Introduction
Private Practice. That was the pinnacle of success I saw when I
decided to change careers and become a social worker. Private, because it was something that would
belong to me, my own creation I would pursue without interference after years
of working for media companies and at the whim of whatever news director was in
charge at the time. This kind of
independence runs in the family. My family
was farmers used to planting their own crops, butchering their own animals,
building their own homes. Only after
farming failed and World War II ended did my grandfathers go to work for the
railroad and an ordinance plant to bring home union paychecks. My father tried all that but chafed under the
supervision of corporate bosses and union chiefs. So, he went from pool hall owner to repo man
to delivering propane to heating and air conditioning with independent efforts
at running a hardware store and real estate scattered in between. He liked making his own decisions and making
his own hours. It’s not a surprise then
that all five of his children are either in business for ourselves or have
carved out unique and independent roles in service to others just like our mother, a registered nurse.
Private also means, to some extent,
solitary. Certainly, private practice
can include working in a group, with other therapists and disciplines, or for a
company providing mental health services.
But for me private practice meant owning my own business as a sole
proprietor or limited liability corporation.
Which means that decisions from advertising to office space, client referrals
to specialized training, to risk assessment, mandated reporting, treatment
planning, and intervention strategies are mine to make. With this privilege comes power, and with
this power comes liability, and with this liability comes a certain amount of
stress, separate from the stress of managing finances, which is often an inside
joke among social workers, but rather serious business when your living depends
on the literal ebb and flow of income and expenses. Which is why a saying sticks with me from
business books to military training to a law and ethics training by Gerry
Grossman: “Never worry alone.”
Maya Angelou describes standing on the
shoulders of those who have gone before and of feeling backed by those who have
supported us on our way. I have been
lucky to have had many of those mentors starting with my own parents and
teachers. In television as in other
industries the moto is “fake it ‘til you make it.” So, when I started reporting the news I would
“channel” Barbara Walters asking serious questions of those in authority or my
journalism professor at the University of Missouri, Columbia, Dan Dugan, in
writing and Walter Cronkite in pacing my delivery. During my master of social work studies at
Our Lady of the Lake University in San Antonio, Texas, I had the excellent
examples of my field instructors. Ed
Cardenas at J.T. Brackenridge Elementary School could calm a group of
hyperactive boys just by walking in the room.
At Catholic Charities of San Antonio Arlis Schmidt took me for a Coke after
a particularly triggering run-in with a nun.
At Child Welfare Services in San Diego my LCSW supervisor Becki DeBont
would simply say, “And the mirror appears”, emphasizing the need for
self-reflection. Supervisor Laurie Adam
would back me to the hilt when I disagreed with management about adoption
recommendations. Also at Child Welfare
Services, first Renee Smylie then Karen Martin turned me loose to create an
internship program that taught me more than anything I had to offer
students. When I did put my foot in the
water of private practice after earning my license Nancy North, LCSW was there
to hold my hand. Then I landed in an
office with exceptional therapists who had already made the leap from
Children’s Hospital. Chris Diani, LCSW,
Laurie Hall, LCSW, and Deborah Holmes, LCSW shared everything from a practice
philosophy to the forms and paperwork to get started on my own. To this day there is a safety net of
colleagues with whom to consult and complain.
The practice part puts you at the party with
doctors, lawyers, and other professionals who have degrees, licenses, offices,
billing, and malpractice insurance. “My
practice,” sounds like you have arrived.
It sounds trite to say that practice is not an end but a beginning and
just as trite to say that practice makes perfect. There can be no end to learning about the nature
of humans, our strengths and challenges and what works to apply one to the
other. And there can be no perfection in
the joining of unique individuals except in the joy of doing so. Practice, then, is not a noun but a verb that
indicates the act of applying knowledge and experience from our education and
training with consultation and supervision to the life experiences and personal
wisdom of clients with the intention to help as much as necessary while hurting
as little as possible. It is also cliché to say that these human
services, from customer care to nursing, from sales to psychotherapy, are as
much art as science. But despite the
efforts of industrial science to quantify human interaction and research into
human behavior to develop evidenced-based practice, there is qualitative
research to indicate it takes some time to achieve mastery. Popular media quote 10-thousand hours to
achieve mastery in one’s field, approximately five years at 40-hours a week
with two weeks off for vacation. If that
is true, I achieved mastery in 2011. But
I and most of my colleagues would say we have achieved some level of competence
but nowhere near perfection.
Why, you may ask, did you switch from a
lucrative career in television reporting to a completely different career in
the profitable field of social work?
(Tongue planted firmly in cheek.)
My answer is that they are essentially the same job. As a reporter I was expected to respond to
crisis situations; fires, floods, tornadoes, murders, political disputes both
major and mundane. I had to find the
source; the victim, the perpetrator, the authority. And, with nothing but a pad and pen, and oh
yes, a camera and a microphone, convince them to tell me their story. I had to ask very personal questions of
complete strangers in a way that would reveal the truth of their
circumstances. Then, under deadline
pressure, turn this raw data into an assessment of sorts, a compelling
narrative with a beginning, middle, and end in the space of a minute and thirty
seconds. Those stories aired on the
evening 6:00 p.m. or late night 11 p.m. newscast could entertain, educate, and
sometimes challenge people and organizations to change. Not all of them in 15 years were
Emmy-winning, in fact none were, but they did get some attention, some a
lot. For some reason, after a time, I
was either assigned or volunteered to find and interview the victims and family
members of the disaster of the day. In
April 1992, it was the family of one of four young people lined up inside a
walk-in cooler and shot in the back of the head execution style at a Lee’s
Famous Recipe Chicken restaurant in Tulsa, Oklahoma. The mother of the 15-year-old boy let me in
the front door. The very top of the
living room walls was lined with pen and ink and watercolor drawings. It was the work of her son. It was his story I told that night on the
news. I sat with her and the other
family members as the suspects were put on trial and convicted, then I went on
to cover the election of President Bill Clinton, lots of 4th of July
parades, and the bombing of the Alfred P. Murrah Federal Building in Oklahoma
City.
In 1998, as I was starting my graduate
education in social work I was sitting at the assignment desk one Saturday
morning at KSAT-TV, the ABC affiliate in San Antonio, Texas where I was working
part time. In the morning mail, there
was an envelope addressed to me personally.
I opened the envelope and out fell two letters, each written two years
apart, and a picture of a woman with long brown hair standing in front of a
bright orange Corvette. I had no clue
who the woman was or how she found me.
This was before Google searches and Facebook. The woman was writing to thank me for my work
in showing compassion and telling the story of her son who was one of the
victims of the chicken shop shooting.
And then I remembered. She had shown
me the shell of a vehicle in the garage that day that was to be her son’s first
car. But he did not live to be 16 and
get his driver’s license, and so she and her husband completed the project and
toured car shows with the restored Corvette in his honor. My lesson: people can survive tragedy and
grow and you play a part. On April 19,
1995, the newsroom secretary interrupted the morning meeting with a report of
an explosion in Oklahoma City. A
photographer and I immediately jumped in a car and headed west on the
interstate. We thought we would be back
by lunch. But the state troopers
speeding past us signaled something serious was happening. The city looked like it had been hit by a
more familiar tornado and we carefully drove down side streets avoiding broken
glass and moving debris. We made it to
a parking lot and saw the federal building two blocks away, its façade sheared
off and a pile of rubble where the entrance use to be as the 13 floors
“pancaked” during the explosion caused by the fuel bomb in the Ryder truck
driven by Timothy McVeigh. For 10 days,
wearing the same blue suit, I broadcast live morning, noon, and night as survivors were pulled from the
pile and the body count ticked up to 168 dead including 19 children in the day
care. At one point rescue workers found
a tattooed severed leg. It was gruesome
and sad. However, it was also
inspiring. The workers needed more
gloves, more masks, more batteries. The
line of reporters bathed in floodlights would turn to our cameras and tell
viewers and trucks of gloves and masks and batteries and more would
arrive. It was my first experience in
direct social work practice.
Then we went into the Red Cross tents and the
hospital wards and began telling the survivors’ stories, administrators,
clerks, and secretaries in wheelchairs and bandages. As the search went on first for a “middle eastern”
suspect then the quick capture of McVeigh, parents and grandparents, husbands
and wives put flowers and pictures on a makeshift memorial fence and waited for
their love ones to be identified. The
question remained, why would someone do something like this? And the broader question for me, why do
people think what they think, feel what they feel, and do what they do? It was the beginning of my social work
education and my journey to private practice.
It would take another four years to leave my first dream job and earn my
graduate degree. I would return to the
Oklahoma City site a year later where the federal building had been levelled
and a memorial park planned. But my
heart and mind were in a different place with hopes of preventing such
tragedies or helping those who survived them.
So my intention here is to explain my thought
process and the steps I took in establishing my “practice”. After deciding that social work with its
broad person-in-environment view was the best fit for me, I had to put on the
mantle of social worker, develop a professional identity, and carve out a niche
for myself. First, there was the role of
social worker in “public” practice as a child welfare worker, and then came
trainer, supervisor, therapist, and teacher, the jobs that would pay the
bills. In the meantime, in order to run
a business, I had to define my product, how to sell it, and what to charge for
it. Marketing a service as nebulous as
human interaction is like selling space on the internet. Others, like Murray Bowen, Virginia Satir, and
Aaron Beck, and more recently Insoo Kim Berg, Daniel Hughes, and Susan Johnson
have quantified their interventions. Yet
in setting your bicycle apart from bicycles sold by other manufactures, it’s
necessary to go beyond the fact that yours has two wheels, handle bars, and a
seat to distinguishing what sets it apart from other models and why someone
should buy and take a ride on yours. To
take the metaphor further, are you going to teach them to ride or repair the
thing if it breaks down? Most
importantly, how will it feel to ride the bike you make? These
are all questions that go into developing your unique brand, the professional
identity that is you.
