Regulatory expectations and requirements or "paperwork."

Dear Michael:

In response to your concerns about all the insurance regulations which must be followed to bill for services I jotted down some of my thoughts.

We can get caught up in the regulations, expectations, and requirements of running a business and practicing a profession when we manage a career in psychotherapy. This obsession with the trees precludes us from seeing the forest. The more basic questions that we overlook are:

What ultimately is the purpose of psychotherapy? 

Who are we ultimately working for?

One of the foundational concepts in TQM (Total quality management) is to know your customer. Who is your customer? There usually are many stakeholders in the business being managed. So these stakeholders can be put in priority.

The managed care model was built on a three legged stool. The model intended three things: good outcomes, achieved cost competitively, with customer satisfaction. Or as the bumper sticker says "Good, cheap, fast pick two."

At the end of the day I am on a mission from God and the client's needs and wishes are my ultimate concerns.

I went to a conference once presented by Michael White, the father of Narrative Therapy. He was asked a question by somebody in the audience who probably was a graduate student "Is Narrative Therapy research based?" Michael paused for a moment and then said, "Well, I am not a researcher. I am a practitioner. I don't know if Narrative Therapy is research based or not and it isn't my biggest concern. My concern is that it be ethically based."

Obviously, I have never forgotten this very important principle. We can worship at the altar of data or we can do the right thing. Hopefully these will usually be the same thing, but sometimes they are not and at the end of the world I'd rather be on the side of the ethical.

There is a line in A Course In Miracles, "Would you rather be right or be happy?" The need to be right may ultimately miss the point, right?

What have you learned being a Social Worker for 53 years?

 Topic One

What have you learned being a Social Worker for 53 years?

David Markham at Park Ridge Mental Health Center in Brockport, NY on 12/07/1988

When I graduated from SUNY Albany in 1972 with a Master’s Degree In Social Work, students were expected in the second of their two years of study to concentrate in casework, group work, or community organization. This was the standard way of organizing graduate social work education until the 80s when Social Work education shifted to a generalist model emphasizing the major competencies as assessment, service planning, implementation, and evaluation at three levels of social organization, individual, group, and community, This led to practice at the micro, mezzo, and macro levels.

The career path I have followed has taken me through all these methodologies and levels. I have provided individual, family, and group counseling as a clinician and also systems management as a supervisor, program director, deputy director for programs, and finally as an executive director. I have also functioned as an adjunct college professor in Health Sciences and in Social Work.

Some people might say cynically that I have been a “jack of all trades and a master of none.” I certainly have been a generalist with wide ranging career experiences but I have mastered some of them and consider myself to have some knowledge, expertise, and skills that are valuable to the right people, in the right places, at the right time, delivered in the right way.

I am very grateful for the career I have engaged in and all the mentors and teachers who taught me along the way. This blog will, hopefully, capture some of this knowledge, experience, and practice wisdom that has been accumulated over 53 years of practice.

Social Work: A Lifetime Of Practice is back up and running.

 After 9 1/2 years Social Work: A Lifetime of Practice is up and running. It is the mission of this project is to capture a lifetime of knoweldge, skills, and practice for the use of subsequent generations of Social Workers and Human Service professional. Feedback and sharing is welcome.