Memoirs of A Healer/Clinical Social Worker: Autobiography of Bruce Whealton

Chapter 36: Trauma Disorders, Client Rights, And Outpatient Treatment

[Disclaimer: I have used aliases to protect the confidentiality and identity of clients or patients. No other names have been changed.]

While I was working at Duplin-Sampson County Mental Health Center in Clinton, North Carolina, I had a number of different responsibilities. I was hired as a Social Worker III. That was my title. I worked as a therapist/psychotherapist and I had to do intake assessments, as well as maintain a caseload of some fifty or so clients who came for therapy and medication monitoring.  

I was frustrated that they didn't let us do therapy with clients without being interrupted. Other mental health clinics in North Carolina manage this but they couldn't figure this out. I would be meeting with someone and the receptionist(s) would get mad if I did not pick up the phone if I was in session with a client.

Sometimes I would pick up on the second call and they (one young woman was the most irritating) would ask me why I didn't answer, and I'd say "I was working with a client - we are doing therapy. I was distracted."

"Well, she has to see the doctor and he's ready."

I would think, and sometimes say, "I'm not ready" or "we aren't ready." I would then say "she's a real bitch!"

I didn't like the psychiatrists and some of the staff. It didn't seem that they respected the clients. I worked side by side with other therapists/social workers, mental health nurses, and case managers.

At least at this job, I was more than a case manager as I had been in my previous job that lasted all of one month. You don't have to have a Master's in Social Work to be a case manager. Plus, I was at home with Lynn every day.

The case managers would bring clients to the clinic for the day treatment program or for sessions with me. So, that was cool.

I was meeting with a Licensed Clinical Social Worker (LCSW) and finishing up my requirements for becoming an LCSW myself - I was still provisional.

I remember being in a staffing meeting when a psychiatrist remarked that he works with "chronic crazies all day." It infuriated me. Plus, why did he think that he was free to speak like this in the clinic? Was this okay here? Did people have such little respect for clients with mental illness?

It's a good thing I was going to get all the hours I needed for my LCSW before leaving. I had in mind working in private practice once I was licensed. Can you blame me?

I reasoned that I could still work with vulnerable people who didn't have lots of money. I had been told that there are ways to be accommodating to people with a limited income when you work in private practice. For one, you can work pro-bono – for free – if people can't afford to pay or if they cannot afford the flat rate.

Anyway, one of my duties was to visit the local hospital to do evaluations at the local hospital to determine if someone required psychiatric hospitalization, such as was the case when suicide was involved.

I would make an assessment as to what happened... how did they end up at the hospital? What method was used to end their lives if that was the case? Did they still have access to that weapon or method of suicide?

Most of the time they were indeed suicidal, and I had to go to the magistrate to request involuntary commitment orders. They would then be taken to the clinic (sometimes) to get the doctor (psychiatrist) to sign the order for commitment.

I was never over-ruled in my assessment. I mention that because not everything I observed and concluded about the treatment of a client was something that the psychiatrists and I saw eye to eye on.

Interestingly, some of these people who were committed to an inpatient hospital (I had to find a placement also) were my clients or I would offer to work with them. Here, I was sending them to a psychiatric hospital against their will for a commitment and they are happy to work with me when they get back!