I don't like cats. I know this is shocking. Actually, I really love the big, big cats. The ones that eat you. Or at least they could eat you if they desired. I like those cats. From a distance. Not up close. Never up close. But, the little cats, the ones that stay inside your house and generally ignore you until it's convenient for them to be your friend- I don't like those cats. For one, they climb up on everything. And secondly, they catch mice and bring them to you as if they've brought you the best present ever. Also, they do their business in a box that ends up stinking up the joint. And, they are moody. Some cats are like dogs. They are cuddly, sweet, and playful. These cats, I truly enjoy. This is why I have a dog. Dogs are playful and sweet and cuddly and they want to hang out with you. Dogs don't bring in dead vermin and they don't climb on everything in sight.
At least that's what I thought was true of dogs. Then, we got Bayley. Bayley is one of those dogs that thinks she's a cat. She has many dog traits: she cuddles (when she wants to), she plays, and she does her business outside. But, she also does many cat like things. She climbs on tables- all of them, not just some of them. She climbs into the window sills as well. If I put the blinds up, she'll stand in the window sill and look outside. She even climbs on the bricks outside that stick out at the bottom of the window. She chases bugs and she has moments of moodiness.
But, the worst, most cat like thing Bayley ever did happened one morning when I let her outside. She found something truly wonderful and delicious and began playing with it. Bayley loves to eat bark. So, when she came to the door, tail wagging and eyes filled with delight, I assumed she had found a piece of bark that made her day. I opened the door saying, 'hey girl, what did you find?" and then immediately shrieked and slammed the door in my poor dog's face. Much to my dismay, Bayley had a full grown grasshopper in her mouth which she was completely intending to bring inside. I told her to leave that nasty thing outside, so she put it down and sat at the door calmly. I opened the door again and she ran to retrieve her prize and carry it into the house. Only, much to her chagrain, she found the door once again slammed in her face. I began to lecture her through the door as if she could understand me, "you are not bringing that thing in my house. Forget it!" Finally, dejected and sorrowful, Bayley came inside leaving the grasshopper on the porch.
Later in the day, we let Bayley out again. She found her delightful toy and began to play with it. Then, as I stood there watching, things went from bad to worse when she ate that dreaded grasshopper. Yep, she ate it. Legs and wings and all. Gross. Pleased as punch, the dog came back inside and immediately proceeded to burp. Guess it was a tasty meal. All I know is that I did not let that creature's mouth anywhere near me for the next several days. Grasshopper cooties... yuck!
Thursday, March 24, 2011
Thursday, March 10, 2011
A Day in the Life
One of the best conversation topics of all time is the topic of work and career choice. Usually, people will ask me what I do for a living and I answer, "I am a crisis counselor". Then follows the blank stare, awkward silence, and finally... "Oh. Cool?" After the awkward wears off, the conversation most frequently turns to questions about what my job actually entails. Today, I have decided to answer this question for my small but loyal following of readers.
I am a crisis counselor. This means I work with individuals who are in a crisis situation. The broad definition of crisis services from which I usually work is that I assist any individual who is suicidal, homicidal, or psychotic in some way. Generally, we also help people who are depressed and thinking of dying a passive death but not actively killing themselves. And, we help people who are experiencing anger to the point of aggressive behaviors that could harm someone but that are not homicidal. In the realm of psychotic, we help anyone who believes they are Jesus, believes they are on a mission from Jesus, believes the FBI is watching them, disrobes in public thinking it's okay, thinks aliens are after them, hears "the voices", believes a sniper is at the window, defecates in inapproriate places, believes they are being poisoned, thinks others can hear their thoughts, or generally does not make sense but thinks he or she does. Some of the most common things I see that contribute to the above crises are trauma resulting in depression, anxiety, and thoughts of death (i.e. PTSD), domestic violence or abusive relationships, general relational difficulties, substance use, sexual assault or past abuse, grief, and unmedicated mental illness including depression, Bipolar, and Schizoprenia.
I become involved with an individual because I get a phone call asking for a psychiatric evaluation on someone who has presented to law enforcement or medical staff either at a private residence, a hospital, a jail, a school, or some other location with one of the above concerns. Once I get called, I go with a partner to the scene and assess the individual for threat of harm to self or others including thoughts of suicide, passive thoughts of death, past suicide attempts, thoughts of homicide, self harm, aggression to others, and psychosis. Once we complete our assessment, we determine one of two things: does this person need inpatient treatment at a psychiatric facility or can they remain safe enough to engage in outpatient treatment.
If we determine that someone needs inpatient treatment, we further assess several things. The first thing we ask is if this person is agreeable to signing him or herself into the hospital. We then determine if the person is oriented enough (knows who he or she is, what date it is, what the situation is, and where he or she is) to sign him or herself in to the hospital. If the answer to both of these questions is yes, we facilitate the client getting to and signing in to a mental health hospital. If one of the above answers is no, we seek an involuntary commitment to the hospital.
In order to involuntarily commit someone to the hospital, we contact another authority, namely our mental health deputies. These folks are part of the sheriff's office and have the right to take someone into protective custody if the person is in immediate danger to self or others. The deputy completes an assessment and either takes the client to the hospital or determines the client can remain safe on an outpatient basis. If the deputy decides for the hospital, the client attends a court hearing the next day to determine length of hospital stay. If the deputy refuses to take the client to the hospital, we work on safety planning for outpatient services.
Now, if we decide on outpatient services, we typically look for a number of things. First, we determine if the person has any social support to help keep him or her safe. Second, we explore if the client is willing to participate in treatment to begin to improve in condition. We also aid the client in developing a safety plan including coping skills as well as removing access to anything the person can use to harm self or others.
If we recommend outpatient for an individual, then they can receive counseling services and medication as well as case management services to increase community supports for the person. If they want counseling services, then either myself or one of the other counselors on staff begins to work with them in counseling. We each have 2 days of the week set aside for counseling clients and the other 3 days of the week are set aside to do psychiatric assessments. We do not counsel psychotic individuals cause, well, it's not terribly effective.
And that, in a brief nutshell, is what I do for a living.
I am a crisis counselor. This means I work with individuals who are in a crisis situation. The broad definition of crisis services from which I usually work is that I assist any individual who is suicidal, homicidal, or psychotic in some way. Generally, we also help people who are depressed and thinking of dying a passive death but not actively killing themselves. And, we help people who are experiencing anger to the point of aggressive behaviors that could harm someone but that are not homicidal. In the realm of psychotic, we help anyone who believes they are Jesus, believes they are on a mission from Jesus, believes the FBI is watching them, disrobes in public thinking it's okay, thinks aliens are after them, hears "the voices", believes a sniper is at the window, defecates in inapproriate places, believes they are being poisoned, thinks others can hear their thoughts, or generally does not make sense but thinks he or she does. Some of the most common things I see that contribute to the above crises are trauma resulting in depression, anxiety, and thoughts of death (i.e. PTSD), domestic violence or abusive relationships, general relational difficulties, substance use, sexual assault or past abuse, grief, and unmedicated mental illness including depression, Bipolar, and Schizoprenia.
I become involved with an individual because I get a phone call asking for a psychiatric evaluation on someone who has presented to law enforcement or medical staff either at a private residence, a hospital, a jail, a school, or some other location with one of the above concerns. Once I get called, I go with a partner to the scene and assess the individual for threat of harm to self or others including thoughts of suicide, passive thoughts of death, past suicide attempts, thoughts of homicide, self harm, aggression to others, and psychosis. Once we complete our assessment, we determine one of two things: does this person need inpatient treatment at a psychiatric facility or can they remain safe enough to engage in outpatient treatment.
If we determine that someone needs inpatient treatment, we further assess several things. The first thing we ask is if this person is agreeable to signing him or herself into the hospital. We then determine if the person is oriented enough (knows who he or she is, what date it is, what the situation is, and where he or she is) to sign him or herself in to the hospital. If the answer to both of these questions is yes, we facilitate the client getting to and signing in to a mental health hospital. If one of the above answers is no, we seek an involuntary commitment to the hospital.
In order to involuntarily commit someone to the hospital, we contact another authority, namely our mental health deputies. These folks are part of the sheriff's office and have the right to take someone into protective custody if the person is in immediate danger to self or others. The deputy completes an assessment and either takes the client to the hospital or determines the client can remain safe on an outpatient basis. If the deputy decides for the hospital, the client attends a court hearing the next day to determine length of hospital stay. If the deputy refuses to take the client to the hospital, we work on safety planning for outpatient services.
Now, if we decide on outpatient services, we typically look for a number of things. First, we determine if the person has any social support to help keep him or her safe. Second, we explore if the client is willing to participate in treatment to begin to improve in condition. We also aid the client in developing a safety plan including coping skills as well as removing access to anything the person can use to harm self or others.
If we recommend outpatient for an individual, then they can receive counseling services and medication as well as case management services to increase community supports for the person. If they want counseling services, then either myself or one of the other counselors on staff begins to work with them in counseling. We each have 2 days of the week set aside for counseling clients and the other 3 days of the week are set aside to do psychiatric assessments. We do not counsel psychotic individuals cause, well, it's not terribly effective.
And that, in a brief nutshell, is what I do for a living.
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