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Holding Hope Services

Julie Fanning LCSW

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holdinghopeservices

Transitioned My Blog To…

Hello,

I’m in the process of transferring my blog posts to my new blog on my website.  Please check me out at http://www.holdinghopeservices.org/news.

If you want to follow my new blog, get updates on my practice and tips on living your best life, sign up now!

 

Considerations – Your Child and Counseling

You would do anything for your child.  It hurts when you see him or her struggling.  Maybe there has been a family trauma.  Maybe a parental divorce and you want to make sure your children are doing OK.  Maybe your child is anxious about school, has bullies they are dealing with, friendship issues or grappling with feelings of self-worth.  Maybe they are struggling with issues such as drugs, sex or cutting.  There are tons of reasons your child might benefit from counseling.  First,  give yourself some praise if you are thinking about helping your child with therapy.  It might feel as if you failed somehow but you haven’t!  Life is difficult for adults and it is sometimes even more so for children and teens.

I believe counseling can be valuable for everyone. I would caution you to consider, that therapy for a child or teen, may look different than for an adult.  As an adult, we know why we are going to therapy.  We may be looking for someone to clarify and ground us or looking for answers to numerous different questions.  At some level, we buy into going to therapy for ourselves, but your child may not have the same buy-in for their therapy,  Even though I believe the relationship is always paramount, an adult may find what they are looking for in a few sessions, but this more difficult outcome when working with children.  The dynamics are different in child therapy.

Continue reading “Considerations – Your Child and Counseling”

May is Mental Health Awareness Month

Although May is just about over – speaking out about mental health is ongoing.

mental health awareness

(This article originally appears:http://mswonlineprograms.org/2016/mental-health-awareness/)

Did you know May is Mental Health Month?  May is designated to highlight the discussion of mental health and helping fight stigma.   The National Alliance on Mental Illness (NAMI) indicates that over 43 million adults live with a mental illness every year – that is approximately 1 in 5 adults in the United States.  This means that you know many people who are struggling with mental health issues.  If you are in a helping profession you are likely encountering many individuals whose mental health is affecting their day to day life.

What can you do to promote mental health awareness and your own mental health?

  • Talk about mental health issues. Secrecy can breed shame and there is nothing shameful about mental illness.  Talk about your stories and talk about how you take care of your own mental health.   Mental Health America this month encouraged individuals to tweet about their own mental health experience (#mentalillnessfeelslike) – Check it out.
  • Consider the language you use every day.  I actually struggle with this one.  I would always use the word “crazy” to describe situations.  With clients, I’ve learned to use the word symptomatic when discussing behaviors or their symptoms.    I still struggle when trying to describe other types of situations so I’m often testing out words other than crazy in my everyday life!
  • While considering your language – remember that individuals who have a mental illness are not just their diagnosis.   Don’t say someone is schizophrenic – say he has a diagnosis of schizophrenia or is living with schizophrenia.
  • Consider downloading and using mental health apps that are available for your phone and tablets. There is an abundance of free and low-cost  apps out there.  Go on a search and see if you find any that fit you. One comprehensive list of mental health apps is http://www.zurinstitute.com/mentalhealthapps_resources.html.  This list is broken down into every area you can think of including depression, substance abuse, eating disorders, weight control,  anxiety, children and much more.
  • Advocate for mental health services. You may not be on the street protesting but there are a lot of little ways to advocate for mental health services.  You still can sign a petition or vote for individuals who support mental health.  Mental Health America states there is 1 mental health provider for 790 adults.   I supervise a team that helps individuals successfully transition back to the community.  Anecdotally,  I know when we try to find individual’s psychiatrists in the community, that the first available appointment is often several months from the time the person needs it.  Talk to your insurance company and local businesses about making sure to have mental health resources available.    Encourage Tele-psych andTele-counseling for individuals who are unable to find or get to traditional services.  When you see an opportunity – speak up and have your opinion known.
  • Take Care of your own mental health.   When you are caring for your own mental health you generally feel better and more confident and you are able to help those you love and those you come across live better also.  Below are some ways to help your own mental health.
    1. Try therapy and counseling. Therapy and Counseling is not just for individuals with severe mental illness or someone going through a severe trauma – although it can certainly help in those situations.  Therapy can help you focus on next steps in your life.  It is undivided attention from someone who is showing you unconditional, positive regard.  Therapy can make your life clearer and more full.  It can help motivate you  or help you work through little things before they become big things.  Sometimes therapy offers validation that you may not be able to get from family or friends.  If you plan on being a therapist yourself, I would strongly encourage you to participate in your own therapy.  I have seen great therapist debates about if therapy is necessary to being a good therapist.  I believe only ones self can answer that.  However, I know I am a much better therapist because I engaged in therapy.  (I also think I am living a happier life!)
    2. Get enough sleep. Our bodies need to rejuvenate.  We need enough sleep and my guess is 5 hours each night doesn’t cut it.
    3. Have something to look forward to. I actually end most of my sessions with clients with the question  “what are you looking forward to?”  Answers vary from something they are doing today to future events to broad plans.  Make sure to have things to look forward to.  I try to have some type of trip planned all the time so I can spend time making plans and getting excited.  You don’t need to be elaborate but plan activities for the future.  It can be planning a road trip someday or spending a day at the museum.  Whatever it is, find activities you can do to get ready for your adventure.
    4. Have a day (or even a few hours) where you just read or catch up on TV shows. Give yourself permission to do nothing.
    5. Laugh and enjoy the relationships in your life.
    6. Add your own. Look back on when you feel relaxed.  Is it a warm bath or a hike outside.  Is it playing the piano or dancing to music or praying?  Whatever it is that brings you peace – go ahead and do it.

Keep up the discussion for mental health awareness all year long.

 

 

Social Work and Professional Grief

Hello!  Happy Spring.  I’m in completely into my “I am not wearing socks until next winter” season.  I don’t care if it 46 degrees out – tomorrow is May and I’m not giving in.

Here is my April MSW online blog post about Social Workers and dealing with clients and loss.  The original link is http://mswonlineprograms.org/2016/social-workers-and-professional-grief/

Although social workers often see the very best of people, there is no doubt that the average worker also sees much sadness and struggle. Some social workers practice among poverty and violence.  Some work with individuals who are physically ill or dying.  It is safe to say that social workers treat an array of people and problems.

This sadness can add up.  I supervise a team of care coordinators who work with individuals who have high acuity of physical and/or mental health needs.  They are transitioning clients from a long term setting into the community.  Although they see lots of success, they encounter loss each day.  They listen to people’s stories which are wrought with loss.  They watch people relapse into addiction.  They watch individuals deteriorate physically and sometimes decompensate mentally.  They have clients die under both expected and unexpected circumstances.  This can be wearing on workers.  When we experience loss we often feel grief.  Grief is one of those uncomfortable feelings we often try to avoid.

Most of us understand personal loss.  Personal loss includes things like a death of family or a loved one.  It may be loss of a pet, a job or of a dream.  It may be loss of an idea or transition to another stage of life or a divorce.   We deal with personal loss by using our support system and talking about it.  We have rituals and memorials.  We use self-care.  Much of our personal life is seen by people we love so there is support.  It can be somewhat different for professional loss.

Professional loss is what we experience in our work lives with clients.  It is different from personal loss because the relationships are different and often we don’t stop and take a moment to acknowledge and grieve.   Professional losses are often internalized.  It is possible we might go home and say we had a rough day or maybe even say a client died but we can’t share much of our experiences with family and friends so we miss out on the support you would get when family and friends are sharing the loss with you.

Some thoughts to remember about professional grief:

  • Just because you have been doing the job for a while or work in a field where people struggle or die often – doesn’t mean you get used to it. The loss may be expected but it is still a loss.  Make time to acknowledge the difficulties of your job and the loss you experience.
  • Don’t ignore the grief because you are busy. I don’t think there are many employed Social Workers who don’t have much more to do than the time they have to do it.  If one of my workers experience a loss with a client, they still are required to keep working with their other clients, make good clinical decisions, keep up on documentation and so on.  Even though someone is busy, ignoring the grief isn’t helpful.  Just because we push away a feeling for a time doesn’t mean we don’t have to deal with it.  Eventually, the grief catches up to you.  Not ignoring it now will help you be healthier and less prone to burning out at your job later.
  • If you are not acknowledging grief and allowing yourself time to feel, your grief may come out in other emotions You might feel snappy, resentful, guilty or helpless. Besides not being fun emotions it may affect your ability to do your job well.
  • You might judge yourself harshly if your client seems to struggle too much or dies – stop it! Of course, it is a good idea to assess what steps we have taken or missed taking.  Recognizing lessons learned is an important part of maintaining and improving our clinical skills.  However, remind yourself that you make the best decision you can with the information you have at the time.  Social workers aren’t omnipotent and you can’t know every possible outcome.
  • When you continuously work with never-ending loss with clients or you work with clients who die – sometimes it will affect your decision-making skills. For example, the care coordinator I had whose client died, assessed another client who presented similarly.  When this case was discussed with the multi-disciplinary team she was adamant the member not move out to the community.  I asked her, if previous to her experience with the member who died, would she have recommended transition to the community.  The care coordinator said yes.  Make sure you don’t over or under react to situations based on grief on the job.  Talk to your supervisor and colleagues.
  • Know your limitations and – especially if you are a supervisor – be flexible. In the case above, the care coordinator said that she wasn’t at a place where she could work the case for the new client.  I was able to assign to another care coordinator who was at a place to work the case.
  • Take time off if you need it. None of us or indispensable.  No matter how talented and wonderful you are- your job can live without you for a day or two.  If you don’t make time when you need it – it is possible you will get to a point you can’t do your job at all.
  • If you are a supervisor, make your team meetings and yourself a safe place to discuss loss. After I saw the struggle some of my team was having with client deaths, we had an open discussion about our experiences with client loss and a discussion of the feelings and struggles we have.  We also talked about our role in client’s lives and how losing the client affected us.  I did a follow-up training on professional loss and encouraged discussion as well as checking in during supervision.
  • Either individually or with colleagues, you might consider have a ritual or memorial when clients die or there is a particularly hard case. Tell your client’s story to each other and tell your story of the client.  By telling your story, I mean tell about your experiences and reactions to the client’s life.  Talk about how it affected you.  Tell about what endeared you to the client and what were the parts with which you had difficulty.
  • Don’t ever forget self-care. If you don’t care for yourself you will have nothing left to give.  Spend time with your family and friends.  Read some books, listening to music, go hiking, meditate or pray, exercise or play with your pets (which is a big one on my team.)  Self-care makes sure you have the emotional energy to grieve and keep going.

The nature of Social Work is that there will always be loss we are working with.  I remind my team (and myself) that it is worth it.  We witness and help heal people.  That even though there is continuous loss that we listen to people’s stories.  We may not be able to fix everything.  We may not be able to stop a relapse or stop a client from dying, but we have the opportunity to honor their self-determination and really hear their story. That is the gift we give our clients most of all.   Take time to grieve the professional losses so you are able to continue witness and heal those with which we serve.

candle

 

Happy New Year!

Happy New Year!  I just want to wish everyone joy and prosperity for the new year!  My wish for you is that you do that one thing you have been wanting to do.  Take that chance, live that dream, believe in yourself.  I want you to remember that you are worthy of love happiness.

I also want to share the link for my MSWonline blog post  – Social Work and Spirituality!

MSW online blog – Social Work Practice and Spirituality

 

Enjoy each moment!

Assisting Individuals With Mental Illness – October MSWonline blog post

Happy October!  My favorite month of the year and it is coming to close.  I struggled with this month’s blog post for MSW online.  I have a passion for helping people who help those with mental illness but had trouble with demonstrating that passion in my writing.   This is geared to people considering a career in social work or new social workers, but I think it can be used as a nice primer for everyone!

Original blog post here:  http://mswonlineprograms.org/2015/assisting-individual-with-a-diagnosis-of-mental-illness/

As a social worker, you often work with vulnerable and struggling clients.  One such group, you may work with are individuals diagnosed with a mental illness.  Mental Illness does not discriminate.  Any population you work with, will likely have some people living their life with mental illness.  Sometimes because of media portrayals and other misconceptions, working with people diagnosed with mental illness can be scary or daunting.

There are many types of mental illness. The DSM-V (where the criteria for different mental health diagnoses is listed) has about 991 pages.

Below are some basic definitions of common diagnosis you might come across.

One definition of Mental Illness I like is from the Mayo Clinic

Mental illness refers to a wide range of mental health conditions —disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time.

(www.mayoclinic.org/diseases-conditions/mental…/definition/con-20033813)

I like this definition because it normalizes mental health issues.  Mental health conditions run on a continuum.  Just like people, mental illness is complicated and some people struggle with more difficult issues than others.

Specific Diagnosis Definitions (Also using the definitions from the Mayo Clinic.)

  • Major depressive disorder — prolonged and persistent periods of extreme sadness
  • Schizophrenia is a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior. Contrary to popular belief, schizophrenia isn’t a split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking.                                          (http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/definition/con-20021077)

Those are just some of the diagnoses you may come across in your work.  Let me share some tips for a social worker to remember when working with this population.

Continue reading “Assisting Individuals With Mental Illness – October MSWonline blog post”

You are a Tea Pot. (Guide to self-care for Social Workers and Everyone else!)

For my September mswonline post I wrote about self-care.   Imagine you are a tea pot.  It is vital you refill so you can share more tea.  For some tips on self-care click on over and tell me what you think!  I hope fall is treating everyone wonderfully and you are finding moments of joy and peace.

 

You are a Tea Pot. Self Care for Social Workers and Everyone Else!

 

 

food-tea-sugar-sweets

August MSW online Blog – Technology, Social Media and Social Work

For my August MSW online blog I wrote a quick overview on Technology and the Social Worker.

 

nature-laptop-outside-macbook

 

Technology, Social Media and the Social Worker

My Rant on Being Fat!

I am fat.  I’ve been told this my whole life by both friends and society.  Sometimes I will look at a photo of myself from when I was young and will wonder why everyone thought I was so fat.   Maybe it was a self-fulfilling prophesy but I am fat and that has been part of my identity as long as I can remember.  At times it has determined what risks I have been willing to take and what experiences I participated in.  I would blame it for relationship troubles or truly believe it was one of the reasons for general unhappiness at different times in my life.   As I’ve gotten older I am able to more often recognize that I am not just a fat person and my weight doesn’t determine my happiness.   Also – and this important for people to remember about themselves too – what I weigh does not determine my worthiness as a person.  I am going to repeat that.  Our weight does not determine our worth as a person.  The value I have as a human and my happiness are not dependent on numbers on a scale.   Each of us is worthy of love, happiness and kindness,  regardless of how much or how little we weigh or our physical appearance.

Right now I am doing the whole30 challenge.  I get accolades about how great it is that I am doing this.  If I lose weight, I will get praise for losing weight.  People will say “You look so good.” Or “It is so great you are hanging in there.”  I soak up any praise and it it is a motivator to keep eating healthy. However,  when it comes down to it, if I choose to live healthier, if I lose 40 pounds or if I end up gaining 40 pounds – it makes no difference in who I am.  I am a not better person if I weigh 40 pounds less.  I will not be less worthy if I gain 40 pounds more.

In my private practice both women and men come in and virtually with each and every person there will come a time where there is a discussion about weight and negative feelings surrounding it.  I have worked with so many teenage girls who have issues around their weight.  They tell me “My mom (or my grandma) told me I need to lose weight.”   These are teens who are active and within the norm of weight for their age and they will cry and ask why their parents can’t accept them if they don’t weigh the right amount.

Then I have adult women come in and tell me the same stories of family members and friends telling them they needed to lose weight.  They are told they will be all alone in life because they are fat or if they didn’t lose weight they would never find happiness.  Generally, these messages are well-intended.    You want the people you love to be happy.  Only, the feelings these messages induce don’t go away.   It sends a subtle implication that you are not quite good enough because of your weight.  You might not even notice you are saying these things to others or yourself because it is such a part of our culture.  It is difficult to step away from thoughts about weight because American society is filled with the messages everywhere telling us that thinner is better.

      Julie in first grade   "Too fat to have friends"
Julie in first grade
“Too fat to have friends”

When I started first grade there was a girl who told me she wished she could be my friend but she couldn’t because I was too fat to have friends.  I wasn’t even six years old.  Now, almost 40 years later I remember this and I know it became part of my identity.  I don’t remember the girl’s name or face but I remember the conversation.  Probably one of my brain’s first lessons on starting to believe “don’t be fat or you will be all alone.”     How much more will words about heaviness stay with someone when it is a family or friend saying them.  You might say “I worry about their health, I want them around for the grandkids” or a hundred other very valid reasons why someone would be better off losing weight.  You are just trying to help.  I would argue that if the person is an adult – they are very aware of how much they weigh.  It only amplifies the shame to be reminded that your fat bothers others and you are not quite good enough because you don’t lose it.   There are ways to be encouraging and supportive without adding to pain.  It is up to the person to decide how they want to tackle their weight.  People have very complicated relationships with food and weight.  You can be pithy and say “just don’t put it in your mouth” but there are often many factors at play.  It is not necessary for you to let someone know they need to lose weight.  Even disguising it with “I worry about you” is still saying “you are not good enough because of your weight.”

I’m not saying you shouldn’t help your children be active and maintain a healthy weight.   I would just say consider how you promote it with your children.  Eat healthy and be active yourself.  Don’t hold others to expectations you aren’t able to sustain.  Live by example.  Which also means recognize that each time you put yourself down for your weight or your eating or exercise habits you are teaching your children and others that your importance has something to do with your physical looks.  You are even reinforcing your own beliefs.  “See I’m not good enough because my body isn’t perfect.”  Stop yourself when you find yourself putting yourself down.  Stop comparing yourself to others.  I bet virtually everyone who reads this has thought at one time or another “at least I’m not as fat as that person.”  I have thought it.  Unfortunately it just reinforces the idea that if I weigh less I am better.  Being a little healthier than someone else does not give us the moral high ground.

Not making your weight be such a huge factor in your identity doesn’t mean someone can’t make changes and be healthier.  I want to live healthier.  I want to lose weight.  I want a better relationship with food.  These are reasons why I am doing the Whole30 challenge.  However, this is my journey.  If I don’t succeed I will be disappointed with myself but it doesn’t make me a failure at life.  Conversely, if I complete the challenge it won’t make me a better person.  Happiness, love, money and opportunity won’t just fall out of the sky to me because I shed a few pounds.  My life will still be my life.  If you are working on changing your weight do it for you and not because you think it will make others accept or love you more.

I want to note that it is OK to accept yourself at whatever weight you are.  You don’t owe anyone explanations on how much you weigh.  You are allowed to be happy and enjoy life and it is not dependent on your size.  You are worthy of love and joy and you will find the people who really matter don’t care how much you weigh.

I know as someone who is heavy that it is easy to forget to live life because you are waiting to lose weight.  Just don’t do that.  I am working hard at living the life I choose, embracing opportunities and not letting my weight stop me from living.  Whatever we are on the outside does not determine our happiness unless we let it.  I know that it is easier said than done, but my hope is that instead of focusing on our perceived shortcomings that we instead embrace life.  You are worthy because you are alive.   Instead of feeling shame over your weight focus on embracing experiences, loving those dear to you and being kind to all.

Julie- July 2015 Living Fully Pacific Ocean
Julie- July 2015
Living Fully
Pacific Ocean
With BFF Karen Campbell Embracing Life Accepting Me
With BFF
Karen Campbell
Embracing Life
Accepting Me

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