DAY NINE
Day nine here at the office turned into a quiet one due to the nature of the patient's cases that were coming into the TiPS offices that day. To begin, my presence here and in the doctor's offices, getting to sit in and watch professionals work is a privilege and a luxury, one that could be terminated by the patient's wish for privacy or due to the nature of their case. An important part of my project was recognizing that people have always been less likely to talk about a mental disorder than they were to talk about a physical aliment. Having out-patient centers like the Children's office in Wexford was a place to combat that fear, this office was more rurally located and didn't require people to travel to Western Psych in Pittsburgh. The out patient office are a lot less intimidating and appear more comforting to patients who are nervous for their appointments. Even still, with the sunny, open offices, and the kind looking staff, it can be nerve raking to go to a behavioral health therapist or doctor for the first time. This is made even harder when a person is a young child and their big decisions are often made by their parents. I often would receive permission to sit in on sessions by the parents of the patients, but I was always aware that I needed to keep my eye on the child and the therapist I was shadowing. If I got the sense that the child was too uncomfortable with me being there even though their parent had said it was okay, I had to make sure my presence was not inhibiting the production of the session. If this was the case I would need to make an excuse to leave.
Fortunately, this level of discomfort never did arise on the sessions that I was able to sit in on, but there were sessions that I was bared from entirely. People protect their privacy and having a stranger sit in on a discussion about how their brain was effecting their behavior is a step outside any normal comfort zone. Today was one of these days more than anything else, but I was not too discouraged because even after not being brought into a session to watch I still got to appreciate the care and respect the therapists and doctors give their patients. Part of why the mental health world has had such a hard time getting a good name for its self, is do to the lack of discussion and research put to new drugs and treatments in the psychiatry field in the way physical medicine receives new work. All medical discoveries had to come from somewhere and unfortunately, some of these trials completed in the name of behavioral and mental health did not follow ethical guidelines. Guidelines that would later be put in place to help keep researchers on the straight and narrow and would later be put into place to protect patients, leading to the bad spots in psychiatry's history.
Today's treatment and what I have had the privilege to follow along is nothing like psychiatry institutes of the past. The Children's office only offers fantastic work, helping kids with an array of behavioral disorders, never judging or causing more pain only a plan and a solution attached. The sessions I have had the chance to sit in on only prove this point over and over. The care that gets put into each session and each kid that comes to visit a therapist, counselor or doctor gets the best care that they could receive and with time, will get a better chance at life from their visits.
DAY TEN
Today I had the chance to shadow Pete Mullican, who is a licensed professional counselor (LPC) who works just for Children's behavioral health center. His job is very similar to Stephanie and Colleen's jobs as licensed clinical social workers (LCSW), the main difference is the schooling and the certain extensions of what an LCSW can do over a LPC.
I learned that Social Anxiety, which manifests as speaking up in call, saying hello to someone in the hall or speaking in public, can cause problems. One time that social anxiety can become a concern is when transitioning from elementary school to middle school. There are many social stressors in middle school. CBT , cognitive behavioral therapy, can be quite helpful for Social Anxiety. Not all therapists do CBT. Pete taught me referred to anxiety like an alarm system Anxiety may be try to tell your brain that a situation is a 911 full panic mode, when it is not. CBT training helps people evaluate the alarm in their head and respond appropriately. Grounding strategies can be used to help children and adolescent cope with uncomfortable feelings. Exposure therapy is a key component of treatment for social anxiety disorder. iN exposure therapy the patient mades a list of the situations that they are afraid of and then ranks them on a ladder. Pete will help patients make this “exposure hierarchy” and then walk them through completing tasks related to each feared situations. They will start with the easiest situation and work up to the most feared. Each opportunity to try a hard situation is an opportunity to practice coping skills and gain control over the fear and worry attached to them.
(This is called mastery)
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