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A Day in the Life of a Social Worker

A Day in the Life of a Social Worker

What happens behind the closed door of the therapy office is often a mystery. By necessity, it’s confidential. Yet beyond the personal details, every clinical alliance unfolds in predictable stages. First, there’s an identifiable beginning, a middle, and an end. Next, each of those stages can be teased apart into those same three categories. In other words, there’s a beginning, middle, and end of the beginning stage, the same three phases are found within the middle stage, and finally, the same three phases are within the end stage. All in all, nine stages.

Now that you’ve been thoroughly confused, let’s take a glimpse at each of the nine stages of the clinical alliance in an imaginary 20-session engagement:

 

Beginning

Early-Beginning (sessions 1 – 2):

  • Welcome the client and invite a healing/learning partnership.

Mid-Beginning (sessions 3 – 4):

  • Gather a comprehensive history with unconditional support and acceptance.

Late-Beginning (sessions 5 – 6):

  • Engage in a working alliance with defined goals and expected outcomes.

 

Middle

Early-Middle (sessions 7 – 8):

  • Maintain a holding environment for pain, struggle, and collaborative discovery.

Mid-Middle (sessions 9 – 11):

  • Investigate the relationship between the client’s history and current circumstances.

Late-Middle (sessions 12 – 13):

  • Invite a new understanding of recurrent cognitive, affective, and behavioral themes.

 

End

Early-Ending (sessions 14 – 16):

  • Teach and practice healthy coping strategies to support a corrective experience.

Mid-Ending (sessions 17 – 18):

  • Empower the transition of gains from the clinical alliance to relationships outside of therapy.

Late-Ending (sessions 19 – 20):

  • Review progress, anticipate future challenges/coping plan, and facilitate emancipation.

 

Clean and simple, right? Establish a working partnership. Gather history and set goals. Create a safe environment to explore the relationship between past traumas and current struggles. Teach coping skills. Test them outside the therapy setting. Set the client free.

As therapists, our job is to put ourselves out of a job by making our clients their own therapists.

About the Author

Steve Ritter, LCSW is the Founder and Executive Director of Elmhurst Counseling. He has served as a teacher, author, consultant, human resources director, health care administrator, and licensed clinical social worker since 1977. A fellow of the American College of Healthcare Executives, Steve has provided coaching, therapy and team development services to thriving schools, businesses and organizations.

Think Globally Act Locally

Think Globally Act Locally

A trusted friend recently reminded us that sometimes the problem is bigger than the solution. “One finger does not lift 1,000 people,” he said, quoting an adage from his country of origin. There, he shared, the depth of national crisis leaves most leaders at a loss for how to make even a tiny dent. So you lift what one finger is able to lift.

Our country is currently in the throws of a mental health crisis. It has two prongs. First, the acuity level struggle among children and teens is at unprecedented levels. Second, there is a shortage of available resources. A shrinking pool of therapists is either backed up with untenable waiting lists or burned out from the long hours and the clinical intensity of the work. Often, it’s both.

So, what can you do if your kiddos are struggling and you can’t find a local resource? In our practice, we field numerous requests with limited clinician availability. We match client needs with therapist skills to the best of our ability and refer out to trusted colleagues when we are unable to provide the needed service. For most families, unless you are lucky enough to snag one of our limited hours, that doesn’t help much.

While you can’t control the availability of community resources, you can influence the wellness of your home. And although you can’t alter the choices of everyone who impacts your family, you are in charge of your home ecosystem. Start there. Your need for outside resources may be less urgent if you are able to stabilize the rhythm and buttress the structure of the crew that makes up your home.

Often, this is precisely the guidance that paid professionals provide:

  • Ensure that everyone is honoring the basics of respect, trust, health, and safety.
  • Call time-out when a crisis alters the family norm, so there’s time to process the change.
  • Attend to little problems before they have a chance to take root and get big.
  • Allow stress to activate coping skills before solving the challenge prematurely.

If you performed an informal check-up on your family’s well-being, you would probably discover some opportunities to put these in play. Are respect, trust, health, and safety your priorities? Are you slowing down enough to discuss transitions? Are you practicing early detection/early intervention to the best of your ability? Are you allowing adaptability to develop rather than jumping in to solve problems too quickly?

You might not need a therapist. Or maybe a session or two gets things on track. Think globally, act locally.

About the Author

Steve Ritter, LCSW is the Founder and Executive Director of Elmhurst Counseling. He has served as a teacher, author, consultant, human resources director, health care administrator, and licensed clinical social worker since 1977. A fellow of the American College of Healthcare Executives, Steve has provided coaching, therapy and team development services to thriving schools, businesses and organizations.

You Have This Moment

You Have This Moment

What’s in front of you at any given moment is your life, quite literally. Here’s the dictionary definition of life (n.): “the animate, immediate existence of an individual.” Let’s stop here. The picture is too big. The present is sacred and it’s the only time we really have.

Taking things for granted is a common trap. If we fail to take advantage of the present moment, the odds are good we will also fail to do so at some hypothetical moment in the future. Keeping ourselves in a constant mode of preparation for the next thing means we’re always keeping our gaze on something that doesn’t exist.

Stakes are higher when we have rapidly growing kids. Blink, and your baby starts kindergarten. Blink again, and your kindergartener has the car keys. Children don’t wait around for us to start paying attention. Time marches on and takes childhood right along with it.

Stressful, right?

The big problem is that parenting requires tons of planning and a near-constant juggling act. How can we possibly balance everyone’s needs while fully appreciating our kids during the short time we have them around? It’s a puzzle I’ve struggled with personally since the moment my oldest son was born.

I’m sorry to report that I haven’t discovered the universal secret sauce to staying present and keeping all the balls in the air, but I have stumbled upon something that makes it easier. It’s the same thing I teach even my youngest clients when they come to me overwhelmed by life.

Breathe.

It seems foolishly simple, I know. But when we simply attend to our breathing we refocus on what’s real. Not yesterday’s memories. Not tomorrow’s projections. Right now. In doing so, we surrender the stressors that are out of our immediate control – if even for a moment.

Yes, there’s a high-stakes assignment due this weekend. Yes, that bully at school will need to be dealt with on Monday. Right now, you have a moment to breathe and see clearly. Inhale deeply. Exhale slowly.

Preparing for what’s to come is easier when you have presence of mind. By some miracle, staying in the present makes it more possible to manage your future with clarity and grace. Breathing in the moment keeps you grounded and lifts the weight of uncertainty. It narrows your focus while broadening your perspective.

It just feels a whole lot better, too – because deep down, we all understand that each new moment is the only thing we truly possess.

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and an occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

The Case Against Perfection

The Case Against Perfection

We all enter parenthood with the hope that we’ll do it right. As our kids don’t come with instruction manuals, we read blogs, buy books, ask questions, and take notes about others’ successes. We catalog the wins and losses from our own childhoods. With a blend of confidence and trepidation, we imagine cheerful, happy children and a joyful family.

Then life happens.

Our babies grow. They challenge us. We make mistakes. We lose our temper. We yell. We worry, feel frustration, and maybe even rage. We’re embarrassed to imagine what others might think if they knew the truth about what happens behind closed doors. We lay awake feeling guilty and wonder where it all went wrong, and why we’re so bad at this.

And yet… what if the point isn’t blissful perfection?

Compassion and hope live in the mending process that occurs whenever we’ve messed up. With each misstep, we have an opportunity to model for our children that we can grow from the stumble. Kids develop a healthier sense of themselves every time they see us fix our mistakes and give ourselves grace. A connection broken and mended is often stronger than a connection never broken.

Not only is the goal of perfection a setup for failure, but its pursuit prevents growth. Our kids yearn to see how we navigate adversity and solve problems. For them, it’s like watching a compelling sitcom. The plot toggles between conflict and resolution in each episode.

Kids only get to witness this when we give ourselves permission to struggle. They learn as we learn. We become authentically human in their eyes. They discover that not knowing what to do is okay because it leads to exploration. They come to see that mistakes are opportunities.

Parenting is hard. There is not a parent alive who hasn’t been overwhelmed by the process. But in the end, when repair occurs, everyone benefits from the growth and closeness that comes from shared experience and understanding.

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and an occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

New Year’s Resolution

New Year’s Resolution

New Year’s arrival inspires us to make hopeful predictions about the future. It’s a curiously strong tradition that most of us uphold – even when our ideas don’t often pan out. So why do we feel compelled to keep doing this?

Our ancestors hardwired us to see the world through an imaginary crystal ball. We can’t help ourselves – the conscious brain’s main purpose is to make predictions. Jeff Hawkins, author of A Thousand Brains, explains: “Prediction is not just one of the things your brain does. It is the primary function of the neo-cortex and the foundation of intelligence.”

To deal with uncertainty, we enlist the neurobiology of prediction. In other words, we assess the environment and guess what will happen next. The brain loves predictability because the threat level is already known, so whatever decisions we need to make require less energy and generate less stress than when the degree of threat is uncertain.

While this function used to keep us safe from wooly mammoths, it’s now about getting us through the day. Simplifying the world through prediction makes our experiences more manageable, takes less brain power, and can make life feel more enjoyable. The trouble is, we can get ourselves stuck in overdrive.

Here’s why: two parts of the brain are always working in partnership: the prefrontal cortex (creative thought, problem-solving, attention) and the limbic system (emotions, memories, survival). When we feel secure that things are under control, we’re operating calmly from the prefrontal cortex. But when things get complicated – unexpected variables, too much environmental stimulus, an onslaught of information to sort through – the limbic system flips us into the dreaded flight/fight/freeze mode.

We’re all living in a period of constant upheaval. The world feels unstable, we’re endlessly busy, and our kids are ticking time bombs of tantrums and out-of-control behavior. When something goes awry, such as getting stuck by a train or not getting a prompt response to an important text, our already heightened state of arousal flips directly into flight/fright/freeze. Everything feels like a crisis – and we’re desperate for resolution so we can calm our system.

We see this same phenomenon in our kids all of the time. The world is still new and often overwhelming. They are operating in a heightened state of arousal whenever events feel unpredictable. Their limbic systems are poised and ready to take over at a moment’s notice. Add a couple of caregivers who are modeling high-stress responses to mini-fires into the mix, and things can spiral out of control quickly.

So this year, consider adding a new resolution to your list on behalf of your brain, and the brains of all the children in your life. As you feel yourself flipping into ancestral fight/fright/freeze mode come January, take a couple of deep breaths to hold the limbic system at bay. Then take a quick moment to assess the scene – is this something I need to predict and control after all? Or will I likely survive (and even thrive!) no matter what comes?

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and an occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

Housekeeping versus Homemaking

Housekeeping versus Homemaking

Question: do you spend more time on housekeeping or homemaking? There’s a subtle emotional difference, and each has its own spin. Although there’s plenty of crossover between the two, the distinction is real. The question already ignites our biases.

So, before we go any further, let’s quickly get an outdated stereotype out of the way. This is not a discussion about Donna Reed-caliber housewives in scalloped aprons and lipstick, vacuuming already-tidy living rooms. What we’re really talking about here are the countless ways we intentionally craft and manipulate our living spaces – in other words, the specific roles we all play in our relationships with our homes. Let’s begin with two definitions:

Housekeeping is creating and maintaining an environment of cleanliness, order, and beauty.

Homemaking is creating and maintaining an environment specific to the needs, comfort, and harmony of your family and friends.

Most of us serve both roles. Knowing which one you tend towards starts with figuring out your central priority. What truly drives you as you clean-up, set-up, and fix-up your home? Are you most excited by having people ‘oo’ and ‘ah’ when they come over? Or are you more energized by arranging things to improve how you and others experience your space?

Beautifying and caring for your home usually has the bonus perk of boosting some family comforts. However, if your main goal is having a magazine-worthy abode and curb appeal that earns long glances from passers-by, you’re likely in the realm of housekeeping.

Homemaking starts from another place altogether. Homemaking is about promoting a welcoming vibe and anticipating people’s needs. It’s about creating ease and facilitating everyone’s well-being. Your home speaks uniquely to everyone who enters or lives in the space. It aims to make the space work for the people’s interests by maximizing the intersection of feeling and function.

Homemaking is personal, and it’s meant to flow with the times. It’s a dynamic and adaptable endeavor that evolves over time based on changing family needs. Even shifts in geography don’t have to alter the homemaking process much. For example, one can execute a near-exact version of it in a vacation rental. The central component of homemaking lives in the family system.

Housekeeping can evolve and be flexible, too, but it’s more often based on routines that depend on external priorities. Housekeeping tends to go on hiatus when there’s a disruption to schedules or you’re on vacation. It can be outsourced completely to professionals. It’s often based on a one-size-fits-most methodology. Homemaking, on the other hand, is as unique as the individual orchestrating it.

This is never an all-or-nothing state of affairs. In reality, we each do both. Mopping the kitchen floor is not warm, fuzzy, or personalized, but it is necessary. Designing a beautiful room, while incorporating the latest decor trends, still requires taking your family’s needs into account.

Whether the scales tip toward housekeeping or homemaking simply depends on where you’re placing the bulk of your focus. This brings us back to our original question: How do you allocate the priorities of your time? And then, a bigger question: How would you like to spend more of your energy going forward? Clean and beautify the space, or create a warm and welcoming place?

Space or place?

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and an occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.