By Erin Hernandez
I began working as a crisis counselor after I graduated from my Masters’ program.This program did not teach me crisis counseling, but did prepare me with a strong foundation of being with people when they are in pain; which is a pretty strong foundation. So, I began this work open and ready to learn and grow. Because I was such a young clinician, this added to my foundation and forever changed the way I will work with clients, people I supervise, or teach. It also has changed how I will forever be in the world at large and how I interact with systems; both large and small.
As I write this I realize that this is a series. One blog could not cover what I learned and a series will cover, in depth, each lesson or area of knowledge that I gained. This first blog will cover, big picture, what the scale of work included and how my job progressed and changed over time. So as to give context to later blogs in the series.
Welcome….to an exercise in tending and tilling the soils of my knowledge and experience. Like cutting into the ground in spring and seeing how the winter has left it. Because of stress and other things, at times I could not see the bigger picture. I could not see all that I was learning and allow myself to take a step back and feel, analyze, synthesize. I welcome you as you join me in this process.
When I first began working in the crisis office at a community mental health center, I was hired to work a night shift; from 9pm-5am. I was on call at home until called out to an ER or jail to complete a mental health evaluation. I was given an online users manual with the rules of our job; to reference before I was called out or while I was completing the evaluations. I was given a pager and used this at first when I would sleep. Even when I began using my cell phone to wake up to; I almost always startled awake, getting a nervous system rush right away. I knew I was being called to an environment that was filled with people who are working at night (a really hard task on the mind and body), to a client that was in crisis and not doing well at all, and that I would need all my faculties present so I could do a good job. All this, as well as everyday life stressors went into my startle response as I was awakened for my calls at night. This startle response continued through the length of my night shifts. I never could get used to being awakened in the dead of night to meet with someone who was in a crisis scenario.
The knowledge I want to share with you here is that there ARE people that continue to do this. Please be aware that crises happen at all hours of the night and day and there are people that respond to this call and try to care for those in need. I have also learned that from the stress of these jobs (the work itself, the hours, the lack of thanks from bosses & clients) can really get to people and they become hardened. Hardened to individuals that are suffering and hardened to those trying to help them.
When you meet someone working within a system, I would recommend to always think about the stress of working within that system and that they may have been doing this a long time and to have compassion if they are starting to lose theirs.
After working nights for this job I graduated to working weekend on call shifts from home Saturdays and Sundays 9am-9pm. This was easier on my body and mind in that I didn’t need to startle awake. I was already awake and could focus easily on using my mind to get ready for meeting with clients.
My jobs quickly progressed, and about 3 years after I began this job I started to supervise interns. I was so eager to supervise interns and was so protective of them! I had learned from my own experience training on the job, that interns and new hires were sometimes thrown into the work after little training. Now, that is one way to teach and people typically do pick up the work; but it can be traumatizing to do this. It can be traumatizing because of the exchange that happens with clients. When a client is experiencing traumatic reactions (often what happens during a crisis), the person with them can experience vicarious trauma from being around the trauma. It is also really hard in the beginning to balance the clinical questions and information you need to gather, with actually being present with the client and when you are new this can feel quite overwhelming. So, I was very protective of interns and how their learning progressed through their internship and would usually provide lots of contact, support and structure.
About a year after supervising interns, I applied for a supervisor job and got it. So, about 4 years after becoming a crisis clinician; I was now a crisis program supervisor. I was overjoyed and ready for the responsibility; and oh boy was it ever a responsibility!! I was in charge of meeting with clinicians for clinical supervision, responsible for all administrative paperwork for myself and my supervisees and being the supervisor on duty while on my shifts.
At first, I was afraid to be on shift by myself as supervisor, knowing that people would be asking me questions. I was afraid that I wouldn’t know the answer. Over time this faded and I began to trust that I would know the answers and if I didn’t; I would be able to either find it or tell the person where they could find it. I eventually became very comfortable trusting my knowledge and passing on my knowledge about crisis work. That will be the next blog; sharing my knowledge about clinical crisis work. Are you thinking about doing crisis work one day? Are you a client who’d like to get the perspective of a therapist? Are you a manager that wonders how your employees might feel? Are you just intrigued with this line of work and like hearing my stories? Well, if any of the above are true, blog #2 in this series will be for you.
Other blogs will cover topics like: clinical supervision & vicarious trauma, how vicarious trauma develops, working in systems (community mental health, government systems like Medicaid/Medicare) and how clients are viewed and how employees can be viewed, spirituality and crisis (what is the relationship between the two?).
If you are a helping professional and want to calm the flames of burnout, exhaustion or overwhelm of working within a high-intensity system, click here to schedule a free 15 minute phone consultation. I look forward to speaking with you.
Erin Hernandez is a Psychotherapist, Core Synchronism Practitioner and Clinical Supervisor for therapists and other holistic practitioners. Click here to read more about Erin and her work.