring up, anticipate how the conversation might go, brainstorm questions to ask, etc. Then throwing the script to the side before the meeting.

4. Looking for more books and articles that might be useful about suicide assessment or working with teens who are dealing with depression, suicidal thoughts, and/or self-harm (feel free to suggest any).

5. Staying hopeful for these kids because otherwise I don’t think I can reasonably expect them to be more hopeful.

6. Taking a lot of post-work naps.

Speaking of naps…

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7 thoughts on “Risky social work business

  1. Eileen says:

    thanks for sharing that article–I’ve tagged it for my own work (and realized that a good thing to do before exiting grad school would be to download as many good articles as possible).

    • Glad it seems useful for your work. And I definitely agree about the articles. I can email that one to you (or anyone else reading this) if you have any trouble accessing it. Just let me know!

  2. Jane says:

    Oh goodness I feel emotionally exhausted just thinking about the challenges you face daily. Please don’t forget how amazingly talented, compassionate and all around awesome you are, and that although you cannot fix everything in these children’s lives, they are SO much better off because they know you. And don’t forget to nap! 🙂

  3. btrflygl says:

    And here I was thinking I had a rough day at work. Thank you for supporting these kids and their families!

  4. God bless you and others who work with children who have mental illness. I can empathize with how difficult it is…

  5. I know this is an old post, so I am curious about what your thoughts are now. How did you managed through this tough time and how are your clients doing. I am graduating with my MSW in May and am applying for jobs in juvenile mental health.

    • Well, speaking of old posts… this is an old comment and I am so sorry for overlooking it. Despite leaving my blog in the dust for awhile, I had tried to keep up with email notifications! I am sure you are in the field now, but if you are checking this… I can say that a few years later, I feel no less affected by suicidal ideation/intent/etc from my clients, but I definitely feel more competent in my ability to assess risk and decide if someone can be safe or needs to be evaluated at a hospital. I think my favorite training post-graduate school was the ASIST training, which is actually oriented towards anyone – not just professionals – with the goal of creating a suicide first aid anyone can use. The aspect I use most is the idea of reasons for living vs. reasons for dying and the idea that the part of a person that wants to live has to save the part that wants to die. That is an oversimplification, but that’s the general idea I suppose. This appears to be the website: https://www.livingworks.net/programs/asist/

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