Do you have any advice for starting field placement? I start this August and am terrified I'll screw up or get too attached to my clients.
Yay! I looooove asks from therapists or from those trainings to do so. I wrote about this here so this is a more expanded answer but will be similar.Ā @othersideofthecouch answered this here. My answer isnāt going to be perfect and itās coming from my experience so itās just as flawed as everyone else. Also I know a lot of folks in therapy who arenāt therapists read this so a heads up - this may be okay for you but it may not. If it feels like too much, bounce out! Take care of you! {This is also like the worldās longest post so just fyi}
Take some breaths - all the shit you are going to be passing along regarding anxiety management, you are passing it on cause it works. So use it. Use the mindfulness and DBT techniques you know. Laugh with your peers, use your supervision and if you have it, use your field placement class if you are still in graduate school. Remember that you are the therapist and they are the client - when you the person is showing up with the room, it needs to be for a reason. Iāve seen therapists who have used sessions to spend the whole thing talking about themselves and it sucks. Remember that your clients donāt owe you trust - you have to earn that. OH and please for love of everythingĀ read this post by @cps-oteric if you are going to do any work with social workerĀ āin the system.ā You also may want to take a look at your social media accounts prior to starting.
The best advice I got in grad school was a professor (who continues to be one of my mentors and leads my consult group). They laid it out: āYou guys are going to fuck up. Every. Single. One. Of. You. Will. Mess. Up. Itās going to happen. Because you are human and your clients are human and there is room for mistakes. Now, Iām not talking about the mistakes you have a choice over - the stuff you guys covered in Law and Ethics. That you should always be aware of and strive to prevent. But the accidental mistakes? The mistakes of inexperience? Those can be incredibly valuable for your client too. Part of our job is give people a different experience - to own up when we fuck up and do the repair work with the client.āĀ
Why was this the most helpful for me? Because it gave me the space to feel like itās okay to make mistakes. It wasnāt okay to ignore those things or be intentionally fucked up but that I didnāt have to be perfect. I āfucked upā early in my first field placement - I had to call out unexpectedly. I did the right thing and called my supervisor, let them know and called the location I was supposed to be at that day. The site was supposed to let my client know and they didnāt. For the client, this is was major thing and we ended up doing a lot of repair work around but in owning up to the experiencing be shit for the client, even thoughĀ that wasnāt my intention, was a huge deposit in the proverbial trust bank and was new experience for the client. I didnāt apologize for taking the time - I needed it full stop - but I did apologize that it wasnāt communicated effectively to this client and validated/normalized the feelings that came up. Itās also important not to let your anxiety/discomfort/fear etc. around messing up, compound the mistake - which is why I am pretty into therapistās knowing their own shit. tldr; You are going to mess up but explore it with your supervisor, your mentors, your cohort. You wonāt be a perfect therapy robot.Ā
As to the second fear - look at what you mean by attached. Whatās the fear there for you? Often, itās around not being able to keep your clinical hat on because you will be too close and/or that it will hurt when you leave. There will be probably clients it hurts to leave. Leaving my last job, I had a couple of clients - man. I still think about them and hope they are doing well. There are a couple of clients right now, who if I left my agency, it would hurt to leave. And Iām not talking about being devastated or anything would indicate an over attachment where you donātĀ keep that clinical hat on but when relationships end - it can be sad.Ā Relationships have two sides, that connection develops no matter your modality - I canāt speak of all therapists here for sure. But all of the therapists I know personally and many of the therapists Iāve take courses from have experienced attachment in some way. Often, your clients will leave their fingerprints on you. Some in dust and some tattooed. Process your countertransference around this. Sometimes, in grad school, you get the idea that countertransference is all about the start of an ethical breach (or my Law and Ethics professor was just a royal assholeĀ which is a distinct possibility). You will have feelings about your clients - positive, negative and in between - and sometimes - right at the beginning especially for me - I thought grownup therapists had all their shit together and they didnāt have feelings about this shit which like WHAT?! No. You get better at riding those waves thatās all. Itās more likeĀ āoh yup, this clientās mom is making me feel Xā orĀ āthis client is bringing up frustration because of x and I know that and thatās just me. Gotta bring that to supervision/consult group/therapyā
It will depend on your placement and other factors. If you are working on a MRT or in a hospital, then you are will be affected by your clients, for sure, but your attachment may be different than it is for others with more long term placements. One of my really good friends from graduate school loves working on mobile response because she likes engaging with folks for a short period of time and has never had a desire to do the more long term work. I ended up being hired by my first placement so I had the opportunity to work with some clients for multiple years. And sometimes the length of time doesnāt matter. I saw a client for I think 2-3 times? Somewhere in there but no more than 4. But there was something about that client and those sessions that will stay with me forever. (I talked about this case in therapy when it was happening and I have a decent idea why). So your mileage will vary.Ā
Do your best to take care of yourself. Put your cases and clients, lovingly away at the end of the day. Set good boundaries with your agency and placement. Yes, you signed up to do a job but they donāt own you 24/7. Hang out with your friends, your family, your partner, your cat - whatever you love. Grab a coffee or a dinner with a friend or a cohort member. Have good boundaries with your friends. If you arenāt sober/working on sobriety, go to team happy hour and if you are, advocate to have a team activity thatās not a bar. Use your supervision. Reach out to mentors if you donāt think the placement is a good fit. Donāt forget to eat. Move your body. Watch TV or read a good book or garden or run or goof off on the internet but do something for you. SLEEP. If you are on meds, take them. If you can make it work (I couldnāt most of my traineeship and regret it), find a therapist. TellĀ āem you are starting your placement and some will dip low on the sliding scale cause weāve been there.Ā
You made it to the end of the this post! Gold Star! This isnāt a master post for starting therapists but itās a start. Check out theĀ ākeep yourself warm therapy posts,āĀ āfor therapists,āĀ ānew therapists,āĀ ābaby therapistsā posts if you want more :) Best of luck anon. Iām rooting for you. Update me if you remember!