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

Chapter 41: Treatment - From Schizophrenia To Eating Disorders

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

I now had a growing client base and an office of my own. I was accepting insurance payments and/or checks for services.  

I now had a growing client base and an office of my own. I was accepting insurance payments and/or checks for services.

I was set up to be able to bill Blue Cross/Blue Shield among others... and Medicare. Clinical Social Workers can't bill Medicaid in North Carolina for some reason. We can bill Medicare, though.

Treating Schizophrenia with Psychotherapy

I was trying to find out if a colleague in the field, named Mary Ellen, who was working with some individuals who had schizophrenia, could find out if some of them wanted a therapy group. She was a volunteer/intern and through her contacts, she had been given the opportunity to work with a few clients in the community.

They were staying at a nursing home not far away. I decided to offer the conference room as a meeting place for a support group for people with schizophrenia. Mary Ellen and I decided that there was a need for a support group that would be of interest to the people she was serving.

She started bringing her clients to my office building. Depending on how many people showed up we would either use my office or the conference room.

This was a great learning experience for me. I really wanted to offer something for people who were battling such a debilitating and disturbing form of mental illness. It was sad that these individuals ranging in age from the late 20s to the 50s were all staying in a nursing home.

I suppose that is better than being homeless. But usually, you think of nursing homes as being there for the elderly who cannot care for themselves.

I had asked if any of them wanted to meet with me one-on-one for therapy. I was sensitive to the fact that some people might see this as a way for me to pad my income to enrich myself, especially if I met them at their residence, the nursing home.

These individuals had Medicare and I could bill Medicare. While it's true that this would increase my income and bring in money for me that doesn't mean I wasn't genuinely interested in helping them. They wanted to have someone listen to them and to try and understand what they were experiencing.

They had a doctor that they were seeing. I knew that much and that they weren't seeing a therapist, though they had someone at the clinic who could provide psychotherapy if the staff person was so inclined to do so.

It had been my observation that some people in my profession thought that the only remedy for schizophrenia was medication. I had noticed this when I was working at Sampson County Mental Health Center. I also remembered that when I was working there some of my clients, if not most of them, if asked, or if it was offered wanted to meet with me for psychotherapy.

In my heart, I knew that I was trying to offer something good for people who might benefit from talking to someone who is grounded in reality but also very empathetic.

In addition to just listening and trying to understand their experiences, I used a few psychological techniques to help them build their self-esteem. I also talked about some skills that would be useful in communicating and coping.

This wasn't something that went on for a long time but I did have a chance to work with some clients for a few weeks.

The Treatment of Eating Disorders

I did have a client named was Anne Marie who had anorexia which was particularly challenging because starvation can cause a variety of serious physical problems. There are also serious challenges in getting accurate information about binging and purging.