This quick guide offers insights for looking inward and “zooming out” when providing behavioral health services.
Tip 1
Pay attention to your prejudices, conditioned reactions, and self-involved perspectives.
To be fully present in person-centered services, it starts with looking inwards. This is especially true when serving people who face poverty, stigma, scarce resources, and broken systems of care. Secondary trauma is an occupational hazard when in contact with such disadvantaged people every day.
- What prejudices do you harbor consciously? — Is this client just here to keep their welfare benefits and uninterested in working and changing?
- What unconscious prejudices might I harbor? — About race, gender, sexual orientation, work ethic, poverty?
- What are my conditioned reactions in assessments? — Daily use of any substance, legal or illegal, is addictive use. Diagnostic criteria for Substance Use Disorder do not reference frequency and quantity of use, but rather the process and effects of using on function and life consequences.
- How stable is your emotional and home life, finances, intimate partner relationships? — Are you so preoccupied that you have little reserve to be present for your clients?
Tip 2
See the forest, not just the trees.
The idiom “not seeing the forest for the trees” means someone is too focused on minor details and failing to grasp the larger, overall picture or situation. It’s like being so close to individual trees that you can’t see the entire forest.
When faced with a challenging client situation, it is easy to get too close to the “trees” of:
- Client reluctance to change and poor follow-through
- Diagnostic ambivalence about marijuana use — is it medical, addictive, or recreational use?
- Self-medication of mental health problems or co-occurring disorder use?
- Lack of resources
- Complex service choices
A 500-foot view of the forest might focus on:
- What does the client want most? — Just to keep their welfare benefits? Mental health services but not addiction treatment or vice versa? To get on disability? To get a job or housing?
- Does the client meet criteria for Substance Use Disorder despite quantity and frequency of use?
- Is more history information needed to look at the time sequence of substance use in relation to mental health symptoms?
- Are their treatment providers skilled in assessing and treating co-occurring disorders?
- What systems changes are needed to meet the need for complexity-capable services?
Read the entire July blog on David Mee-Lee's Tips n Topics here →
Authored by Dr. David Mee-Lee, “Tips & Topics” is a monthly blog covering three sections: Savvy, Skills and Soul, with additional sections varying from month to month. Topics include Stump the Shrink, Success Stories and Shameless Selling.