CuffJ-MFT6106 - 6

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CuffJ-MFT6106 - 6 MFT-6106 – Families in Crisis Jocelyn Cuff Dr. Baker Northcentral University

CuffJ-MFT6106 - 6 Interview with a clinician In this assignment, I am tasked with interviewing a clinician who works with families in crisis. I will be interviewing Wanda Berroa. She is a licensed clinician and the Director of Social Services for a homeless shelter in New York City. Not only does she work with families in crisis but these families have lost their homes due to either a fire, or it has been determined by New York City building code enforcement that the building is uninhabitable and the families must vacate immediately. Most challenging Wanda states that the most challenging aspect of her work is helping the families in working through the loss. Many of the families that she works with have lived in their homes for a long time and even though they have lived in buildings that are what we would call substandard living it was home to them. She also stated that it is difficult to explain to an elderly family member who has lived in the building for 40 years that their home is no longer their home. They would have to start new in a place that is unfamiliar to them and establish a new connection to a new community. Managing those challenges As a clinician working with families in crisis, there are many aspects of a client's life that may need support. As Wanda is working with the families in her shelter she recognizes that the families are grieving and works with them just as she would with a person that lost a loved one. She said she asks the client about the specifics of their building vacate, how they have been

CuffJ-MFT6106 - 6 coping since they moved. She explores the range of emotions and struggles the client is experiencing and how this loss is affecting their daily routine, their jobs, and social interactions. She also explores the effects of their support system both in relation to the family and the shelter team. She works with the family in accepting their new reality, envisioning a new happy future that has meaning and purpose while also reaffirming the good memories of the home they used to reside in. Managing risks related to suicide and self-harm Suicide is complex and encompasses several factors that may contribute to a person's risk of death by suicide. Families in crisis are struggling and these thoughts and ideations can be a factor as they try to navigate their struggles. Families and youth respond differently to risk- assessment and screening questions, but as Wanda states it is her job to focus her work on the needs and experiences of the clients she serves. She manages by ensuring that her staff are consistently assessing and screening for risks. She promotes that they build a rapport with the clients and establish a trusting relationship with them. She advises that consistency is key – meeting the clients as scheduled, being honest, and following up on agreed-upon tasks in a timely manner. It is also very important to use a non-judgmental tone as they are asking questions and ensure the use of active listening when clients state anything that is indicative of suicidal or self-harming thoughts or behaviors. Response to indications or reports of intimate partner violence, domestic violence, and sexual violence

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CuffJ-MFT6106 - 6 According to the CDC “about 41% of women and 26% of men experienced contact sexual violence, physical violence, and/or stalking by an intimate partner and reported an intimate partner violence-related impact during their lifetime”. Those stats include a high percentage of the families that Wanda works with. One of the unique struggles with her team is that on intake they talk about the need for all adult members in the family to be available when they are meeting with a Case Manager. This can be difficult if there are indications of abuse because the abusive partner will always be present. If they know or get an indication of abuse they will often make exceptions to that rule so that they can ensure that the person is able to speak in a private space and that they are not in the presence of their abuser so that the conversation is not overheard. Since she is a mandated reporter, there are some instances they may be required to report their disclosure but they take care in being honest with their clients if the need arises otherwise they would not share the information without speaking to the client first, out of respect and safety. She expressed that they listen without interruption, believe them, empathize, and ask if they can provide them with resources. Depending on the situation (age, severity) they do not move on any outside resources unless the survivor agrees. Importance of self-care It is important to maintain physical, mental, and emotional health. No matter the field of work these factors are key. For people who work in the helping field, it can be difficult to ensure to keep a healthy work-life balance. Wanda states that practicing self-care is the key factor in alleviating burnout. People in this field are at risk because of the extremely high need for empathy which is a must for this work. She said working with clients in crisis is extremely stressful, staff turnover is high and resources are scarce. She ensures that her staff have “no

CuffJ-MFT6106 - 6 client” days where they are able to work on paperwork, leave their desks for lunch, and utilize their breaks to destress and remove themselves from work. Your self-care routine for vicarious trauma Wanda states that she will often speak with her mentor when she is struggling to disconnect from the work as she is often able to convince her to take time away from work. She intentionally takes time to enjoy family incorporating exercise – walking, yoga - in her daily routine. She never used to take vacations but has made a point to take two two-week vacations per year which gives her the opportunity to reset. She said her husband has been immensely supportive at home with their “disconnect” strategies. They only talk about work for one hour when they get home, they take walks in the park and feed the squirrels. Why did you get into this field? Wanda took a moment to reflect when asked this question. She then stated that she was a victim of childhood abuse, sexual abuse, and domestic violence so she knows this work intimately. She said that while her story is not unique she did not come out of trauma to begin this work, she was in the midst of her trauma and her mentor saw greatness in her. She began this work in the middle of her abuse. She was actively being abused and started providing peer-to- peer support to victims. She said she would have never thought that she could do this work but someone helped her to refocus, create a plan, and work toward a better life.

CuffJ-MFT6106 - 6 References Centers for Disease Control and Prevention. (2022, October 11). Fast facts: Preventing intimate partner violence |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html#:~:text=IP V%20is%20common.&text=Data%20from%20CDC’s%20National %20Intimate,related%20impact%20during%20their%20lifetime . Rauvola R. S., Vega D. M., Lavigne K. N. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatization: A qualitative review and research agenda. Occupational Health Science, 3, 297–336. Simon MA. Responding to Intimate Partner Violence During Telehealth Clinical Encounters. JAMA. 2021;325(22):2307–2308. doi:10.1001/jama.2021.1071

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