The Riggs Blog

Family Treatment at Austen Riggs

At the Austen Riggs Center, clinical social workers offer a range of valuable services to patients and their families. In our latest video, Margaret Kotarba, Senior Social Worker, explains the role of the social worker and the value of the family's involvement in the treatment.

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Although I am a nurse at Austen Riggs, I am also a social worker in the state of Massachusetts. The work I did with families was in a totally different setting; that of a Nursing and  Rehab center. However, some things are always the same. The roles family members have in the family. When the matriach or patriarch of the family is ill, the children or close friends, step in to meet with the Social Workers, to find out what might come next for the patient. When talking about discharge, suddenly we start to learn about who wants to share responsibilty, who wants to take all the responsibility, and then you hear from the patient, that states she/he would prefer none of her friends or family are welcomed to take responsibility...that the patients will either take care of themselves or let the SW get them paid help. The In-fighting has begun. But, what the SW might take away from this experience, is how this family may have operated for many many years, how decisions were made, and by whom, who felt unheard and/or left out, and who might be identified as the favorite..the one who would take no responsibility and would not be asked, by the parent, to be of any help because of personal reasons.

At Austen Riggs, the whole idea  from beginning to discharge,  is to understand the family dynamics. Because of the desire to understand it, the Social Wokers, work very hard to get a handle on how a family operates, not waiting for a point of crisis during the discharge, like I just explained. Austen Riggs Social Workers, have a unique job in that they are the gahterers of family history, sometimes the peace makers, enough so the patient allows a meeting to happen; they are mediators in tumultuous or volatile situtaions, and can also wind up being the confidants of family members and the patient. Honesty and openness are the mantra at ARC, so no secrets will be held unless the paiients says that will be the case...the families might not have that right....since they are not the patient.

Social Work at Austen Riggs, is more unque than anywhere I else I have seen SW exisit. Those who do this job, have to make difficult deicision daily, tell patients bad news from family members, help create discharge plans for patients who are still unsure they can boil water, but want to live in NYC with a few friends and see a therapist there....even if the SW along ithe Team disagree, the SW is going to come up with the most comprehesive discharge plan, along with the patient, because they are totally committed to the independence and best plan for the paitent.   Some patients might be young, but they 18 and over and can make their own decisions. That is why the SW dept has to be at the top of their game all the time...working with the therapists, precribers, and nursing, to gather everything, that makes for a viable discharge plan. But during treatment, the SW performs that cohesive duty of keeping the family enaged, even when enraged; keeping the patient open to having family meetings, when furious with the family. and keep the failth with the patient, that somehow, all this messy stuff, will have a much less messy ending...of sorts.

I have great respect for our Social Work Dept. Thank you Margaret for a glimpse into, what I have noted as very busy, confusing, and sometimes chaotic job...that very few people understand. This is my view of your work....maybe I am wrong...but I think I am close to parts of it being reality...We could not do what we do without you all. Thank you for all your hard work, patience, and broad shoulders.

 

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