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What's Better This Week?

Matthew L. Schwartz, MBA, LMSW

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What's Better This Week?

What's Better This Week?

Matthew L. Schwartz, MBA, LMSW

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What's Better This Week? is a weekly podcast focusing on balancing the practice of Solutions Focused Brief Therapy with the realities and the demands of a clinical environment in the USA.

Latest Episodes

Episode 7: Making Treatment Plans Solutions Focused

Welcome to What’s Better This Week? Episode 7: Making Treatment Plans Solutions FocusedWhen we last left off, we had collected some superfluous data and some pee, and now, here in our fourth appointment, we need to make a treatment plan that we’re going to refer back to regularly for a host of reasons. First, and foremost, at least in New York State, where we are mandated to by the Office of Mental Health: patients’ discharge planning is actually begun at their admission, or at least we have to check a box that says “discharge planning has begun.” Why? Because someone on the state or funding level has said that it is vitally critical that we make it apparent that we’re not trying to create patients for life, and that we are actively working on moving our patients along. For someone who is a Solutions Focused Brief Therapist, this is a no-brainer: the Brief, in SFBT means that we never keep a patient a micro-second longer than they want, to be in treatment. We don’t want patient’s for life, it means we’re n to doing our jobs. It is antithetical to our treatment model. However, part of proving that we’re being honest with the finances of insurance companies (who again, dominate this industry far more than they should) is that we indicate that we have already begun discharge planning by our fourth apartment (right after admitting our patient) and we continue this through the collaborative creation of a treatment plan.Additionally, the Treatment Plan ensures (or, in theory it works to try to ensure) for therapists and counselors who are not Solution Focused, that they are working with a goals/objective modality of therapy, rather than just talk therapy: those paying for therapy want to make sure that something more than a therapeutic relationship is happening…they want to make sure that patients are getting somewhere and that somewhere is “cured” and out the door. It is the Medical, not the Sociological model. Goal/Objective therapy removes “talk therapy” largely as an option, because a patient must consistently be doing something, to consistently be moving toward their goals…for my astute listeners, you will note that this is actually placing (or can have the trap of placing) many patients into some kind of pass/fail model of therapy, where they're “not making progress” quickly enough…and it’s largely nonsense; it also serves two interests: first the funders/insurance companies, and second, those clinicians who don’t take a step or two step down approach, but rather wish to seem superior to their patients who don’t “make enough” progress in their own eyes.So what do we do about this nonsense? And how on EARTH do we ethically and honestly connect Solution Focused Brief Therapy work into this insurance based, financially based, diagnostically riddled model? Actually, quite easily - but we have to be careful about it.First, our treatment plans follow a Problem -> Goal -> Objective -> Intervention model. This means that we have to share what our patient’s problem is, what their goal is, how they’re going to get to their goal, and what specific intervention is going to get them there. We call it a “PGOI” for short. Ergh.When working with patients, I will often explain - much like when I explain that all a diagnosis is, is a title heading that works to explain a combination of symptoms that go together, a treatment plan works like a journal, to log what we’ve been working on, and to make sure that I understand them correctly. I also - much like we have discussed to date - will then have to balance out the patient’s wants, needs, desires, and goals - my own, as an SFBT therapist - and the state’s, as our licensor, and of course the insurance company (as funder, and of course sometimes that’s the state).So first is working with the patient to explain to them all of the reasons that we have to co-create this document together, and then explain how on earth we can make it useful (“it’s like a journal, you can use it to hold us ac

9 MINMAR 23
Comments
Episode 7: Making Treatment Plans Solutions Focused

Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode)

Welcome to What’s Better This Week?Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode). With everything going on with COVID-19/the Novel Corona Virus, I figured a Special Episode might be helpful, whether for yourself, or as an intervention when working with patients and clients who may very well view this as a crisis well beyond their capacity to cope (especially if their traditional services are being interrupted, or you’re providing services over the phone). Unlike a “traditional” SFBT appointment, I have used the following very often in Crisis Appointments, both in person, and over the phone (and, to be honest, sometimes with myself!). When a patient presents dysregulated and in crisis, it behoves us to take a Solution Focused approach with them (for all of the reasons that we are SFBT counselors). Also because SFBT is usually the most effective approach at providing an immediate experiment that our patients and clients can leave with to proactively work on whatever it was that brought them into our office in the first place. However, dysregulation usually requires a different approach than a traditional appointment, so while not necessarily Solution Focused, I find it helpful to start the session (in person or on the phone) by asking my patients to join me in taking three deep breathes (slowly in through the nose, and then slowly out through the mouth). Good….now again…and now one more, slowly. The reason is because many of my patients will often begin restricting their breathe when dysregulated, or anxious, or in a panic, and it’s important we work to decrease the physiological symptoms of flight, fight, or freeze (those times when we don’t have Behavioral Ownership). In a crisis, I will adjust my opening question of “What’s better this week” to instead be: “have things gotten better, stayed the same, or gotten worse?” If this is a patient I have never met with, I will adjust the time frame. Maybe I’ll ask “since yesterday? Last week? Last month?” If I’m working with myself as my own patient (yes, you can use this with yourself) I will often ask “since you last had a moment to reflect?” Then it’s time to listen reflectively. If things have gotten better, we want to respond with a reflection, validate, and then ask them “how did you make that happen?” If things have stayed the same, again, we want to respond with a reflective statement, validate, and ask them “how have you managed to make sure that things have stayed balanced? That’s really hard work to do sometimes? How did you make it happen? What coping skills have you been using?” If our patient, client, or ourselves respond with “things have gotten worse! So much worse!” then we want to respond with a reflective statement, validation, and ask them how they’ve been coping with that. Almost universally the response I get when I ask a patient “how have you been coping with that” when they tell me that things have gotten worse is “but I haven’t been coping!” and generally I’ll reply with “Nonsense, you’re here! You made it to my office! I see that you’re largely in one piece! To my knowledge you didn’t assassinate an Arch Duke and start a World War, so, somehow, you’re coping, maybe we just have to figure out how…let’s think…maybe if you describe what you’ve been doing, we can figure out how you’ve been coping together…” Then validate, validate, validate. After this, I will ask my usual scaling question of “on a scale from 1-10, where 1 is everything in the world is awful, like Zombies, and not even the cool ones, but the gross ones, and 10 is everything in the entire universe is amazing, like unicorns are just farting rainbows and glitter…where would you put yourself right now in this moment?” I will then work the scale with the patient in half steps (for those not used to scaling questions, that’s okay, we’ll be covering scaling sometime in the next three weeks). I will only ask for a half step because in a crisis a whole step is usu

6 MINMAR 17
Comments
Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode)

Episode 5: More Superfluous Data & Pee

Welcome to What’s Better This Week? Episode 5: More Superfluous Data & Pee When we last left off, we covered what happens in the second assessment appointment, and we put our pinky toe in the water for how solutions focused counselors begin to address the concept of diagnosis with patients, while balancing out clinical requirements to New York State, the Office of Mental Health, the Office of Substance Alcohol and Substance Abuse Services, and payers like Medicare and Medicaid. So what happens in our Third Assessment Appointment? During the third assessment appointment, we will again be gathering data that is less relevant for our work with our patient, and that benefits, on the whole, the Department of Health’s mission to gather statistics for the sake of gathering statistics: what is your Tuberculosis status? What is your Hepatitis Status? What is your HIV Status? If a patient really wants services they’re not necessarily going to be forthcoming with us, and they may not necessarily know, and even if we *give* them referral information they may take it and throw it in the trash which is why these screening questions are - at best - superfluous, and at worst a waste of time: I don’t want to say that this *isn’t* our job (I do believe in the “it takes a village” concept toward community health) but I do believe that we should be providing the services that patients have come to us for, not what we *think* they need. If a patient has come to me for counseling, it’s not to receive the Department of Health’s Statistical Questionnaire. We then provide our patients with printed information on all of the above without cause or concern for their ability to read and comprehend that information (more on that in a future episode, because we will be working with patients who have a variety of different cognitive abilities). So it is VERY easy to see why our patients can think that we’re totally out of touch, and totally out to lunch…because here it is, week THREE, and we’re not doing counseling…we’re still asking them questions…and now we’re asking them healthcare questions…so it’s vital that we take a solutions focused approach to this: “I know that this information isn’t what you want to talk about today; and I apologize that we’re required to ask it. Let’s try and get through it efficiently so we can get to what’s really important: the reason why you’re here. I’ll absolutely work to save a good half an hour today so we can talk with one another.” After asking these health questions, we will then ask some more questions about orientation, and identity, straight off the bat, with only two previous sessions of rapport built up, which can be terrifyingly forward for our patients (since we’re the one’s asking the questions, rather than eliciting information through a Solution Focused model) - but it’s there on an assessment form, and we have to provide a response: because if we don’t we’re not doing our duty to our agency, and we cannot simply respond with our own guess work, and we have to also respect the personal right of our patients to also choose to respond (or not) to their comfort levels to these assessment questions (and some are perfectly fine responding to any and all questions asked, having been socialized to do so). After this, we’ll then ask intimate questions about their relationship with their partner or spouse or significant other, and then their relationship to their family as a whole. Finally, we’ll ask them for information on their CPS connection, and then we’ll ask for legal information (criminal background, arrests, any criminal justice hearings pending, etc.). Here’s the thing: in ANY Solution Focused Brief Therapy session…if ANY of this was at ALL relevant to the work that the patient wanted, or felt needed to be done…it would COME OUT, all on its own…so once we’re done with this display of superfluous data gathering for the sake of gathering data, then we have to go and get some pee. Why? There is a clini

6 MINMAR 16
Comments
Episode 5: More Superfluous Data & Pee

Episode 4: Welcome Back

Hello Everyone and welcome back! I apologize for the brief hiatus with no notice! Since the last episode two things happened at the exact same time: first I got very sick, and second (and more important) I bought and moved into my very own home. Personally, I hope it is my last move ever, because honestly it was a lot. Since then I’ve been recovering (and with a suppressed immune system and chronic illness, it’s taken longer than I’ve hoped for). This sadly hasn’t lent itself to working on a podcast…to say nothing of attempting to find my podcasting gear in all of the boxes that were set aside in my home office. However, my home office is now setup, and I have found my podcasting gear, which means that as you are listening to this, I am recording this Sunday’s episode…uploading it, and setting it to auto publish! So please tune in this Sunday as we continue forward together down our solutions focused path. Thank you for bearing with me, The music you’re listening to in the background today is Boston Landing on “Blue Dot Sessions" generously shared through a creative commons license. Please find more of their music at www.sessions.blue, that’s w-w-w- dot s-e-s-s-i-o-n-s- dot b-l-u-e. I’ll see you this Sunday with more; until then, make good choices.

1 MINMAR 12
Comments
Episode 4: Welcome Back

Episode 3: What’s A Diagnosis Anyway?

Welcome to What’s Better This Week? Episode 3: What’s A Diagnosis Anyway? Last week we covered what happens in an initial assessment session, the complications that assessment appointments bring when attempting to have a solutions focused practice in a clinical environment, and we finished with our hypothetical patient leaving their first (of three) assessment appointments. So what happens after they leave my office? What do we do during their second assessment appointment? How do we prepare them for their third assessment appointment? All good questions. I’m glad you asked them. After I’ve walked the patient back to the waiting room, there are certain things I haveto go back and do that are not in line with solutions focused practice. I have to add a mental status exam note (or MSE) to my documentation. This is a requirement in clinical practice. But just because something’s a requirement doesn’t mean that we can’t be solutions focused about it. Generally speaking any standa...

9 MIN2019 DEC 9
Comments
Episode 3: What’s A Diagnosis Anyway?

Episode 2: Starting From The Beginning

Welcome to What’s Better This Week? Episode 2: Starting From the Beginning. So I’ve put a lot of thought into the best way to show the juxtaposition of Solutions Focused Work in a clinical setting, especially in a New York State, Office of Mental Health Licensed, Outpatient Community Mental Health Clinic. What I’ve come up with (and we’ll see if it pans out, and if it doesn’t, we’ll change tracks) is to go through (at least for the very start of this program) what our patients experience when connecting to the process by going through the process itself, step by step; so I can show where the potential for clashes with the modality and clinical reality are, and how I address and account for them (where possible) in a solutions focused way, and how I make solutions focused work in all of this in general. Then, after that, each week, we’ll tackle general solutions focused stuff that comes up in the clinical world: advances, techniques, new evidenced based research, how we contin...

14 MIN2019 DEC 1
Comments
Episode 2: Starting From The Beginning

Episode 1: (Again): The Reboot

Welcome to What’s Better This Week? My newly rebranded podcast. I had taken around a year off because I wasn’t really sure where I was going with my podcast, and because I needed to upgrade some of my technology (thank you Sony voice recorder, and iPad pro). However, I recently attended the Solutions Focused Brief Therapy Association’s 2019 Annual Conference and, while there, I realized that - in many ways - my practice of Solutions Focused Brief Therapy is unique. While many practitioners work in schools, or in Solutions Focused Centers, or in countries where socialized or nationalized healthcare is the norm, my practice is at a community mental health clinic, licensed underneath New York State’s Office of Mental Health, where I have to balance the requirements of New York State’s Goal/Objective oriented treatment plans, Medicaid, Medicare, and other Insurance Companies insurance requirements, and the need for Diagnosis at the first session with Solution Focused Brief Therapy ...

2 MIN2019 NOV 28
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Episode 1: (Again): The Reboot

Episode 3: Self-Care & Sniffles

Welcome to TheMattSchwartz(Cast) where each week we dive into the world of Social Work in Mental Health & Counseling Settings and hopefully provide you with some inspiration to start your week! I’m your host, Matt Schwartz. This week’s episode is Episode 3: Self Care & Sniffles. So last episode I said we would start getting into Caseload Management techniques, and we are…but then I came down with an awful chest infection, missed a couple of weeks of podcasting, went on a wonderful vacation to Vienna, Austria for the holidays, came back to work, had a blizzard (had the furnace go out on the first day of the blizzard), and then have been in a flareup for the past few days (we’ll get back to that in a minute). During all of this, I had a bit of an epiphany: you can’t actually talk about Caseload Management in Social Work (clinical or otherwise) unless you first talk about self-care. Like…actual self-care. Meaningful self-care. For realsies self-care. As social workers, we hear a ...

7 MIN2019 FEB 4
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Episode 3: Self-Care & Sniffles

Episode 2: Getting a Clinical Field Placement

Welcome to TheMattSchwartz(Cast) where each week we dive into the world of Social Work in Mental Health & Counseling Settings, and hopefully provide you with some inspiration to start your week! I’m your host, Matt Schwartz. This week’s episode is Episode 2: Getting a Clinical Field Placement. I was asked by Michael Lynch, a Clinical Assistant Professor for Field Education at the University at Buffalo School of Social Work to make a short three-minute video on what it takes to prepare for and obtain a clinical field placement...abbbboooouuuuuuuuut six months ago. He asked me to make a video about it because apparently, Social Work students were having a hard time getting into clinical field placements. I will admit that the process of obtaining my placements were pretty grueling. I tried making the video (I honestly did), and it just wasn’t working out, and sometimes you just have to go with what you know (so sorry for the delay and radio silence, Mike!), um it’s just that I hav...

12 MIN2018 OCT 29
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Episode 2: Getting a Clinical Field Placement

Episode 1: What's Better This Week?

What's Better This Week? is a weekly podcast focusing on balancing the practice of Solutions Focused Brief Therapy with the realities and the demands of a clinical environment in the USA.

4 MIN2018 OCT 21
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Episode 1: What's Better This Week?

Latest Episodes

Episode 7: Making Treatment Plans Solutions Focused

Welcome to What’s Better This Week? Episode 7: Making Treatment Plans Solutions FocusedWhen we last left off, we had collected some superfluous data and some pee, and now, here in our fourth appointment, we need to make a treatment plan that we’re going to refer back to regularly for a host of reasons. First, and foremost, at least in New York State, where we are mandated to by the Office of Mental Health: patients’ discharge planning is actually begun at their admission, or at least we have to check a box that says “discharge planning has begun.” Why? Because someone on the state or funding level has said that it is vitally critical that we make it apparent that we’re not trying to create patients for life, and that we are actively working on moving our patients along. For someone who is a Solutions Focused Brief Therapist, this is a no-brainer: the Brief, in SFBT means that we never keep a patient a micro-second longer than they want, to be in treatment. We don’t want patient’s for life, it means we’re n to doing our jobs. It is antithetical to our treatment model. However, part of proving that we’re being honest with the finances of insurance companies (who again, dominate this industry far more than they should) is that we indicate that we have already begun discharge planning by our fourth apartment (right after admitting our patient) and we continue this through the collaborative creation of a treatment plan.Additionally, the Treatment Plan ensures (or, in theory it works to try to ensure) for therapists and counselors who are not Solution Focused, that they are working with a goals/objective modality of therapy, rather than just talk therapy: those paying for therapy want to make sure that something more than a therapeutic relationship is happening…they want to make sure that patients are getting somewhere and that somewhere is “cured” and out the door. It is the Medical, not the Sociological model. Goal/Objective therapy removes “talk therapy” largely as an option, because a patient must consistently be doing something, to consistently be moving toward their goals…for my astute listeners, you will note that this is actually placing (or can have the trap of placing) many patients into some kind of pass/fail model of therapy, where they're “not making progress” quickly enough…and it’s largely nonsense; it also serves two interests: first the funders/insurance companies, and second, those clinicians who don’t take a step or two step down approach, but rather wish to seem superior to their patients who don’t “make enough” progress in their own eyes.So what do we do about this nonsense? And how on EARTH do we ethically and honestly connect Solution Focused Brief Therapy work into this insurance based, financially based, diagnostically riddled model? Actually, quite easily - but we have to be careful about it.First, our treatment plans follow a Problem -> Goal -> Objective -> Intervention model. This means that we have to share what our patient’s problem is, what their goal is, how they’re going to get to their goal, and what specific intervention is going to get them there. We call it a “PGOI” for short. Ergh.When working with patients, I will often explain - much like when I explain that all a diagnosis is, is a title heading that works to explain a combination of symptoms that go together, a treatment plan works like a journal, to log what we’ve been working on, and to make sure that I understand them correctly. I also - much like we have discussed to date - will then have to balance out the patient’s wants, needs, desires, and goals - my own, as an SFBT therapist - and the state’s, as our licensor, and of course the insurance company (as funder, and of course sometimes that’s the state).So first is working with the patient to explain to them all of the reasons that we have to co-create this document together, and then explain how on earth we can make it useful (“it’s like a journal, you can use it to hold us ac

9 MINMAR 23
Comments
Episode 7: Making Treatment Plans Solutions Focused

Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode)

Welcome to What’s Better This Week?Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode). With everything going on with COVID-19/the Novel Corona Virus, I figured a Special Episode might be helpful, whether for yourself, or as an intervention when working with patients and clients who may very well view this as a crisis well beyond their capacity to cope (especially if their traditional services are being interrupted, or you’re providing services over the phone). Unlike a “traditional” SFBT appointment, I have used the following very often in Crisis Appointments, both in person, and over the phone (and, to be honest, sometimes with myself!). When a patient presents dysregulated and in crisis, it behoves us to take a Solution Focused approach with them (for all of the reasons that we are SFBT counselors). Also because SFBT is usually the most effective approach at providing an immediate experiment that our patients and clients can leave with to proactively work on whatever it was that brought them into our office in the first place. However, dysregulation usually requires a different approach than a traditional appointment, so while not necessarily Solution Focused, I find it helpful to start the session (in person or on the phone) by asking my patients to join me in taking three deep breathes (slowly in through the nose, and then slowly out through the mouth). Good….now again…and now one more, slowly. The reason is because many of my patients will often begin restricting their breathe when dysregulated, or anxious, or in a panic, and it’s important we work to decrease the physiological symptoms of flight, fight, or freeze (those times when we don’t have Behavioral Ownership). In a crisis, I will adjust my opening question of “What’s better this week” to instead be: “have things gotten better, stayed the same, or gotten worse?” If this is a patient I have never met with, I will adjust the time frame. Maybe I’ll ask “since yesterday? Last week? Last month?” If I’m working with myself as my own patient (yes, you can use this with yourself) I will often ask “since you last had a moment to reflect?” Then it’s time to listen reflectively. If things have gotten better, we want to respond with a reflection, validate, and then ask them “how did you make that happen?” If things have stayed the same, again, we want to respond with a reflective statement, validate, and ask them “how have you managed to make sure that things have stayed balanced? That’s really hard work to do sometimes? How did you make it happen? What coping skills have you been using?” If our patient, client, or ourselves respond with “things have gotten worse! So much worse!” then we want to respond with a reflective statement, validation, and ask them how they’ve been coping with that. Almost universally the response I get when I ask a patient “how have you been coping with that” when they tell me that things have gotten worse is “but I haven’t been coping!” and generally I’ll reply with “Nonsense, you’re here! You made it to my office! I see that you’re largely in one piece! To my knowledge you didn’t assassinate an Arch Duke and start a World War, so, somehow, you’re coping, maybe we just have to figure out how…let’s think…maybe if you describe what you’ve been doing, we can figure out how you’ve been coping together…” Then validate, validate, validate. After this, I will ask my usual scaling question of “on a scale from 1-10, where 1 is everything in the world is awful, like Zombies, and not even the cool ones, but the gross ones, and 10 is everything in the entire universe is amazing, like unicorns are just farting rainbows and glitter…where would you put yourself right now in this moment?” I will then work the scale with the patient in half steps (for those not used to scaling questions, that’s okay, we’ll be covering scaling sometime in the next three weeks). I will only ask for a half step because in a crisis a whole step is usu

6 MINMAR 17
Comments
Episode 6: How to Be Solutions Focused in a Crisis (Special COVID-19 Episode)

Episode 5: More Superfluous Data & Pee

Welcome to What’s Better This Week? Episode 5: More Superfluous Data & Pee When we last left off, we covered what happens in the second assessment appointment, and we put our pinky toe in the water for how solutions focused counselors begin to address the concept of diagnosis with patients, while balancing out clinical requirements to New York State, the Office of Mental Health, the Office of Substance Alcohol and Substance Abuse Services, and payers like Medicare and Medicaid. So what happens in our Third Assessment Appointment? During the third assessment appointment, we will again be gathering data that is less relevant for our work with our patient, and that benefits, on the whole, the Department of Health’s mission to gather statistics for the sake of gathering statistics: what is your Tuberculosis status? What is your Hepatitis Status? What is your HIV Status? If a patient really wants services they’re not necessarily going to be forthcoming with us, and they may not necessarily know, and even if we *give* them referral information they may take it and throw it in the trash which is why these screening questions are - at best - superfluous, and at worst a waste of time: I don’t want to say that this *isn’t* our job (I do believe in the “it takes a village” concept toward community health) but I do believe that we should be providing the services that patients have come to us for, not what we *think* they need. If a patient has come to me for counseling, it’s not to receive the Department of Health’s Statistical Questionnaire. We then provide our patients with printed information on all of the above without cause or concern for their ability to read and comprehend that information (more on that in a future episode, because we will be working with patients who have a variety of different cognitive abilities). So it is VERY easy to see why our patients can think that we’re totally out of touch, and totally out to lunch…because here it is, week THREE, and we’re not doing counseling…we’re still asking them questions…and now we’re asking them healthcare questions…so it’s vital that we take a solutions focused approach to this: “I know that this information isn’t what you want to talk about today; and I apologize that we’re required to ask it. Let’s try and get through it efficiently so we can get to what’s really important: the reason why you’re here. I’ll absolutely work to save a good half an hour today so we can talk with one another.” After asking these health questions, we will then ask some more questions about orientation, and identity, straight off the bat, with only two previous sessions of rapport built up, which can be terrifyingly forward for our patients (since we’re the one’s asking the questions, rather than eliciting information through a Solution Focused model) - but it’s there on an assessment form, and we have to provide a response: because if we don’t we’re not doing our duty to our agency, and we cannot simply respond with our own guess work, and we have to also respect the personal right of our patients to also choose to respond (or not) to their comfort levels to these assessment questions (and some are perfectly fine responding to any and all questions asked, having been socialized to do so). After this, we’ll then ask intimate questions about their relationship with their partner or spouse or significant other, and then their relationship to their family as a whole. Finally, we’ll ask them for information on their CPS connection, and then we’ll ask for legal information (criminal background, arrests, any criminal justice hearings pending, etc.). Here’s the thing: in ANY Solution Focused Brief Therapy session…if ANY of this was at ALL relevant to the work that the patient wanted, or felt needed to be done…it would COME OUT, all on its own…so once we’re done with this display of superfluous data gathering for the sake of gathering data, then we have to go and get some pee. Why? There is a clini

6 MINMAR 16
Comments
Episode 5: More Superfluous Data & Pee

Episode 4: Welcome Back

Hello Everyone and welcome back! I apologize for the brief hiatus with no notice! Since the last episode two things happened at the exact same time: first I got very sick, and second (and more important) I bought and moved into my very own home. Personally, I hope it is my last move ever, because honestly it was a lot. Since then I’ve been recovering (and with a suppressed immune system and chronic illness, it’s taken longer than I’ve hoped for). This sadly hasn’t lent itself to working on a podcast…to say nothing of attempting to find my podcasting gear in all of the boxes that were set aside in my home office. However, my home office is now setup, and I have found my podcasting gear, which means that as you are listening to this, I am recording this Sunday’s episode…uploading it, and setting it to auto publish! So please tune in this Sunday as we continue forward together down our solutions focused path. Thank you for bearing with me, The music you’re listening to in the background today is Boston Landing on “Blue Dot Sessions" generously shared through a creative commons license. Please find more of their music at www.sessions.blue, that’s w-w-w- dot s-e-s-s-i-o-n-s- dot b-l-u-e. I’ll see you this Sunday with more; until then, make good choices.

1 MINMAR 12
Comments
Episode 4: Welcome Back

Episode 3: What’s A Diagnosis Anyway?

Welcome to What’s Better This Week? Episode 3: What’s A Diagnosis Anyway? Last week we covered what happens in an initial assessment session, the complications that assessment appointments bring when attempting to have a solutions focused practice in a clinical environment, and we finished with our hypothetical patient leaving their first (of three) assessment appointments. So what happens after they leave my office? What do we do during their second assessment appointment? How do we prepare them for their third assessment appointment? All good questions. I’m glad you asked them. After I’ve walked the patient back to the waiting room, there are certain things I haveto go back and do that are not in line with solutions focused practice. I have to add a mental status exam note (or MSE) to my documentation. This is a requirement in clinical practice. But just because something’s a requirement doesn’t mean that we can’t be solutions focused about it. Generally speaking any standa...

9 MIN2019 DEC 9
Comments
Episode 3: What’s A Diagnosis Anyway?

Episode 2: Starting From The Beginning

Welcome to What’s Better This Week? Episode 2: Starting From the Beginning. So I’ve put a lot of thought into the best way to show the juxtaposition of Solutions Focused Work in a clinical setting, especially in a New York State, Office of Mental Health Licensed, Outpatient Community Mental Health Clinic. What I’ve come up with (and we’ll see if it pans out, and if it doesn’t, we’ll change tracks) is to go through (at least for the very start of this program) what our patients experience when connecting to the process by going through the process itself, step by step; so I can show where the potential for clashes with the modality and clinical reality are, and how I address and account for them (where possible) in a solutions focused way, and how I make solutions focused work in all of this in general. Then, after that, each week, we’ll tackle general solutions focused stuff that comes up in the clinical world: advances, techniques, new evidenced based research, how we contin...

14 MIN2019 DEC 1
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Episode 2: Starting From The Beginning

Episode 1: (Again): The Reboot

Welcome to What’s Better This Week? My newly rebranded podcast. I had taken around a year off because I wasn’t really sure where I was going with my podcast, and because I needed to upgrade some of my technology (thank you Sony voice recorder, and iPad pro). However, I recently attended the Solutions Focused Brief Therapy Association’s 2019 Annual Conference and, while there, I realized that - in many ways - my practice of Solutions Focused Brief Therapy is unique. While many practitioners work in schools, or in Solutions Focused Centers, or in countries where socialized or nationalized healthcare is the norm, my practice is at a community mental health clinic, licensed underneath New York State’s Office of Mental Health, where I have to balance the requirements of New York State’s Goal/Objective oriented treatment plans, Medicaid, Medicare, and other Insurance Companies insurance requirements, and the need for Diagnosis at the first session with Solution Focused Brief Therapy ...

2 MIN2019 NOV 28
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Episode 1: (Again): The Reboot

Episode 3: Self-Care & Sniffles

Welcome to TheMattSchwartz(Cast) where each week we dive into the world of Social Work in Mental Health & Counseling Settings and hopefully provide you with some inspiration to start your week! I’m your host, Matt Schwartz. This week’s episode is Episode 3: Self Care & Sniffles. So last episode I said we would start getting into Caseload Management techniques, and we are…but then I came down with an awful chest infection, missed a couple of weeks of podcasting, went on a wonderful vacation to Vienna, Austria for the holidays, came back to work, had a blizzard (had the furnace go out on the first day of the blizzard), and then have been in a flareup for the past few days (we’ll get back to that in a minute). During all of this, I had a bit of an epiphany: you can’t actually talk about Caseload Management in Social Work (clinical or otherwise) unless you first talk about self-care. Like…actual self-care. Meaningful self-care. For realsies self-care. As social workers, we hear a ...

7 MIN2019 FEB 4
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Episode 3: Self-Care & Sniffles

Episode 2: Getting a Clinical Field Placement

Welcome to TheMattSchwartz(Cast) where each week we dive into the world of Social Work in Mental Health & Counseling Settings, and hopefully provide you with some inspiration to start your week! I’m your host, Matt Schwartz. This week’s episode is Episode 2: Getting a Clinical Field Placement. I was asked by Michael Lynch, a Clinical Assistant Professor for Field Education at the University at Buffalo School of Social Work to make a short three-minute video on what it takes to prepare for and obtain a clinical field placement...abbbboooouuuuuuuuut six months ago. He asked me to make a video about it because apparently, Social Work students were having a hard time getting into clinical field placements. I will admit that the process of obtaining my placements were pretty grueling. I tried making the video (I honestly did), and it just wasn’t working out, and sometimes you just have to go with what you know (so sorry for the delay and radio silence, Mike!), um it’s just that I hav...

12 MIN2018 OCT 29
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Episode 2: Getting a Clinical Field Placement

Episode 1: What's Better This Week?

What's Better This Week? is a weekly podcast focusing on balancing the practice of Solutions Focused Brief Therapy with the realities and the demands of a clinical environment in the USA.

4 MIN2018 OCT 21
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Episode 1: What's Better This Week?
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