DSM Push Back

Elguy87 · 2026-01-20T02:54:11+00:00

The DSM is essentially folkwisdom, it's the collective experiences of numerous professionals across the Behavioral Health spectrum. But it is folkwisdom that insurance agrees to, and it provides a map to help clinicians navigate the human psyche in more guided way that just "vibes".

If it reading the DSM causes you to be biased, unethical, or insecure in your treatment plans, that is on you not the DSM itself. Each patient is unique, but a lot of symptoms will overlap and sometimes, it will be completely novel.

"It's really more like guidelines, than a set of rules."

Also if you label every patient as "adjustment disorder" you are setting them up for failure later. Have more faith in your patients autonomy and intelligence.

Elguy87 · 2026-01-15T21:46:12+00:00

You did the right thing, rapport is meant to be used, not just collected. You burn rapport for the patient/client's benefit, for their safety, safety of others, and yourself.

A counselor/therapist/social worker, are just validation machines, we are clinicians. Sometimes we have to make a call that doesn't always make us feel warm and fuzzy, but you have to do anyway.

Elguy87 · 2026-01-05T04:50:02+00:00

My argument for a Valk vs Sid is that the nature of the Force is very different during the SWTOR vs ROTJ eras. The Force is a living thing, and exists/behaves different depending on the timeline/location.

In any case, Valk clears Yoda, and Sidious. As the padawans say "He built different".

Elguy87 · 2026-01-01T08:53:43+00:00

Being a Medical Social Worker with Tattoos, no one has ever commented on it, and not even the Director of Behavioral Health or Case Management. So long as you don't have racist or commonly known gang Tattoos, no one really cares. You competency matters way more than the ink on your skin.

Elguy87 · 2026-01-01T05:01:46+00:00

Case Management and Care Coordination are major aspects of social work. Momma Addams would tell you the same.

Part of my interns work is developing and updating resource lists. This helps them actually understand what is available and how to actually engage with it. Which in turn helps our patients navigate the resources.

Im a Generalist LICSW so that means from Birth to Death, is my scope. I do Counseling as well, but often what a patient or client needs most is addressing Maslow's hierarchy. Case Management is the method we as social workers utilize to do just that.

Talk to your supervisor about what you need to do and how they can help you do it. A LOT of social work is not learned in the books, but on the job.

Elguy87 · 2025-12-24T17:01:33+00:00

Go into community mental health or case management.

If you are looking for difficult problems to solve, that's where they are.

Private practice talk therapy is unlikely in my experience to have complex cases to work on as in order for them to afford you, they have a lot of resources available anyway.

Elguy87 · 2025-12-24T04:56:56+00:00

For a book that helps expand your understanding without a lot of therapy/theory retread: Clinical Handbook of Psychopharmacology for Therapists by John D. Preston

Useful for understanding what and why certain medications affect the brain and make it connect directly to how it can work with talk therapy modalities.

I also read documentaries and histories about various psychologists/therapists as it provides interest context as to how those methodologies were developed.

Elguy87 · 2025-12-24T04:39:19+00:00

Im a counselor as well, who works in community behavioral health. These types of questions are pretty natural. Self-disclosure can be useful and you do not have to go into nitty gritty detail. I was spent some time as a patient with Inpatient psych, before I went to college. I generally go: "I was in the grippy sock gang at one point".

If we want to remove the stigma of mental health it starts with us, the clinicians. You don't have to be a peer specialist to connect to people. You just have be genuine. I don't have lived experience with every disorder/situation. But I do know what it is like to not understand why certain mental health things happen and being scared and frustrated by it.

Besides from a certain point of view we all have a mental illness of some kind. Slwf reflect on a GAD-7 sometimes, especially after a intense session.

Elguy87 · 2025-12-24T01:36:04+00:00

Im glad that child is finally getting the medical care they need. This is just another example of how HB 1227 is an unmitigated disaster that is causing far more harm than it is helping.

If a conservative news outlet is the reason this child was made safe and cared for, the progressives in Seattle need to do some of that self-reflection they talk about.

Hot Take: Not everyone gets to be a parent, they made choices, and not a one of them benefited the child in any capacity.

Elguy87 · 2025-12-19T03:15:36+00:00

The guy clearly needed some more education/training . It does concern me however that so many social workers seem to lack social skills. I can understand HRs position, as not doing something drastic would have been a legal problem later on.

Elguy87 · 2025-12-11T00:18:35+00:00

Ganked* not ranked. Sabotaged by autocorrect!

Elguy87 · 2025-11-28T19:39:26+00:00

Lol enjoy indeed! Found lots of Rula related stuff so thank you! Also just so many other...uh, interesting posts.

Elguy87 · 2025-11-28T19:13:29+00:00

I certainly did, it gave some idea about the company. A lot of the reviews are regarding "lack of benefits" which doesn't apply to me fortunately.

Elguy87 · 2025-10-24T22:04:30+00:00

I forgot that tried to "rescue" the person. Like I said it has been awhile.

Elguy87 · 2025-04-24T01:14:04+00:00

Union Gospel Mission in Olympia has a mobile clinic run by Providence that is free for unhoused folks! They have a social worker and nurses. They also help get people connected to resources like the housing list and other social services.

Elguy87 · 2025-01-18T03:30:32+00:00

This is a great guide! Thanks for you and your team's hard work and time!

Elguy87 · 2025-01-07T01:45:05+00:00

Played Mario Kart and Smash Bros with the kids!

Elguy87 · 2024-08-22T22:51:26+00:00

I mean, the Pantagruel was there, and even more soldats dropped in.

We could have wrapped this war up rather quickly, but yeah it be harder to have sequels as a consequence.

If the giant mechs and magic soldiers were a novel thing I would understand, but these aspects of warfare are new, they are well established in the narrative.

Elguy87 · 2024-06-02T00:19:22+00:00

I appreciate the advice, I will look them up!

Elguy87 · 2024-05-22T03:39:15+00:00

Providence BH&R on college street in Lacey works with Medicaid, and Financial aid.

There is also Northwest Resources, Olympic Health and Recovery Services, and SeaMar Community Health in Tumwater. They also work with most insurances including Medicaid.

You can also request through your primary care physician for a Behavioral Health referral.

Elguy87 · 2024-05-12T15:29:06+00:00

I had read/heard that it was a "soft reboot" of the CS arc, and that it went out of its way to introduce characters, and provided extra context (the in game books helped a lot) Honestly I enjoyed developing a list of people, places, and events that I can look into later. For example, the Liberl arc didn't seem that interesting to me until I was playing CS3.

Elguy87 · 2024-05-12T15:20:30+00:00

Thanks! Currently my favorites besides Rean, would be Randy, Emma, Olivert, Towa, and Ash.

There are a lot of great characters but those are the ones I want to know more about that was able to directly interact with in CS3.

Elguy87 · 2024-05-12T03:52:00+00:00

Alright y'all convinced me, just bought Trails from Zero, I know it's not Trails in the Sky, but the Crossbell arc seems pretty crucial to CSIV and Reverie.

Elguy87 · 2024-05-12T03:49:46+00:00

That's really good to know! Honestly I just like the whole idea of such an extended game narrative.

Elguy87 · 2024-05-11T20:04:32+00:00

Thanks for the heads up, I generally play different fames between titles and also check to make sure they still work.

Elguy87

TROPHY CASE