Monday, October 29, 2007

Self-Determination is a RIGHT...Let folks have it!

Hey my peoples! Today is Monday and I'm feeling a little...MEH. As luck would have it, I received a wonderful telephone call from a good friend of mine who is finishing up a research fellowship that's also a part of her dissertation (She's always been great at killing two birds with one stone). Today we talked about our mutual experiences in working with the less fortunate and how our ideologies, as they relate to race, class, and poverty have changed. She is a kick ass clinical social worker who is graduating this May with a Ph.D in Clinical Psychology. I am social worker functionally, but I lack the academic training to possess authentic credentials. Suffice it to say, we have markedly different approaches when it comes to working with clients, but we hold some of the same fundamental beliefs. Chief among those beliefs is that clients have a right to self-determination; that is, they should be allowed to make decision for themselves even if those decisions are to their detriment.

It's quite difficult to watch someone you've been working with for years regress back to the original state in which you first encountered them. Frankly, it's the pits. I am so tired of working my ass off to get people to a certain point in their lives only to be disappointed by them. This level of direct service is the most unrewarding, unkind, and thankless kind of work. I rarely ever have clients who continue to grow after we mutually agree to limit our contact with each other. Instead, I find myself going into crackhouses, heroin alleys, or the sex worker strolls to physically pull them up and out, to get them back into treatment or stable housing. When I do have a client who bucks the trend, they seldom live long enough to enjoy the accoutrements of their newly found independence from drugs and the poverty mindset (which is markedly different from poverty). See, my goal for most of my clients is to show them a different way to compensate for many of the things they see as shortcomings in their lives. We accomplish this by meeting clients where they are and by creating treatment plans that emphasize a client's strengths. We then create S.M.A.R.T. objectives or incremental action steps to achieve the goals of the treatment plan. Sometimes the plans work for a spell; most of the time, they don't.

I'm ambivalent, because many times I find myself judging them. I chide them for being lazy and complacent or for using illness and addiction to abrogate them from personal responsibility. I find myself being the polemicist, wanting to arrest the disciplines of abnormal psychology and psychiatry for providing people with a cadre of disorders to again, escape responsibility. Conversely, I find myself trying to be the understanding social worker, attempting to explain away bad choices as personality disorders or the direct result of drug addictions. What I'm learning now though, is that people definitely have the right to self determination. I should not expect less of them than they expect of themselves. I am learning that it's okay to be a help as long as I don't become an enabler. Most importantly, I am learning not to be married to people's outcomes; it's their life to make. I can only provide good advice (based on what information I have) and have a reasonable expectation that at some point people will have enough self-determination to expect more of themselves---and work toward achieving all that life has for them.

1 comment:

Miriam said...

poverty mindset (which is markedly different from poverty).

I think a lot of people don't know that there even IS a difference.