Monday, November 30, 2009

Off my game

Three days at Jerusha's -- Friday, Saturday, Sunday -- means three days off the light box. I used it today, but probably not long enough. So when I got to work I was kind of relieved that a few of my clients didn't feel like showing up.

My newest client, however, was so eager for treatment that he arrived half an hour early. (I'm still getting used to having clients who voluntarily sign up for treatment, instead of being coerced by parole or probation.) And appeared disheveled and distraught. I was so busy soothing him and trying to hear his story, I completed the biopsychosocial assessment but completely forgot the confidentiality paperwork.

Confidentiality is extremely important in mental health care. Clients have the right to have their information protected to the greatest legal extent. They also are entitled to read and sign the program contract, so they know what's expected of them, and to designate an emergency contract.

I forgot to do all of that, so I'm pretty appalled at myself. True, nobody is going to die, but it's a pretty serious mistake. How could I forget it? I'm going to have to talk about it in supervision. I'm pretty sure my supervisor will cut me some slack, but seriously: this is a mistake a first-year social work student wouldn't make.

The distraught client left the office in a pretty good mood. Said that was mainly because my voice was so soothing. (I speak very differently in therapy session than I do in my personal life or staff meetings.) I also talked another voluntary client out of leaving the program after he relapsed, and even got him to give up a urine sample when he felt it was sufficient to tell me it would be positive and initially refused to pee in a cup.

So I guess I got a few things right. But I'm not functioning at 100% of capacity. Tomorrow I'm watching the light box for at least half an hour.
Copyright (c) "Ayelet Survivor"


  1. I am totally not going to say "give yourself a break," as I expect most will. You should be appalled at yourself: how would YOU feel if your new psychologist/social worker/psychiatrist forgot to give you confidentiality paperwork?!!! If it was me, I wouldn't come back.

    Also, you're probably right, probably no one will die. But - this is a guy who came in distraught and left in a good mood because of simply your voice. To say he's emotionally labile is probably an understatement. I hope he doesn't flip back to distraught. I hope nothing does happen to him. You don't have an emergency contract (you wrote) or contact (not sure if that's what you meant) for him. Either way.....

    No way can you write this off on missing some time with your light box. If that's what it is, next time, you need to take the day off.

    Sorry, I know this was rough, but seriously? this is a big deal. Let everyone make you feel better. Someone should be honest.

  2. After that, I don't think anything anyone says will make me feel better. I appreciate the honesty. And I did mean "emergency contact," not "contract."

  3. Oh, Gabrielle, whoever you are, lighten up. Of course it's serious but everyone makes mistakes. Just read stuff medical doctors write on this topic. Ayelet gets how important it is. We all have off days.

    Ayelet, own up to the error and then move on! You are a great therapist. There, I said it.

  4. that voice, try using it on yourself.

  5. Agree with FTT, as usual. I'm going to have to post faster so she'll agree with me at least one time instead of vice versa! :)


  6. This is not a big deal, move on and have him sign it at the next session.