Week in review

I spent my first real week as somebody's official primary therapist/case manager/crisis interventionist at VTCC. I met the three individual sessions and one family session per week quota, and turned in all my paperwork. I also tried food from the Caribbean street vendor, and let me tell you, the jerk chicken is AMAZING. It's incredible to me how quickly I learned things this week. And, I'm really excited about how much better I am at case conceptualization and treatment planning. And treatment plan implementation--that's the big deal. I mean, I actually DO the things I plan to do in therapy, and I'm not doing things on accident. Dr. Rudd told me during my first year that the difference between Master's and doctoral level people is that the doctoral people know both the how and the why of what they do in therapy, and I'm proud to say that I'm squarely planted in that doctoral category!

My client is a bit of a challenge...her cluster of issues aren't easy breezy from an interpersonal standpoint, all the axes are filled with diagnoses, or at least traits. She's not always a joy to be with, let me tell you. But she's let me be around her, and I even surprise her into remaining in her therapy sessions for an hour--I've learned that most are 30 minutes (you need to document 20 minutes in order to get paid by Medicaid). This has netted me the honor of the potential of becoming an attachment figure for her. So much necessary developmental work has gone unfinished, and even unstarted, which has resulted in a really young, immature ego in a much older body. I learned Wednesday night during the family phone session, that the parent is willing to come down to Richmond twice a month on Friday evenings for family therapy with me and an interpreter. My supervisor asked me how I felt about that when she heard about the arrangements--I've been so impressed at how the faculty have really encouraged us to protect our time, and use our vacation/sick time. While this arrangement isn't great, its the only option at this point to have ANY family therapy, and so I agreed readily, with the stipulation that the session had to start by 7:00 and not later. The session on the phone was a nightmare, and just not a long term solution. So, I will have the opportunity to work for the first time with an interpreter in therapy, which coincides with my Cultural Diversity seminar that started this week. The psych interns and child psychiatry fellows are participating for 6 weeks in this group led by one of my supervisors and one of the attending psychiatrists. I agreed to share my experiences with this patient/family next time. Wednesday is our official didactics day, so we also had an ethics seminar with just the interns and our training director. For being a dry topic, we sure had a lot of fun, and afterwards Sarah huddled us in the hall and asked if we could all hang out after the Psych/Psychiatry social on Sunday afternoon. We've all been invited to a faculty member's home for a brunch/pool party thing to welcome us to MCV/VCU and VTCC. I'm not clear on the relationship of the host to VTCC, but evidently there is one. On my way back from Newport News (I'm Jay's date to his brother's wedding) I am going to swing by. Anyway, tonight I suggested a post-work dinner in Carytown, which was total fun, although the Mexican food was not so great. The margaritas, on the other hand...were another story altogether.

Sarah, come to find out, plays rugby and her season starts up next month. And more importantly, she invited us to the after parties! I hear they are pretty damn wild, as this was true of the Northwestern rugby teams too. I learned that Beth spent a year in Thailand teaching at a school for refugees, and Jon can speak fluent German. His wife came to join us after a job interview, and I think we were all pretty relieved to start having a social life. Jon's next mission is to get us all to the Capital Ale House on a Monday to enjoy the $1 burger Happy Hour special. Beth, who probably weighs 85 pounds and is maybe 5 feet tall, lit up, eyes wide, exclaiming "I LOVE burgers!" We determined that patronizing the Capital Ale House, archnemesis of Sarah's husband's bar Richbrau, was not against the rules and her marriage would not be wrecked, so Jon will lead the charge in scheduling the next post-work fun.

Tomorrow I don't have that much going on, although I'm sure I'll be surprised. I have grand rounds and then residential rounds on my schedule, and I agreed to resesarch a current article for my consultation clinic about diagnosis and the differentiation between auditory hallucinations and malingering. I hope to sneak out kinda early and beat the beach traffic down to Newport News. I hear after the rehearsal dinner we're going to see The Dark Knight!