Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum Program Transcript

Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum

Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum Program Transcript

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CRAIG BLUM: Hi. I’m Craig Blum, a core member of the Clinical Mental Health Counseling faculty. And I’ve been asked to talk a little bit about my experience and thoughts about crisis, trauma, and disaster response. I have a Master’s degree in Rehabilitation Counseling from Syracuse University, and then went off eventually to get a Doctorate from the University of Buffalo.

After my master’s degree, I worked in a variety of pretty typical kind of rehab counseling situations, worked in a sheltered workshop. I worked for a book rehab, worked for private rehab company. And during that time, I didn’t have an awful lot of experience or exposure to either of the ideas that we’re talking about here, or all the ideas, crisis, trauma, or disaster response.

My field work experiences in my master’s were all in clinical programs in day programs for general, psychiatric hospitals for the state of New York. I had a little bit more experience there with some of that anyway, at least around crisis, suicidal clients, and other situations like that. But I didn’t have a whole lot of experience until after I got my doctorate.

I taught in a couple of programs, university programs, and then went off in working in the field, working in a community mental health center associated with a hospital in New Jersey. And in that situation, most of my experience was, at least initially, was in crisis hospital work where I would go down to the emergency room and evaluate the various folks that would come in that had various crises and traumatic situations that would happen to them.

Also, I had a general outpatient practice in the hospital setting there, community mental health setting. Eventually, worked there for approximately four years, then did some inpatient psychiatric hospital work in that same setting. I eventually, got a private practice and did that for about 10 years and had a few other experiences along the way in direct clinical experience. But a lot of my experience around the pure crisis and trauma work were related to my hospital- based work as well as to my private practice.

Certainly, the foundational skills, the basic counseling skills that we are going to be trained in, have already been working on, are vital to the work. But I think is most important is two things. One of them is, especially with crisis work, especially with clients that come in for being suicidal, various traumatic events that have happened to them, that the work is much quicker. You have to really work much quicker. Quicker in a variety of ways– quicker in terms of making a

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Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum

connection with the client, in terms of really developing a rapport with them, and quicker in terms of dispositional issues.

You’ve got to really make some decisions that need to be implemented pretty quickly as to whether somebody needs to go into the hospital, whether they can go home safely, engineering situations to help support them in the community. And so whatever work you need to do needs to happen that much quicker than it would happen in a regular, outpatient setting or even in a residential program. You’ve got a lot more time in those places to really do the work that would typically need to be done.

So you really need to have your skills really at the highest level, since you need to really use them very, very efficiently, very effectively in terms of working with people. You need to know how to interview rapidly, to ask for the right kinds of things. You really need to develop really a protocol for how to go about assessing clients for risk factors, whether it’s related to suicidal issues, homicidal issues, or other factors that might be impacting themselves and others.

And so you need to use all those basic skills that you’re going to be learning in your program. But there are specific skills and information and knowledge that you’re going to really need to know and really have at your fingertips if you’re going to do this work effectively. And that really comes, not only from just going to training programs, but getting supervision from folks that are really expert to be able to really help you to deal with these sort of things in a real timely and effective and efficient fashion.

One of the things we used to talk about when I was in, especially crisis work, there’s this notion, it’s based on a Chinese pictogram for crisis. And the notion is it’s an opportunity for change. And I think that’s one of the things that I’ve really learned to embrace as I’ve worked in the field is that many times under crisis situations, under situations that really have pushed people to the limits, there can be an opportunity for change, that it can happen on a pretty rapid basis for them. The pressures for them to really make some changes can, if done well, can really be very helpful for them, ultimately, making some changes that are lifelong in nature. And so that notion of it’s an opportunity for change, I think, is really a productive, positive way to view what can often be looked upon as a really negative and awful situation for everybody concerned.

This is tough work. It’s challenging work. I’m no longer a young guy as you can tell by the video here. I’m not sure that I could do the crisis work day to day anymore. It just takes an awful lot of effort, challenge, and so it gets to those issues around vicarious trauma, compassion fatigue, and burnout. I did that real actively for four years, and then I moved on to other things. Still very challenging work that I did, but not to the same extent as it was during those four years.

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Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum

Many people can do that longer than I. I got bored and wanted to do other things. But it’s a tough– it’s tough to do crisis work all the time. You need to really have a balance, I think of the kind of clients that you work, the kind of work that you do. And so I would really encourage you to really take care of that. It’s very rewarding work, and so many of us would really like to do this work and want to do this work.

But as a full-time diet of your clinical practice, I think I would warn you not to do that too much. Find other things to do in addition to any work that you might do around crisis, trauma, disaster response. These are very touching and difficult to handle stories when we’re dealing with folks that are suicidal, homicidal, clients that have had trauma issues. The work is very difficult emotionally, intellectually, and even physically. So you really need to pay attention to all those signs and symptoms of your own response to these really very powerful human experiences.

So what do you look for? So you’re going to learn about that in the course that you’re taking. But there’s certainly physical signs that you’re going to notice where you’re feeling tired. You’re looking at the situation saying, can I do this again? Can I go to talk to this person again? I’m not sure I’m ready for this. So that’s that kind of talk that you find yourself doing. When you find yourself sometimes, if you’ve got too many clients that have these sorts of situations, you can find yourself just not even sure what are the details of this client’s story that I need to be paying attention to.

You can be taking it out in your family because you’re emotionally not available for them. And so you really need to find some good colleagues that can help you to be a good sounding board and also a good place for them to communicate with you if they feel like and maybe you’re feeling like you need to talk to somebody, feel like things are getting too overwhelming. That notion of having colleagues is just so vital to the work.

I would encourage you to also try to find ways to do self-care throughout the day. Try to find a break between clients. Listen to some music. Take a brief walk. Play a game on your smartphone. Do something where you can have a change of pace. When I used to work in emergency services, we would always spend time, when we could and we’re not on call for that particular shift, to make sure you had lunch with your buddies, walk around the hospital grounds when you could, and just have some time where you could just do other things in your activities to have a break from things.

Humor is just a big part of this I think. Sometimes there’s a bit of a gallows humor when you deal with so much pain and suffering that you can catch yourself really having humor about things that other folks might not even begin to think is humorous. I think we have to be cautious with that. Obviously, that can be a sign

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Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum

that you’re doing too much of this if you’re having that but having a good sense of humor about things.

And I learned in that whole set of experiences that I came up with a phrase for myself that humor is the only antidote to life. Life is challenging and difficult, and things don’t always go well. And so finding a way to have a good laugh, get a relief from things, do something else, talk about different topics. All that is going to be important for you.

You really need to know the laws in your state and if there’s any local and other issues to pay attention to. It’s vital for you to know that. You need to know it in an out. You need to have access to legal services as necessary. As much as you think you might know something, you think it’s going to be cut and dried, things in this business are not always so cut and dried.

And so having the ability to talk to somebody who has legal standing is really helpful at times also. Make sure that you’re thinking about all the issues. And there’s also legal support for that also. It really helps you to be less worried that you’re going to be sued. You can be sued for anything but successfully sued is much less likely if you’ve reached out appropriately to your colleagues.

One of the things that the agency that I worked for, the hospital setting for the crisis folks, we used to have forensic lawyers that would come and talk to us generally once to twice a year really just focusing on telling us what the rules are, what the laws are, how to be able to document effectively so you are protected. Now that notion of CYA, cover your butt, is really important, not only for you, but for your agency and ultimately, for the clients too. It doesn’t help that you’re not doing the right sorts of things.

Covering yourself is to be able to reach out to the appropriate colleagues, the appropriate supervisors, and also to make sure that you document. That’s the other thing that I learned how to do really quite well and quite quickly is to appropriately document the work that you do. It’s just such a crucial thing in any event but especially under crisis and trauma situations is to be able to effectively document the assessments that you’ve done, the interventions you’ve done, and the dispositions that you’ve set up for your clients.

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Roles, Responsibilities and Self-Care of Crisis Responders: Craig Blum

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