The Role and Life

I have been working in a community mental health agency for 12 years. I was hired as a counselor in recovery services. Three years ago I became coordinator of recovery services. I found being "just" a counselor more enjoyable than being a coordinator. I had more time to spend with clients, less paperwork, and about a hundred fewer meetings per week.

The focus of my work is helping people diagnosed with severe, persistent mental illness. The people I counsel are learning to manage diagnoses such as clinical depression, bipolar disorder, schizophrenia, obsessive-compulsive and panic disorders. Many of our clients also struggle with a personality disorder, and several have a "duel diagnosis," meaning they have substance abuse issues and a mental illness.

In this field, the word recovery expresses the idea that people with mental illness (or MI) can have meaningful, productive lives even though their symptoms persist. In our recovery program, members come to our facility one to five days per week. Each day they receive five hours of group and individual counseling, life skills training, and interaction with peers.

Would you describe the things you do on a typical day?

One of the things I love about my job is that there is no such thing as a typical day. Although we have a weekly schedule of activities, you never know what is going to come up when with a group of 25-30 people who have mental illness.

I arrive in my office about 8:00 a.m., make coffee (top priority), and tackle some paperwork. I actually know one coworker that loves doing paperwork - the rest of us just do it to get by. From nine until noon I run groups, have individual sessions, consult with colleagues, or have meetings to attend.

I enjoy eating lunch with the clients. You'd be surprised how much therapy you can sneak in while laughing with your mouth full and chatting about "stuff." During the afternoon, I perform the same activities as in the morning. Clients go home at 3:00 p.m. Then there is time to make and return phone calls, write treatment plans, assessments, chart notes, and talk about important (and unimportant things) with coworkers.

Now, throw into that nice neat schedule, a client who admits they've been out of medication for three days, another who is boiling over because his or her lunch was stolen (we usually find it), one more who is in tears over something said in a group, and someone who pulls up their sleeves to reveal fresh cuts (self-injury). All of that can transpire within one hour.

On a scale of 1 to 10 how would you rate your job satisfaction? What would it take to increase that rating?

I will say 7.725.

...the amount of paperwork required will have to return to the realm of common sense. If we say that a client took a breath, the state (Medicaid) wants proof.

Community mental health is becoming a managed care system. To increase that satisfaction number ...the amount of paperwork required will have to return to the realm of common sense. If we say that a client took a breath, the state (Medicaid) wants proof. You can be sure I am not the only person who whines about this.

There is also the matter of salary. I took my job knowing that getting wealthy while working at a nonprofit agency is an anomaly. The salary range is below average compared to other professionals with a masters degree. New teachers have a higher starting salary than fledgling mental health counselors. Everyone knows life isn't fair, but that doesn't make it less annoying.

What did you learn the hard way in this job and how did that happen?

I worked with a gentleman, Ben, for the first 3 1/2 years of my counseling career. He was extremely anxious, depressed, and had social phobia. However, Ben had faith in therapy. We met weekly, and he participated in many groups I facilitated. I put hours of effort into helping him see how his distorted thoughts were the reason for most of his anxiety. Hours, I tell you.

He came into my office one morning with an ear-to-ear smile. He opened the book in his hand to a dog-eared page and read a paragraph explaining how our thoughts affect our emotions and feelings. Then he looked up and said, "I had a revelation when I read this, it explains my problem! It's the way I think about things that triggers my anxiety. I wish you had told me."

Now, I laugh. In that moment, I wanted to strangle him. (He's still alive.) I realized that my efforts were not necessarily going to be rewarded with appreciation. My gems of insightfulness may not open my client's eyes, but a stupid paragraph in a library book might. One of my supervisors had told me this job is basically to plant seeds in others. The seeds may or may not grow. If they do grow, it will be when that person is ready.

What don't they teach in school that would have helped you?

A couple things come to mind. I wish they had warned us how utterly clueless we were going to feel sitting across from our first client. Even though I had been through a year-long internship, it is different when you are the responsible go-to person for someone. From talking to many other counselors, I discovered this is a natural part of the process for most newbies.

The second thing is this. In school you learn theory, counseling ethics and skills, how to build trust and how to help people help themselves. What no one ever said was, "To be good at this you have to relax into the skills and let your personality shine through." I discovered over time I needed to give the work my unique imprint to be effective. It is a fine line to walk - a balance of objectivity and letting your personality sparkle. I should add that some therapists may not agree with this; but I wouldn't go to them for help.

How did you get started in this line of work? If you could back and do it differently, what would you change

I am in this field partly because of a divorce, and also because I felt I was marking time at my former job. My husband did not want to try marriage counseling although I dragged him to three sessions of futility. When I realized the break-up was going to happen, it opened my inner Pandora's Box, and I started individual therapy.

The therapy process captured my interest right away, and I wanted to learn more about it. From the time I started talking about going back to school for a masters, until I actually stepped foot in a classroom, was three years. I wanted to make sure I wasn't changing professions