Thursday, December 10, 2015

When Justice Meets Compassion

By: Lauren Marker


Providing short-term mental health services can be challenging. Engaging clients quickly, building rapport, and establishing trust to garner a sense of the client’s needs can be hard-won efforts. One of the things that makes social service provision at Midtown Community Court unique is the tailored approach implemented to appropriately match clients with needs-based services. This wraparound service model begins in the holding cells when Sonia, our wonderful Resource Coordinator, briefly assesses defendants for possible substance abuse and/or mental health concerns. During that initial screening, she usually makes a determination about appropriateness of fit for our group services. Often, a member of the clinic will conduct a more in-depth assessment to ascertain the nature of mental health concerns or severity of substance use. Clients are then recommended to either group or individual sessions to best help them address their needs. 

The groups incorporate aspects of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and components of Seeking Safety, an evidence-based group model to address trauma and co-occurring disorders.  We work to not only address issues which have brought the client to the court, but also some of the underlying issues which may have contributed to the incident. We discuss various coping techniques, including grounding, reframing thoughts, mindfulness exercises, and the importance of having compassion with self, that are transferrable to many situations. When discussing these coping skills, clients will often say, “Oh, I do that already!” Despite the work being short-term at Midtown, assisting clients in harnessing the skills they already have—and adding to those strengths—can help a great deal.

Individual counseling sessions cater to a client’s specific needs. We often assist clients with connecting them to services to address basic needs including housing, benefits, clothing and food resources. Individual sessions also allow for deeper discussions of familial trauma, community violence, and the tremendous hardships of re-entry. Clients frequently discuss feelings of depression, anxiety, and interpersonal relationship issues. We work to validate a client’s experience within multiple systems of oppression while connecting the individual to additional supports as needed. We refer to and collaborate with partner agencies, including the Nathaniel Clinic, Institute for Family Health, Harlem United, and other agencies with mental health services to provide a long term continuum of care.

Recently, a former client called to update me since I last saw him about six months ago. He had been homeless at the time and was adamant about not going into the shelter system where he had many negative experiences previously. During our short-term work together, he discussed his persistent mental health issues, exacerbated by the death of his wife eight years ago and using substances to numb that pain. With his feelings of severe depression and hopelessness, we discussed that inpatient psychiatric stabilization may be a good option to help him get some reprieve. From the hospitalization, he voluntarily enrolled in drug treatment. He is now housed and shared with me that he began a relationship a couple of months ago. He expressed that he had not felt this content since before he lost his wife. Through Midtown’s unique service model, the client felt empowered to voice his needs and was linked with appropriate supports in a compassionate setting to assist him in fulfilling his goals.