u/maybeoneday44

Hi everyone,

I was curious if anyone has good book recommendations for psychosis that isn’t bipolar or schizophrenia but more aligned with it as a spectrum of symptoms and experiences?

I hate my job currently. I have secured a new job that is much more aligned with my preferred population and service.

TLDR: I’m the therapist working with an IOP provider service in skilled nursing homes. I don’t get to do individual therapy with my clients because a different company is contracted to do so. I can only do “case management” which is almost futile due to the structured environment of the snf. And it’s actually a well ran and funded snf.

Now the concern that’s giving me anxiety:

Due to burnout/stress/ and expectations that I feel are impossible to achieve, I had slacked hard on case management notes. Due to being pressured to start an extra “smaller” group. I kept getting mixed messages from clinical director and my “direct” boss and it made me sick how anxious I was about producing the outcomes they wanted to finally be told not to worry about it.

I’m still doing my IOP notes but when I have met with clients I didn’t track time but also sometimes the conversations don’t even last 15 minutes.

All my treatment plans and outcomes are up to date.

Should I be worried about this agency calling the board on me because my case management stuff isn’t up to productivity?

I have put in non billable updates so there is something documented because I do not feel it’s ethical to lie about times or structure case management like an individual session.

Sorry I am having so much trouble managing my anxiety over this situation. I have never had this much anxiety over a job until this one.

Thank you in advance.

I hate my job currently. I have secured a new job that is much more aligned with my preferred population and service.

TLDR: I’m the therapist working with an IOP provider service in skilled nursing homes. I don’t get to do individual therapy with my clients because a different company is contracted to do so. I can only do “case management” which is almost futile due to the structured environment of the snf. And it’s actually a well ran and funded snf.

Now the concern that’s giving me anxiety:

Due to burnout/stress/ and expectations that I feel are impossible to achieve, I had slacked hard on case management notes. Due to being pressured to start an extra “smaller” group. I kept getting mixed messages from clinical director and my “direct” boss and it made me sick how anxious I was about producing the outcomes they wanted to finally be told not to worry about it.

I’m still doing my IOP notes but when I have met with clients I didn’t track time but also sometimes the conversations don’t even last 15 minutes.

All my treatment plans and outcomes are up to date.

Should I be worried about this agency calling the board on me because my case management stuff isn’t up to productivity?

I have put in non billable updates so there is something documented because I do not feel it’s ethical to lie about times or structure case management like an individual session.

Sorry I am having so much trouble managing my anxiety over this situation. I have never had this much anxiety over a job until this one.

Thank you in advance.

I hate my job currently. I have secured a new job that is much more aligned with my preferred population and service.

TLDR: I’m the therapist working with an IOP provider service in skilled nursing homes. I don’t get to do individual therapy with my clients because a different company is contracted to do so. I can only do “case management” which is almost futile due to the structured environment of the snf. And it’s actually a well ran and funded snf.

Now the concern that’s giving me anxiety:

Due to burnout/stress/ and expectations that I feel are impossible to achieve, I had slacked hard on case management notes. Due to being pressured to start an extra “smaller” group. I kept getting mixed messages from clinical director and my “direct” boss and it made me sick how anxious I was about producing the outcomes they wanted to finally be told not to worry about it.

I’m still doing my IOP notes but when I have met with clients I didn’t track time but also sometimes the conversations don’t even last 15 minutes.

All my treatment plans and outcomes are up to date.

Should I be worried about this agency calling the board on me because my case management stuff isn’t up to productivity?

I have put in non billable updates so there is something documented because I do not feel it’s ethical to lie about times or structure case management like an individual session.

Sorry I am having so much trouble managing my anxiety over this situation. I have never had this much anxiety over a job until this one.

Thank you in advance.

I have had cartilage piercings before and I was instructed to use salt water solution and after piercing solution. It healed up great and my lobe piercings.

I got another cartilage piercing and went to a different place and the guy said:

“Let our bodies to its natural healing and use a warm compress twice a day”.

I’m diabetic so I was a little nervous about taking that advice.

What do you all think?

I took a different job because the company and work that I am doing, IOP, is not fulfilling or working for me emotionally and professionally.

A former supervisor was kind enough to help me work through the realization that if I am not happy it’s not the best idea to keep doing the work.

But yesterday someone found out and the entire group found out at the same time that I am leaving in 2.5 weeks.

The clients aren’t why I am leaving I actually really appreciate my clients but yesterday made me feel so guilty I almost reconsidered my decision to leave.

Any support, advice, insight right now would be greatly appreciated due to the fact I am so incredibly unhappy but also don’t want my clients to feel resentment and stop doing IOP because so many of them had made leaps and bounds in their goals.

Thank you all so much.

Not what you think; context in a LISW/LCSW in Ohio.

There has been discussion around making therapy more accessible and for licensing to be more universal across states.

I think that in order for there to be more consistency there has to be universal standards across all the states. Each state has such different standards and expectations compared to other health professionals, and for people to be able to practice more universally there has to be some major, and unfortunate, changes.

So recently as many of you know CAQH was bought out to private insurance companies.

I realized in Ohio they got rid of LPC needing to take an exam to get their extra C due to “cross state” licensing. I do not agree with this. I have met some very questionable therapist but I digress.

They say it’s all in the name of making therapist wanting move and or being credentialed in others states “easier” because I guess in other states Ohio has some very “rigorous” rules and stipulations to become fully licensed like New York and California levels. Was never aware of that.

I’m not enthused by any of this, it’s just an opinion and maybe the necessary evil to be able to ban together across states and platforms to advocate more effectively too? Maybe im too optimistic?

Recently I have become extremely unhappy in a job I took back in March. I got a job offer but I’m in my feelings, I’ll explain the situation and if anyone could weigh in with input it would be appreciated.

Context; all I do is run IOP groups, no individuals, in a snf but I am unsure if I am being weird like I need to reflect or if the company, which is for profit, is also being weird.

1: I don’t have a direct clinical supervisor for the “division” I am in. They technically offered me a promotion but I have to be there for 6 months before I can be promoted. The person I report to is 100% business oriented. There’s always pressure to get new referrals but in the snf I am in, it’s not a revolving door of clients like in some places. Which leads into 2

2: they began discussing what it means to step people down which impact my census which is ALL they talk about

3: my “direct” boss kept telling me we were planning on starting a smaller tbs group and gave me a very small timeline to accomplish this goal. When I tried to discuss this with the clinical director she was clueless. This happened more than once where my “direct” boss contradicts the clinical director. It happened today too and almost sent me through the roof. I got physically ill trying to prepare for group, do assessments, plan for this new group, and keep up with everything they want.

4: I feel they exploit lower level licenses through conversations. With people at different locations.

5: once carf came and went no one talks to me about performance reviews or my documentation.

6: I think I light weight hate this service delivery without individual sessions and the snf contracts with a different agency for individuals, but something about that is still weird to me because I’m offering day treatment not this other therapist.

7: I love the snf I am at and the staff and the fact they technically offered me a promotion has me feeling guilty for wanting to leave.

Any thoughts, ideas? Or should I run for the hills?

Potential new job is a state job working in a juvenile detention center I come from working with troubled youth in their homes.

PSA for those preparing for LCSW

I’m going to give some advice! Context:

I am the absolute worst test taker on the planet. I have always been bad at tests. I have to study and prepare A LOT to get a passing grade on a test since I could remember. I’m pretty confident I have an undiagnosed learning disability.

I passed my LCSW exam on the first try recently!

Pocket Prep was genuinely useful. If you do the level up portion you get more questions that are like the questions on the exam. It was the most useful tool I paid for. 100% worth the money in my opinion. They also have 3 practice tests that were very similar to the real thing and the ASWB official practice exam. I passed all 3.

I also used the ASWB app for exam questions and felt that it was also useful. I did not use the practice exams on this app but, my friend said they did and they found it useful.

I took the ASWB practice exam. I paid for it and it was genuinely helpful. Exactly what the real thing is like. I passed it.

The Apgar book is helpful for going over material but I did not like the practice tests it offered. The material for recall and refresher is on point and was helpful in that way. I read it 2x.

I found some extremely helpful YouTube videos like Agents of Changes free practice questions, Phillip Luttrell was the most helpful, and RayTube.

I studied on and off since January but locked in 6-7 week before my exam date.

I hope this information is helpful for anyone who may feel lost on where to start.