Congratulations to the graduate students from the Social Work and Mental Health programs across the program. Your hard work and dedication will pay off as you enter the “real world.” Here is the top ten list from a seasoned professional of fourteen years in the trenches:
10. Know who your supervisor will be in your first job after graduate school. One thing I learned is that having a unprofessional boss who exhibits unethical behaviors and is simply “rude” and “unkind” to you is not worth staying on the job. Know your rights when you have been taken advantage of and don’t be afraid to stand up for yourself.
9. Select a new job where the commute is reasonable and feasible. Why take a job that can wear and tear on your car and is far away from your home. If you do home visits as well, pick a job closer to home. Car repairs are very expensive.
8. Be aware of the parameters when taking a salary job as opposed to a fee for service job. If you don’t make productivity, you are in danger of losing your salary and benefits and being stuck as a fee for service clinician. Choose carefully and wisely.
7. To add to number 8, if you are in job that requires reaching unfair productivity quotas, be ethical in your billing practices. There are too many clinicians who bill for hourly sessions when they saw their client for a half hour if they double booked them that way.
6. Provide support for your colleagues by being non-competitive and being a good listener. Select an employer where the work environment can be a “second family” to you. I have been blessed twice over the years to have worked in this type of environment. It helped to decrease my stress levels very much.
5. Be nice to the administrative staff that does your billing and filing. Even though you are educated, it does not mean you are better than them. Treat them with compassion and kindness.
4. It sometimes pays to be choosey in deciding what clients you want to counsel. It is not ethically appropriate to see a client where their issues may push your buttons or is out of your league. If a client is not a good fit, please remember to not take it personally. If you wish to grow and expand your horizons in working with different clients, that is OK too. Just remember to know your limits and not use your “ego” to reach productivity standards that are beyond your control.
3. Customer Service applies when seeing your clients. If you offend them by accident, say you are sorry and be humble. Thank them for coming in to see you. Don’t forget to smile as well.
2. Keep up on the latest trends and knowledge in your profession. Go to conferences; attend workshops; read books and magazines; and stretch yourself to read books outside of your profession. I read books from the business sector to get ideas on how to perfect my customer service skills and to market my work to others.
1. Take care of yourself. If you need to speak to a counselor, go and do it. It does not help you and your client if you are not able to counsel them objectively and fairly. Choose at least three interest/pleasurable activities to engage in to get grounded and balanced.
--------------------------------------------------------------------------------
Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, “Miller Chat” in Massachusetts.
Monday, May 2, 2011
Sunday, April 3, 2011
Odds and Ends as Spring Arrives....
I love when Spring arrives in New England. "It comes in like a lion and goes out like a lamb" as the saying goes. I have good news to report in my neck of the words. I wrote in the past about the inequities in the mental health system for children on commercial health insurances who need intensive services and can't access them. I am glad to hear that there is proposed legislation in Massachusetts to mandate that commercial insurance cover children who need intensive care coordiation for their mental health needs. What this acutally means is that counselors and social workers would get paid for doing collateral services such as going to school meetings and calling primary care doctors on behalf of their clients. At the present time, providers are unreimbursed for their time if they conduct these extra services outside of the counseling parameter for their clients. Over one thirty five organizations co-sponsor this legislation. The state chapter of the National Social Work Association is one the organizations co-sponsoring this bill. However, I don't know if the state chapter for Mental Health Counselors Association is co-sponsoring this bill as there is no information on their website (www.mamhca.org) that says they do. If anyone who belongs to this organization knows, please email me privately. If the bill passes, all children and not just those on Mass Health (medicaid) will receive due diligence for their mental health needs.
I am so glad to hear that the ACA is forming an Ethics Revision Task Force. I would like this Task Force to implement regulations on ethical billing practices. For example, there is some professionals who bill for an hour when they see their clients for only thirty minutes. The rationale is twofold: 1) They have productivity requirements to meet or lose their benefits and salaries if they don't meet their monthly quotas and; 2) Some agencies/practitioners operate on the principle if your client wishes to end thirty minutes early or comes late, you have the right to bill for an hour. I look forward to debate on this controversial issue. Another area to look at is Section F.11.c.Multicultural/
Diversity Competence. This area needs to include what cultural competencies are required to be taught to graduate students. Right now, some counseling programs across the country are not teaching their students to be disability sensitive when counseling those with physical and psychiatric disabilities. I speak from professional experiences working with graduate interns and fellow colleagues who have clients with disabilities. I welcome again your feedback on this topic area. The Task Force needs to look at how social networking mediums such as Facebook; Twitter; and Linkedin can affect the counselor-client relationshp. It is obvious that counselor should not "friend" their clients on Facebook. However, if you counsel a fellow colleague who wants to be in your linkedin group, what do you say? Can counselors/agencies twitter their clients on announcements? What do you think?
I wish everyone a Happy Easter and Passover in April.
I am so glad to hear that the ACA is forming an Ethics Revision Task Force. I would like this Task Force to implement regulations on ethical billing practices. For example, there is some professionals who bill for an hour when they see their clients for only thirty minutes. The rationale is twofold: 1) They have productivity requirements to meet or lose their benefits and salaries if they don't meet their monthly quotas and; 2) Some agencies/practitioners operate on the principle if your client wishes to end thirty minutes early or comes late, you have the right to bill for an hour. I look forward to debate on this controversial issue. Another area to look at is Section F.11.c.Multicultural/
Diversity Competence. This area needs to include what cultural competencies are required to be taught to graduate students. Right now, some counseling programs across the country are not teaching their students to be disability sensitive when counseling those with physical and psychiatric disabilities. I speak from professional experiences working with graduate interns and fellow colleagues who have clients with disabilities. I welcome again your feedback on this topic area. The Task Force needs to look at how social networking mediums such as Facebook; Twitter; and Linkedin can affect the counselor-client relationshp. It is obvious that counselor should not "friend" their clients on Facebook. However, if you counsel a fellow colleague who wants to be in your linkedin group, what do you say? Can counselors/agencies twitter their clients on announcements? What do you think?
I wish everyone a Happy Easter and Passover in April.
Saturday, December 4, 2010
The Mental Health's Big White Elephant
Bravo to the physicians for speaking against the upcoming cuts in Medicare reimbursements and the threat of refusal of accepting more patients in their medical practices. How come mental health professionals can’t follow this same pursuit?
Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients.
I will give you an example on what I am talking about. Two years, one big powerful health insurance company in Central Massachusetts cut reimbursements from $ 55.00 to $ 50.00 for providing mental health services to their clients. There are two things wrong: 1) Why on earth are mental health professionals taking their clients for low pay? 2) Where is the threat from the profession to stop taking their clients when the rate dropped to $ 50.00?
I have more pet peeve with this provider. Last Spring, they implemented a new conversion of billing claims with their contracted provider to pay mental health professionals. It has been a nightmare in getting paid on time. From June to November, I called the contact in provider relations to complain that I was not being paid for my services. Due to my constant telephone calling on a weekly basis, I was paid for one claim in October after I saw the client in April. In November, I was paid for two claims (after being overpaid twice) after I saw the client in June. As I write this blogpost, I am still have not been paid for ten claims since September to October due to their billing company losing the claims and my bookkeeper having to fax the claims to their supervisor.
Isn’t this ridiculous and insult to injury to fellow counselors?
Regarding low reimbursement rates, this health insurance company does not value the work that we do in our state. I am very disappointed with the leadership from both the mental health counselor and social work association for not speaking out on these two issues.
Regarding this horrible billing system, many complaints have been noted on their annual feedback form that the health insurance emailed to use to fill out this year.
You may ask why we continue to take their clients. There are two reasons: 1) In my area, many companies have switched from Blue Cross to this provider who have cheaper rates. 2) Getting private pay clients is not happening. In fact, many working families are now on the state medicaid system due to not being able to purchase an affordable health insurance commercial program.
What can we do about these issues?
1) The state social work and mental health counselor association need to speak out against this insulting low reimbursement rates.
2) They also need to meet with this provider to negotiate a high reimbursement rate to accept their clients.
3) If the above two tactics don’t work, then I advocate that the two associations call for a statewide boycott of accepting more clients from this provider.
I don’t know if the velvet glove approach will. I welcome your comments.
Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients.
I will give you an example on what I am talking about. Two years, one big powerful health insurance company in Central Massachusetts cut reimbursements from $ 55.00 to $ 50.00 for providing mental health services to their clients. There are two things wrong: 1) Why on earth are mental health professionals taking their clients for low pay? 2) Where is the threat from the profession to stop taking their clients when the rate dropped to $ 50.00?
I have more pet peeve with this provider. Last Spring, they implemented a new conversion of billing claims with their contracted provider to pay mental health professionals. It has been a nightmare in getting paid on time. From June to November, I called the contact in provider relations to complain that I was not being paid for my services. Due to my constant telephone calling on a weekly basis, I was paid for one claim in October after I saw the client in April. In November, I was paid for two claims (after being overpaid twice) after I saw the client in June. As I write this blogpost, I am still have not been paid for ten claims since September to October due to their billing company losing the claims and my bookkeeper having to fax the claims to their supervisor.
Isn’t this ridiculous and insult to injury to fellow counselors?
Regarding low reimbursement rates, this health insurance company does not value the work that we do in our state. I am very disappointed with the leadership from both the mental health counselor and social work association for not speaking out on these two issues.
Regarding this horrible billing system, many complaints have been noted on their annual feedback form that the health insurance emailed to use to fill out this year.
You may ask why we continue to take their clients. There are two reasons: 1) In my area, many companies have switched from Blue Cross to this provider who have cheaper rates. 2) Getting private pay clients is not happening. In fact, many working families are now on the state medicaid system due to not being able to purchase an affordable health insurance commercial program.
What can we do about these issues?
1) The state social work and mental health counselor association need to speak out against this insulting low reimbursement rates.
2) They also need to meet with this provider to negotiate a high reimbursement rate to accept their clients.
3) If the above two tactics don’t work, then I advocate that the two associations call for a statewide boycott of accepting more clients from this provider.
I don’t know if the velvet glove approach will. I welcome your comments.
Saturday, October 23, 2010
Is Blood Thicker Than Water?
I heard about a very sad event that an adoptive single parent endured this past week. She had to relinquish her 17 month old preadoptive son from the state foster care system to his biological father. Apparently, the birth mother told the state who the father was after a year in which she refused to identify him at birth. The birth mother held back the information due to her belief she would get custody back of her baby after she cleaned up her act in a drug rehabilitation facility. When the birth mother found out her parental rights were terminated this year, she decided to identify the birth father so she can still see her son in his custody. What a tragedy for this parent and for this baby.
How did this happen? In Massachusetts, the foster care/adoption system runs a little differently as opposed to doing a domestic adoption from a licensed agency. For the former, there is no system in place to post announcements in public newspapers that call birth fathers to identify themselves during the adoption hearings. For the latter, this system is in place. If the birth father does not show up during an adoption hearing, his rights are terminated.
As a counselor, I believe that the foster system for preadoptions is broken. I have heard of other similar cases where children were going to be adopted by their foster parents and liberal judges painfully tore them away and placed them with biological relatives who came out of no where. This dysfunctional process hurts the attachment bonds between the children and preadoptive parents. The slogan, “ Blood is Thicker than Water, “ is bogus and harmful to preadoptive families.
In 2005, I taught a class to non-traditional students entitled, “Functional Families,” which defines families as a group of individuals living together and establishing healthy bonds regardless how they were formed. This definition needs to be taught to judges and lawyers who create outdated laws that hurt adoption options for families who want to be parents.
What can the counseling profession do about it? We need to be vocal in educating lawmakers about antiquated laws that say a family is made by DNA only. We also need to promote equal laws and processes for both the foster care and domestic adoption systems in your state.
Counselors can educate legislators about the broken attachment bonds that can develop between a child and adoptive parents when their adoption is “interrupted” and a child is forced back with their biological parents. Massachusetts promotes unhealthy families when they reunite children with their biological parents who are not capable of parenting them. This policy goes against the mission that both the social work and counseling professions hold in promoting healthy development and growth and the fullest potential in individuals and in families.
We can do something as a collective to make positive changes.
I welcome your feedback.
Robbin Miller
Moderator
How did this happen? In Massachusetts, the foster care/adoption system runs a little differently as opposed to doing a domestic adoption from a licensed agency. For the former, there is no system in place to post announcements in public newspapers that call birth fathers to identify themselves during the adoption hearings. For the latter, this system is in place. If the birth father does not show up during an adoption hearing, his rights are terminated.
As a counselor, I believe that the foster system for preadoptions is broken. I have heard of other similar cases where children were going to be adopted by their foster parents and liberal judges painfully tore them away and placed them with biological relatives who came out of no where. This dysfunctional process hurts the attachment bonds between the children and preadoptive parents. The slogan, “ Blood is Thicker than Water, “ is bogus and harmful to preadoptive families.
In 2005, I taught a class to non-traditional students entitled, “Functional Families,” which defines families as a group of individuals living together and establishing healthy bonds regardless how they were formed. This definition needs to be taught to judges and lawyers who create outdated laws that hurt adoption options for families who want to be parents.
What can the counseling profession do about it? We need to be vocal in educating lawmakers about antiquated laws that say a family is made by DNA only. We also need to promote equal laws and processes for both the foster care and domestic adoption systems in your state.
Counselors can educate legislators about the broken attachment bonds that can develop between a child and adoptive parents when their adoption is “interrupted” and a child is forced back with their biological parents. Massachusetts promotes unhealthy families when they reunite children with their biological parents who are not capable of parenting them. This policy goes against the mission that both the social work and counseling professions hold in promoting healthy development and growth and the fullest potential in individuals and in families.
We can do something as a collective to make positive changes.
I welcome your feedback.
Robbin Miller
Moderator
Sunday, August 22, 2010
Bullying: A Counselor's Perspective
Massachusetts passed a new law entitled, "An Act Relative to Bullying in Schools," in 2010. The purpose of this new law is to "create more positive school climates and age-appropriate instruction on bullying prevention in each grade, and schools must offer information to parents on bullying prevention." (Worcester Medicine, July/August 2010). School personnel (teachers, guidance counselors, aides, bus drives and cafeteria workers) are required to report incidents to the appropriate officials for them to investigate and to take disciplinary actions when appropriate. Bullying includes not only verbal, physical and written repeated acts of aggression and gestures but now includes cyberbullying through electronic means-Facebook; Twitter; Emails; Texting, and through other electronic devices.
As counselors, we see the direct effects on bullying on our clients who come to us with a variety of symptoms:low self-esteem; sadness; agitation; anxiety and fears; nightmares; refusal to go to school; bed wetting; binge eating; and low school performance. Sometimes, some parents just don't know what is going on their with child because their child is either afraid or ashamed to tell them. For a boy raised in a home with a male parent/caretaker being macho and proud and/or culture promoting this environment, he may be afraid to tell him for fear of ridicule or shame. For girls, it may be a little easier due to cultural acceptance to share with their parents/caretakes. However, both girls and boys may be afraid to tell due to fear of being a snitch in school or are facing similar abuses at home where they don't know who to tell or to trust.
I provide my clients a booklet put by the American Medical Association Alliance entitled, "You Don't Have to Be Bullied," (2006) that tells a story of cartoon character by the name of Keith who is experiencing symptoms anxiety and nervousness due to a kid picking on him in school. The booklet provides good and bad choices in handling a bully in school ,and most of all, promoting prosocial behaviors of being calm and cool in dealing with these situations.
However, I need to share with you one caveat that was discussed at a past work meeting this week. Despite teaching our clients to handle bullying in a positive way, a fellow colleague suggested that letting the student punch back the bully would cease it. Honestly, I punched a girl in high school who kept repeatedly taunting me for weeks at a cooking class in high school in the 1980's. The teacher ignored it and my peers did nothing about it. I had enough as I got tired of ignoring it and could not take her hitting me one day in class. I hit her back but the teacher did nothing to stop it. After this incident, the girl became my friend in school. As I look back on this encounter and teach my clients coping skills to deal with a bully, I sometimes find it hard to not agree with their parents' suggestion and my colleague's comment "to punch back" to defend yourself if nothing is done to positively stop it.
What do you think?
Robbin Miller, LMHC
As counselors, we see the direct effects on bullying on our clients who come to us with a variety of symptoms:low self-esteem; sadness; agitation; anxiety and fears; nightmares; refusal to go to school; bed wetting; binge eating; and low school performance. Sometimes, some parents just don't know what is going on their with child because their child is either afraid or ashamed to tell them. For a boy raised in a home with a male parent/caretaker being macho and proud and/or culture promoting this environment, he may be afraid to tell him for fear of ridicule or shame. For girls, it may be a little easier due to cultural acceptance to share with their parents/caretakes. However, both girls and boys may be afraid to tell due to fear of being a snitch in school or are facing similar abuses at home where they don't know who to tell or to trust.
I provide my clients a booklet put by the American Medical Association Alliance entitled, "You Don't Have to Be Bullied," (2006) that tells a story of cartoon character by the name of Keith who is experiencing symptoms anxiety and nervousness due to a kid picking on him in school. The booklet provides good and bad choices in handling a bully in school ,and most of all, promoting prosocial behaviors of being calm and cool in dealing with these situations.
However, I need to share with you one caveat that was discussed at a past work meeting this week. Despite teaching our clients to handle bullying in a positive way, a fellow colleague suggested that letting the student punch back the bully would cease it. Honestly, I punched a girl in high school who kept repeatedly taunting me for weeks at a cooking class in high school in the 1980's. The teacher ignored it and my peers did nothing about it. I had enough as I got tired of ignoring it and could not take her hitting me one day in class. I hit her back but the teacher did nothing to stop it. After this incident, the girl became my friend in school. As I look back on this encounter and teach my clients coping skills to deal with a bully, I sometimes find it hard to not agree with their parents' suggestion and my colleague's comment "to punch back" to defend yourself if nothing is done to positively stop it.
What do you think?
Robbin Miller, LMHC
Subscribe to:
Posts (Atom)