Welcome to the March edition of Tips and Topics and to all the new subscribers. In SAVVY, two staff scenarios raise some clinical supervision and organizational development learning lessons. One has to do with clients who show up late for appointments and the other is when staff feel unsafe with clients. In SKILLS, these two scenarios highlight the skills needed in supervision and organizational interventions to first assess the situation and needs before taking clinical and organizational action. In SOUL, I have decided to down-size and live in a turn-key situation that makes it easier to lock the door and travel free from the responsibility of home maintenance. I quickly offered to buy a townhouse that had just come on the market, then abruptly yanked my offer when considering the downsides. Fools rush in where angels fear to tread, or Opportunity knocks but once. So which is it? David Mee-Lee, M.D.  DML Training and Consulting SAVVY Recently, I was consulting with a Clinical Director about two staff situations that had caused supervisory and organizational development challenges. Scenario 1 It is not unusual with a client population that suffers from addiction, trauma, severe mental illness and co-occurring disorders for them to come late for their assessment appointment. It could be 15 or 30 minutes late and some even two hours. Some staff members have become increasingly frustrated to the point that they simply tell the receptionist to inform the client that they need to reschedule. Tip 1 For any client behavior that is “inappropriate”, antisocial, and especially if annoying, the first step is always to speak with the client in person and be genuinely curious about what happened to cause the behavior. In the behavioral health world and actually in healthcare in general, person-centered care includes, but is not limited to the following practices: Recognize that clients may be overwhelmed, disorganized and dysregulated. They first need to feel respected, accepted and welcomed for making the effort to show up. Recognize our own feelings of annoyance and frustration. Remember that our job is to engage and attract a person into a self change process, not demand compliance with what makes us feel comfortable….it’s not just about us; it’s about them. Develop skills to calm, de-escalate, understand and empathize with the client’s distress and behaviors. Scenario 2 A counselor assessed a client who seemed to get increasingly frustrated with all the assessment questions he had to answer. He started mumbling to himself and his legs were anxiously restless. When asked if anything was bothering him, he said “no”, but continued to appear frustrated. He asked for a pen to write down some information. The counselor started to feel unsafe as the desk was positioned in such a way that the client was near the door, which would block any need to quickly exit. The counselor started feeling that the client could use the pen as a weapon and asked Security to escort the client from the building.            At a systems level, the counselor asked that a panic button be installed in the office. …

“Doing time” versus “Doing treatment”; Drought and storms

TIPS & TOPICS Volume 5, No.11 March 2008 In this issue — SAVVY — SKILLS — SOUL — SHAMELESS SELLING — As a RESULT of your FEEDBACK — Until Next Time Welcome to March’s Tips and Topics (TNT), especially to the many new subscribers. As usual we are running late, so this March edition will likely get to you in early April. It is after all, free, so I guess you get what you pay for!