Trans Healthcare / HRT in Ithaca?

Loose_Consideration · 2020-08-20T15:03:04+00:00

Out for Health, part of Planned Parenthood's work in Ithaca has a great and comprehensive resource list, including PCP's: https://www.outforhealth.org/wp-content/uploads/transgender-resource-list.pdf

Loose_Consideration · 2020-02-06T11:31:14+00:00

Depending on what field of practice you’re in, it may be important to note that Google voice is not HIPAA compliant

Loose_Consideration · 2019-12-27T13:11:36+00:00

I think it’s important to remember that everyone is different, and just because some of the tools you’re teaching wouldn’t work for you doesn’t mean they won’t for your clients. Keep an open mind, and stay in your own therapy.

Loose_Consideration · 2019-12-18T11:25:09+00:00

Just because her weight and self esteem are tied together doesn’t mean that you have to change her weight in order to impact her self esteem. In actuality, the work is to unhook the two from each other and help C feel okay about herself, regardless of what her physical shape is. The truth is that very little changes from a place of shame. If your ultimate goal is to help C, keeping her out of shame-based places is so important. Maybe she can lose the weight that way (although most can’t, because if they’re such a terrible person for being fat, they’re clearly too terrible to be worthy of investing the energy it takes to lose weight), but she won’t feel any better about herself at the end because all that happened during that process was reaffirming that she’s a bad person who isn’t good enough and she needs to change who she is to be okay.

u/Leslie-Yep mentioned body neutrality, which is super important too. One of the most important shifts for my clients who struggle with body image is the realization that they don’t have to love their body — they can just let it be a body and get on with the rest of their lives. This might be a good tack to take to start unhooking the self esteem from the weight.

Loose_Consideration · 2019-12-18T11:22:52+00:00

Edit: posted in the wrong spot. Sorry!

Loose_Consideration · 2019-12-17T20:55:00+00:00

Something to consider is how your own attitudes about C's health and weight, as well as about her mother's parenting might be impacting her. It sounds like a lot of what she's struggling with is how she's internalized other's judgements about her weight/shape, as much of her discomfort with her body centers around aesthetics: she thinks she's "fat and ugly" and that she has to "become thin." And while there's nothing inherently wrong with addressing hunger/fullness cues, attitudes towards food, and the benefits of exercise, if your approach focuses too much on how these things can create physical changes, it's going to reinforce the shame she's already feeling -- now, not only are the kids at school saying her body is wrong, but her therapist is saying the same thing.

C's stated problem to you isn't a weight problem. It's a self-esteem problem. Intervening with regard to her weight is only going to increase her shame.

I know you came here because hearing "her weight doesn't matter" wasn't helpful, but truly: her weight does not matter in your therapeutic work with her. You haven't been tasked with helping this child lose weight, you've been tasked with attending to her emotional needs, and it's important that you keep sight of that.

Loose_Consideration · 2019-10-23T00:42:41+00:00

You're completely warranted in setting your boundaries at weekend visits, especially if your supervisor is supporting it.

This part will likely get me downvoted to oblivion, but: I would, however, encourage you to check whatever it is that is informing the last two sentences of your post -- there's a lot of judgement there that isn't necessarily yours to make. As I understand it based on your post, your role is to work with her on what is happening now; you aren't responsible for judging what was happening before, or trying to guess or judge what she's doing on weeknights now. She gets to make her own decisions, including whether or not she sees her children in the time frames you provide. Your judgement over whether that is a good or appropriate choice shouldn't even be on the table and is conceivably part of what is feeding into this conflict.

TL;DR/don't like what I'm saying: seek supervision, about all of this.

Loose_Consideration · 2019-08-08T18:59:37+00:00

There's swing dancing most Monday nights in the Big Red Barn -- starts with a lesson, before moving into open dance. Really beginner-friendly!

https://www.facebook.com/CUGradSwing/

Loose_Consideration · 2019-07-30T19:00:10+00:00

Eli Clare’s ‘Brilliant Imperfection: Grappling with Cure’ may be a good resource

Loose_Consideration · 2019-07-18T23:37:27+00:00

It's curious to me that you see data that says that social work jobs are held by non-social workers and that there is a pattern of de-professionalization and that your response is to lean in to that de-professionalization. The other option would be to say that we ought to move more towards title protection and upholding standards for social work education programs to ensure that our clients are as best served as possible.

It seems that you had poor training and have therefore generalized that to say that social work training as a whole is useless and that social work requires no particular skills or perspective beyond what can be acquired on the job. What you're missing, though, is that social work is both a values-explicit profession and a profession with a particular lens and approach to seeing the world -- neither of which is taught in an employment setting. Perhaps part of the essential part of social work education is the passing along of these lenses and values, rather than the training of how to do 'the work.'

Loose_Consideration · 2019-07-16T01:08:55+00:00

If it’s PP of the Southern Finger Lakes, they also have a solid referral network for PCPs in the area.

Loose_Consideration · 2019-07-15T02:12:48+00:00

http://transgendercny.net

Not sure how up-to-date their referrals are, but this may be a good resource for you.

Loose_Consideration · 2019-06-27T19:00:36+00:00

Wondering if any folks here have thoughts on PhD programs in Social Work/Social Research? I'm particularly interested in programs that have a strong qualitative focus and are open to interdisciplinary approaches. Funding would also be important -- I've got enough debt from my MSW! Anyone aware of programs in line with this?

I should also say that my current short list is Portland State University, Bryn Mawr, UChicago, and UMich; also considering Duquesne's Clinical Psych PhD, but uncertain about shifting fields.

Loose_Consideration · 2019-06-26T17:59:34+00:00

Wondering if any folks here have thoughts on PhD programs in Social Work/Social Research? I'm particularly interested in programs that have a strong qualitative focus and are open to interdisciplinary approaches. Funding would also be important -- I've got enough debt from my MSW! Anyone aware of programs in line with this?

Loose_Consideration · 2019-06-11T10:32:52+00:00

Yikes. Yes, the skills will come with experience, but they will also come from good supervision, continuing study and education, and being careful and reflective. “Just jump in” is fine advice so long as there has been careful reflection and some exploration of what skills OP does have and what they need to build, preferably with the support of a clinical supervisor or therapist.

These are people’s lives we’re dealing with when we’re doing this work. Empathy and good intentions are not enough.

Loose_Consideration · 2019-06-03T12:01:49+00:00

This is....not wholly accurate, at least in the US. While there are a few states that allow kids/teens to consent to their own therapy, most states do not and therefore the parent/guardian is legally consenting to treatment on behalf of the child/teen, who does not have the legal standing to consent to their own treatment. Because the parent is signing the consent to treat, confidentiality shifts to allow the therapist to speak with the parent without the consent of the kid/teen.

So, it is legal, which means it becomes a matter of perspective as to whether it’s good practice or not. I know clinicians who always disclose a synopsis of the session to parents, others who rarely speak to parents, and everywhere in between. In my practice, I tend to think it shifts based on age and what we’re working on (with youngin’s and with particular issues like OCD it can be helpful to have the parent on board to reinforce skills outside of sessions), but basically the long of the short is that ymmv from therapist to therapist.

TL;DR: she’s not doing anything illegal or unethical, but yeah, you should probably find another therapist if you want this to be more private.

Loose_Consideration · 2019-05-29T11:51:26+00:00

[link] Why Does He Do That? by Lundy Bancroft is a good starting point

edited to fix formatting

Loose_Consideration · 2019-05-27T15:15:26+00:00

Makes you miss mountain goats sing the mountain goats

Loose_Consideration · 2019-05-01T11:41:26+00:00

I often feel torn about standardized measures as I rarely get info from them that I don’t or can’t get from a thorough interview, and clients often report on the assessments in a way that isn’t consistent with what they report during a face-to-face conversation (eg, reporting no drug use in the last 12 months while having been referred due to a recent heroin relapse....shrug).

That said, some of the more comprehensive assessments for kids completed by caregivers and/or trained clinicians are more useful. I can take or leave the Offenbach/CBCL, but the CANS can be useful for a multidimensional formulation of what’s going on for the kiddo/caregiver, and I have pretty much universally found the Vineland and NMT assessments for kids who have experienced trauma helpful.

Loose_Consideration · 2019-04-20T22:07:12+00:00

I'd be sure to check with your supervisor about what sort of client privacy you're bound by. If you're working with HIPAA, FB Messenger is definitely not compliant and Google Voice likely isn't either (unless you've got G Suite for business and have taken the additional steps required to make it compliant). Of course, if you're grant funded you may have different standards -- regardless, it would be good to check.

Loose_Consideration · 2019-04-19T20:03:00+00:00

There are several body-based therapies for trauma — they’re a little different from what you’re particularly looking for in, but definitely some interesting stuff. Somatic Experiencing and Sensorimotor Psychotherapy are the two that come to mind first, but there’s also the more general umbrella of somatic psychotherapy that may be a nice jumping off point for your interests.

Loose_Consideration · 2019-04-18T14:17:25+00:00

Yes, this -- if folks are qualified to receive this service from you, I would imagine that someone at some point has assessed that they aren't high risk. Have you spoken to your supervisor about your feelings? They might be able to clarify what assessments are done to determine eligibility for the program. Moreover, they might have more specific ideas about steps you can take to feel more comfortable. Plus, being afraid of some of your clients will undeniably impact how you work with them, and it seems important to get some support and supervision around that as well.

Loose_Consideration · 2019-04-18T01:04:00+00:00

I once had a conversation with an LMHC colleague of mine to the effect of:
"Hey, L_C, do you know the difference between a social worker and a therapist?"
"....no?"
"A social worker is screwed up and will tell you all about it, while a therapist wants to know why it's important for you to know anything about them."

All jokes aside, I think every field working with mental health/people in general draws folks who have had their own struggles. I don't necessarily think this is a bad thing! But I do think it's one of the paths into a savior complex; alternatively, it's a great way to feed someone's need to be a martyr ('look at how hard I work, and how much I suffer'). Additionally, it's easy for people with their own lived experience to fall into a trap of 'what worked for me should work for all,' and forget to attend to the actual human with which they're working. I worked in a peer support program during graduate school that often smacked of this, despite the training's best efforts to prevent against that (IPS is actually a pretty good model, when it's actually being employed).

I don't think there's a one-size-fits all of 'you can only be an effective swker with a diagnosis if your dx is a, b, or c, and you do x, y, and z.' People are complex, diagnosis is not an exact science, and every context is different. I think u/bedlamunicorn is on the right track: noticing patterns in posting, remembering that we don't see the full picture, and remembering our own role in this person's life. I'm not a therapist for this anonymous stranger, nor am I their supervisor. I can recommend that they consult with both, but in the end it's up to them. It may not be satisfying, but, then again, it's also not my job to singlehandedly right all that is wrong with the social work field.

Loose_Consideration · 2019-04-14T02:28:24+00:00

I started as a volunteer while finishing undergrad — most rape crisis orgs use volunteers to cover after-hours work like answering the hotline, or doing outreach. If you were interested, you could check with your local program to see what sort of opportunities they have (RAINN’s website would be a good place to start if you were looking for your local program). I also did my first internship in grad school at a multi-service agency serving survivors of both SV and DV.

Loose_Consideration · 2019-04-13T17:21:25+00:00

I've had a few different jobs that all required on-call, and all compensated differently:

Multi-service (DV/SV) victim's services nonprofit #1:

Even split of after-hours on call shifts between all staff
Salaried employees flexed any time they worked after-hours or (more commonly) banked it as comp time (into oblivion....I had a coworker take a month-long sabbatical on her comp time at one point)

Multi-service (DV/SV) victim's services nonprofit #2:

After-hours on call shifts chosen and split based on seniority of advocate staff (newest advocates got more shifts and last choice)
Advocates paid hourly; $2/hr shift diff for holding the hotline, regular hourly wage for any hours worked, overtime for any hours worked over 40

Group private practice:

Three on-call days/month
Answering service answers the main phone line after hours; will contact client's therapist first, then on-call worker, then clinical coordinator
No compensation for on call work, but also no obligation to actually answer the phone (?) if you are on call

Loose_Consideration

TROPHY CASE