Manda

@lucyruthe
81 Followers
79 Following
1.9K Posts

Part time single mom with two extraordinary kids on the rainbow spectrum.

Theatre/storytelling nerd from a heavily geek family, though for me it is a recessive trait while the arts are more dominant. I gravitate toward dark humor, gothy fantasy, and creature features, but mostly want fully developed characters and immersive storytelling.

I'm kinda an open book. It’s just long and complicated. And it takes a while for me to relax enough to flip through all the pages.

she/he
My feminism will be intersectional or it will be bullshit
MandaMar 11
Oh you guys, with everything else going on right now, Daylight Savings is hitting like a dirty trick this year.
MandaMar 10

I think my biggest challenge right now is what to prioritize and how to pace myself.

All this new information, lots of big projects, and I started off in the weeds. Kinda gotta grind my way through a number of things, not sure which task to take on, and not enough time in the day.

Learned right quick that a deadline focus meant burn out because all the things. But like, where to start and what to prioritize.

Show threadMandaMar 6
We have to revisit the plan periodically anyway, so we can prioritize together and decide which pieces to start with. And include other things as we get there.
Show threadMandaMar 6

I've talked through a few approaches, and there's a book I need to check out with examples for different diagnoses.

But I realized that my prior approach with DAs could work here. And I can keep it collaborative.

I pull basic ideas related to the client's diagnoses as a template to go through with them. They tell me which things apply to them or how they would adjust the idea to fit them and participate in ranking them based on intensity and how long they've been dealing with it.

MandaMar 6

Apologies for another dump and dash, but I'm having a busy mind insomniac sorta evening and just figured out my angle on the next process I need to get in place.

Still digging out of the weeds from a bunch of CEs with a side task of updating a few early ones.

The next obstacle is treatment plans which I haven't done before. The biggest struggle is trying to establish long term goals when you're first getting to know someone and they can't yet fully name what they're experiencing.

MandaFeb 27

Well hi there!

Apologies for the quiet and absent bit. In the process of learning six new complicated things at the same time and a whole digital documentation system.

A little overwhelmed by all the moving pieces as a complete new guy, but very glad I ended up where I am and feel solid about the environment.

I'll circle back around once I figure out how to even budget my time, but it's a whole thing.

Show threadMandaFeb 15

Then you can tell them they already did the hardest part and the next session will just be gathering things like medical details, medication, etc.

But what I realized tonight is that I still owe those two the conversation about what's been bothering them. And it would be irresponsible for me to do the diagnostic summary without it

Anyway, thanks to that supervisor for giving me a better angle on the "how." People had been kinda implying it already, but I still don't fully understand the form

Show threadMandaFeb 15

One of the realizations I had Friday was that paperwork functioned differently in the last job. You had to check all the right boxes the first time, or they would send you back to redo it with the client.

But the thing in the background that was bothering me is that the client _wants_ to start with the topic that's bothering them the most. And that's exactly how you ask the right questions for differential diagnosis.

It actually makes sense for them to let that part out first.

Show threadMandaFeb 15

So I asked the supervisor how they prioritize the information while meeting with the client.

They start with "So what's been going on?"
Symptoms
Assessments

So I tried it that afternoon, and it was a whole different kind of conversation. I just recorded the information on another document and got into clarifying questions.

But I think the next step is to enter everything I already recorded in the formal document and make notes of details to gather in the follow up. (It's a two parter)

Show threadMandaFeb 15

But the thing that bothers me the most is that while I was wrestling with technology and trying to figure out something new, they both spontaneously started telling me what was really bothering them, and I didn't even know what part of the form to go to and record that information.

They were both gracious about it and very engaged in the conversation. But I never got to the part where I talked to them in depth about the symptoms they were experiencing

Friday morning was an orientation meeting