Volunteering - populations

[hall]

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It seems to me that there's something wrong with an infrastructure that insists the most untrained people earn their stripes with the most vulnerable populations. Most of us (myself included) aspire to private practice for lots of reasons, including hoping to provide effective and focused care. This, though, tends to favour comparatively unafflicted (and moneyed) clients/patients. In effect, it appears we aiming to work our way 'up' to the middle class, while, for example, prisoners, seniors, and the homeless remain underserved by a relatively underskilled (and underpaid) workforce. Thoughts?

 

[erg923]

So you're saying you have some empirical evidence demontrating that private practitioners are more skilled clinicians than those working in public sector positions in Academic Medical Centers/hospitals, VAs, rehabilitation hospitals, Federal Bureau of Prisons, etc? Please provide the citation for this...🙄

I also think it's pretty flawed logic to assume private practioners always see people with "money" or even "middle class" lifestyles. The vast majority of psychologists in private practuice do NOT run a cash only practice. Most are reimbursed (at rather poor rates) by their patient's insurance carriers. Moreover, with parity taking effect, all those who have basic health insurance now have access to mental health treatment coverage as well. Having a basic health insurance plan generally requires one to have a full time job. It certainly doesn't mean that they make alot of money at that job.

 

[hall]

Sorry, I should have clarified - I was talking about the volunteer experiences available to undergraduate level students, and required for grad school applications. I was NOT talking about the skilled work done by trained professionals who work with underprivileged populations.

Eg, at suicide helplines, it's the least experienced who are most often asked to take night shifts.

Residential care homes for the homeless, seniors, and highly distressed youth pay care attendants (again, often psych students in waiting) just above minimum wage.

And yes, I'm happy to say, without recourse to statistics of any kind, that having a full time job and a decent insurance package is improbable for the *most* vulnerable.

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edit: I didn't say that psychologists in private practice *only* serve rich folk. And it's psychologists who provide at least assessment and treatment for patients/clients who have become institutionalized. But many of the volunteer and paid (entry) level positions required for entry to grad school involve hands-on work with homeless, addicted, and criminal populations. I just wonder whether that makes sense.

 

[erg923]

Sorry, I should have clarified - I was talking about the volunteer experiences available to undergraduate level students, and required for grad school applications. I was NOT talking about the skilled work done by trained professionals who work with underprivileged populations.

Eg, at suicide helplines, it's the least experienced who are most often asked to take night shifts.

Residential care homes for the homeless, seniors, and highly distressed youth pay care attendants (again, often psych students in waiting) just above minimum wage.

And yes, I'm happy to say, without recourse to statistics of any kind, that having a full time job and a decent insurance package is improbable for the *most* vulnerable.

--
edit: I didn't say that psychologists in private practice *only* serve rich folk. And it's psychologists who provide at least assessment and treatment for patients/clients who have become institutionalized. But many of the volunteer and paid (entry) level positions required for entry to grad school involve hands-on work with homeless, addicted, and criminal populations. I just wonder whether that makes sense.

Sorry, I'm just not sure I follow. 1.) I am not sure how much money you would expect to make in places like these, no matter who you are. The places you mentioned appear to be social safety net-like facilities/places (eg., residential care homes, homeless shelters, suicide hotlines, etc). They don't have alot of money to through around. I would guarantee their docs make less than the docs at a place like the Mayo Clinic too. 2.) The people you mentioned have no formal education or trained skill sets. On top of this, they are working at facilties that operate on tax dollars, government subsudies, and probably lose money on each patient they see. I'm not sure there is much economic justification for paying them much over the minimum wage.

Yes, I think it makes good sense to volunteer and gain experience with such difficult popluations prior to grad school. You can learn alot of valuable things from these people...as well as working in those types of facilites. I worked 12 hour night shifts for 2 years at a state hospital during undergrad...I thought it was a blast!!

 

[hall]

It makes perfect sense from the perspective of the grad applicant. I'm not sure it makes sense for the homeless guy.

I'm suggesting that there might be something wrong with the interplay of the various relevant infrastructures - the way funding/governmental bodies, agencies operate, and the expectations of grad school admissions cultures - that offers the most disadvantaged populations the most inexperienced care.

While the economic rationale for this setup might be clear, I'm not sure there's a moral justification for this distribution of skills.

 

[erg923]

Being a care attendant in a rehab hospital, psych unit/hospital, or homeless shelter requires that you be awake, alert, and prefeably polite and pleasant. I think minimum wage fits just fine. Who exactly are you suggesting be a care attendant? The doctor?

Everything on the face of this earth comes down to a cost/benefit analaysis based on what one gets out of the service per the amount of time or amount of money spent on said service (ie., the law of diminishing returns). Healthcare is no excption to this.

 

[hall]

Does it seem plausible to you that a BSW with one year's experience would be genuinely equipped to perform the services described in the following advert, to the degree that his/her prospective clients deserve?


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Reporting to the Manager of _____, the Part-Time Transitional and Housing Support Worker is responsible for delivering services to residents and ex-shelter residents and women in the community who have experienced domestic violence and are trying to establish lives separate from their abuser. The Part-Time Transitional and Housing Support Worker is responsible for providing crisis counselling, informal group work, advocacy, and support services directed towards assisting women to secure and maintain safe housing.

You will have: in-depth knowledge of an academic discipline normally acquired through completion of a clinically supervised undergraduate degree (e.g. BSW); an analytic framework that identifies clients’ relation to social systems and the demonstrated practical application of this framework; 1-3 years experience in group work with clients at risk with demonstrated ability to work under pressure; in-depth knowledge of legislation and administration procedure regarding social welfare, housing, employment, child welfare, immigration and refugee laws and skills in advocacy usually acquired through 1 to 3 years of case management experience with a diverse range of clients; demonstrated experience in the development, delivery and evaluation of workshops and groups; counselling approach that is flexible, de-escalates tension, teaches conflict resolution and is focused on success; ability to deliver culturally sensitive services in a multicultural environment; ability to work with an anti-oppression and feminist framework; knowledge and understanding of trauma, mental health issues, advocacy, substance abuse, employment, child development and parenting and/or children’s programming would be an asset; strong interpersonal skills; excellent written and verbal communication skills; proficiency in Microsoft Word, e-mail and the Internet; ability to maintain a positive approach and a professional manner at all times; knowledge of a second language an asset. Core competencies: engage in a self reflective and collaborative practice that is non-judgmental and compassionate and reflects the mission of ___________; incorporates principles of anti-oppression and equity in responding to the service needs of women and children and work toward removing systemic barriers to independence and wellbeing; demonstrate respect, consideration and acceptance of the opinions of others while expressing her own expertise and effectively utilizing relevant resources and specialists; consistently collaborate with team members, sharing ideas and differences openly; be receptive to new ideas and adapt to change as necessary; value the contribution of others and take action to strengthen partnerships and support others to achieve effective outcomes; take action to avoid or solve problems and create opportunities for positive change; demonstrate commitment to ongoing personal and professional development.

 

[erg923]

This appears to be a case-manager position (although they have titled the position differently-"Support Worker"). I do think it would be imperative that any person applying for a job like this have previous exposure/experience working with vulnerable populations in the midst of acute crisis/distress though, as one will obviously need to know how to implore appropriate empathy without violating professional boundaries or getting too personally invested. And indeed, they specify this as a requirement.

What skills/education do you think being a case worker requires? You appear to be approaching this as if you think this person is solely responsible for client's mental health treatment and care. That is simply not the case. The case manager is an integral part of the team, but in terms of psychotherapy and mental health work, they are pretty low on the totem pole.