Alternative jobs
How to choose the best vocational fit among social work, occupational therapy and physical therapy
Introduction
My intention in writing this blog is to share the experiences that I went through with my son, starting with the first manifestation of his illness and our journey through numerous subsequent episodes. Also to provide commentary as a parent and psychiatrist on issues that these experiences bring up, such as how the diagnostic process works in mental health, how to work with treatment providers and medication issues. My hope is that reading this may be helpful for people with mental health issues and also their families and friends.
Alternative Jobs
People in my family ask when I’m going to move forward with another social work job or go back to school to get another credential. I’ve started to look at options for being an OT assistant and also for what social worker positions are listed. Getting a slot in an OT assistant program would be easier than PT assistant and pays almost as much, both of them better than for a social worker. I think the work would be really interesting so I’ve gathered some information from the internet about different Wisconsin programs. I’m thinking that fall of ’22 would be the logical time to enroll. If I go in the state of WI I can get in-state tuition so I’m looking fairly broadly across the whole state, although I’d really prefer to stay in Madison.
The other option is getting a social work position, although my recent efforts haven’t panned out. And mom says its unlikely I could find one in Madison because I’m too well known in social work circles here from all my ER visits and hospitalizations—“notorious” is her word. Possibly I could look in other locations where I have family like Philadelphia, Maryland, St Louis, Texas or Oregon where they don’t know me and I could get a fresh start. I did put in one application in Portland to the mental health organization there but they didn’t have any positions. I think during the pandemic may be a hard time to find a job, especially in a new location. Jason says I should be a blue collar worker and get paid substantially more than I am now. But a lot of jobs such as electrician require that I have steady hands. And on lithium that’s not going to happen. Even construction jobs require a pretty major level of motor coordination. Also I’m not sure I’d like those jobs. I think I’d rather be an OT assistant or social worker.
Some of the jobs that are posted for social work are for people with lived experience, meaning they have experience as a client like me. I think that is something that I bring to a job because when my clients have to deal with the mental health system I know what they’re going through. A lot of it is just explaining what to expect, like how long the wait time will be. Also when I get to know my clients I can anticipate if they might have problems in certain situations, like Jerry who wanted to talk to every single person we crossed paths with. Or with Dave, who because of his developmental disabilities needed help with all his ADL, even finishing getting dressed or getting his coat on to go outside. And reminding him not to pick his nose in public. Most of my earlier jobs were working with DD clients, which seem to be the most plentiful. Now that I’ve done several years though I really want to focus on jobs in the mental health sector. I know quite a bit about the psychology of mental disorders from my courses, from my own experience and from loads of other patients I’ve met in the hospital or worked with as clients. When a client talks about not wanting to take meds I know exactly what they mean and I can totally empathize. We talk about side effects like leg cramps and drowsiness. I know how badly the dystonic reactions hurt. I use my motivational interviewing skills to get them to rethink their opposition. I ask them what their main goals are and what are the steps they will need to take to get there. Then we talk about each of those steps –most of them entail staying stable and not being hospitalized. I don’t talk about myself personally—we’ve been told that’s not professional although sometimes I think it might be more helpful than talking about it in general terms. But I talk about how “clients I have known” or people I’ve known. And of course I include my own experiences of becoming psychotic when I go off meds. I try to convince them of the same things that I tell myself about meds—that they are the lesser of two evils. That even though the symptoms they produce are distressing, the ability to avoid doing embarrassing things that wind you up in the hospital or worse is a good tradeoff. I remember all the crazy things I’ve done when I’m manic and how great I felt at the time, euphoric on top of the world but then afterwards when people tell me what I’ve done or when the memories float to the surface I feel bad, terrible actually. And often right after mania comes a severe depression, which is the worst possible state to be in, literally a living hell. So I use some of those experiences when I talk to clients. Often it doesn’t make a difference but sometimes I can see I’ve gotten to them and it feels really good to have made that connection. If only I could keep that perspective when I’m starting to get manic myself. But I find that once the mania creeps in it is accompanied by every sort of rationalization about why I need to lower the dose of medicine—and once the escalation starts in then I’m in a cycle I can’t escape.