Interview with Samantha Roberts, LCSW – Clinical Case Manager at UCSF Citywide Forensics
About Samantha Roberts, LCSW: Samantha Roberts works as a Clinical Case Manager at the University of San Francisco’s (UCSF) Department of Psychiatry, on the Citywide Forensics Team. As a Clinical Case Manager, Ms. Roberts provides chemical dependency treatment services, intake assessments, psychotherapy, and crisis interventions to individuals who are involved in the criminal justice system and who are also dually diagnosed (i.e. struggling with a mental illness on top of a substance addiction).
Before her role at UCSF, Ms. Roberts was a Clinical Supervisor for the Adolescent Drug Treatment Program at Odyssey House Outpatient Services, as well as the Program Coordinator for the Substance Abuse and Mental Health Services Administration (SAMSHA) Grant Program. During her time at Odyssey House, she also supervised an MSW student, which required her to earn a certificate in Seminar in Field Instruction (SIFI) from Columbia University in 2012. She also received her certification as an A-CRA (Adolescent Community Reinforcement Approach) and ACC (Assertive Continuing Care) Clinician and Clinical Supervisor in 2012, and applied her knowledge and skills from these certifications to her work at Odyssey House. Prior to her work at Odyssey House, Ms. Roberts was a Mental Health Clinician at Rikers Island Correctional Facility for more than three years, where she provided mental health support to incarcerated adolescent and adult male patients.
Ms. Roberts earned her undergraduate degree in 2003 from the University of Florida, where she majored in Criminology. She received her MSW in 2008 from Fordham’s Graduate School of Social Service in New York City. She holds an LCSW credential in both New York State (2011) and California (2014). Samantha Roberts was compensated to participate in this interview.
[OnlineMSWPrograms.com] Could you please give a brief overview of Odyssey House Outpatient Services, and the role of social workers in this setting?
[Samantha Roberts, LCSW] Odyssey House is a non-profit substance abuse treatment facility, mental health care provider, and supportive housing agency. Odyssey House Outpatient Services is a specific department within the organization that provides services to help men and women maintain sobriety in the face of chemical dependency, reunify with their family, meet educational or professional goals, and maintain their general health and well-being. These services include but are not limited to psychiatric evaluations, individual, group, and family therapy, parenting skills trainings, health education seminars, relapse prevention services, vocational and educational evaluations, and pharmacological support. Outpatient Services also runs a new peer mentoring/support service for individuals in early substance abuse recovery, called Odyssey House Recovery Oriented Care System (OH ROCS). My role was initially running the BUY-in grant, which was a grant funded program designed specifically for 18-24 year olds.
The clients that were eligible for services in our clinic ranged in age from 12 years old, to senior citizens in their 70s. Some of them were there voluntarily and some were mandated due to probation or parole. The majority of the clients had dual diagnoses (co-occurring mental illness along with a substance use disorder) and were living in the Hunt’s Point section of the Bronx, in New York. This area was one of the most impoverished areas I’ve ever worked in, and most clients received some kind of government assistance, and/or lived in government housing or shelters. These clients had difficulty getting jobs and many were involved in illegal activity to support themselves or due to gang affiliation. There was a very high prevalence of gang activity in the area and fights broke out on the street in front of our office regularly. Most of our clients spoke about using drugs to escape from the reality that they were living in or just to fit in, but every day was a challenge in this neighborhood. There was actually a documentary on HBO made about this area because it is known for its prostitution.
My team specifically helped 18 to 24 year olds with substance abuse issues through a harm reduction modality of treatment, the Adolescent Community Reinforcement Approach (ACRA) and Assertive Continuing Care (ACC). Through this grant we were able to incentivize many tasks and give clients gift cards to grocery stores or clothing stores if they completed their homework and attended sessions. Once the grant ended, we extended our services to 12 to 24 year olds, but initially we focused on the Transitional Age Youth, who faced a number of problems specific to their age group. Many of them were either still living with their parents or were parents themselves and stuck in this place of going to school, having dropped out of school or trying to get a job to support themselves and maybe their children.
We had two full time social workers on my team and one Master’s Level Social Work intern and they played a huge role in the running of the program. They each had individual case loads, ran groups and did outreaches to clients they may have lost touch with. The social workers did everything from clients’ initial assessments, individual therapy, group therapy, sometimes case management, and advocacy, to accompanying clients to court, running family sessions, going to clients’ schools, and having case conferences with probation officers, school counselors or whoever was in clients’ lives that they needed help communicating with. Since most of the other employees on staff at Odyssey House were CASACs (Credentialed Alcoholism and Substance Abuse Counselor), the Social Workers were responsible for various issues that required licensed clinicians to address. These were issues such as assessment for suicidal/homicidal ideation, signing treatment plans, making diagnoses, referring clients for psychiatric evaluation, and many other responsibilities. It became clear after working there for a few months that these roles were essential to the running of Odyssey House, and the management was actively looking for staff that had social work credentials.
[OnlineMSWPrograms.com] Could you elaborate on the responsibilities you had as a field instructor and clinical supervisor?
[Samantha Roberts, LCSW] As a field instructor I was responsible for creating a plan with the students to have them engage in all areas of the program. I met with them weekly for individual supervision, assigned them a caseload, met with their field advisor and reviewed their process recording. Personally I had to attend Seminar In Field Instruction (SIFI) classes led by an LCSW who was on staff at Columbia University (the school where my student was from) and complete assignments that related to my direct work with the student.
As an intern, the student was able to have a small caseload and eventually do initial assessments, intakes, Global Appraisals of Individual Needs (GAINs) for the BUY-in program, and run groups. She was able to write her own notes, but I had to review everything and co-sign it before it went in the chart.
The ideal dynamic between a student and field instructor, I believe, is different for each person. For me, as a student, I wanted someone who was brutally honest, but supportive, compassionate, smart and quick. As an instructor, I wanted a student who was smart, driven, detail oriented and reliable. I prefer not to micro manage, but with students, initially you have to, to ensure they are completing paperwork correctly and engaging with the client’s appropriately.
I was able to measure my student’s progress in a number of ways. She happened to be an extremely shy person and that wasn’t the best fit with adolescent males who were involved in the criminal justice system by the time they were in middle school. Just watching how she engaged with these clients and how that changed over time was a great measure of her progress. She handed in weekly process recordings, which would allow me a small window into her sessions and interactions with the clients. This was important because it allowed me to see what issues she addressed and what topics she avoided. This was essential for supervision, as I couldn’t adequately assess her sessions by sitting in on them. That would potentially make her look incapable and ruin the therapeutic alliance between her and her clients.
All of the assignments I had in my SIFI class were used to assess the student’s performance and provide appropriate feedback to her, which was very useful. I had some difficulty relaying constructive criticism without my student getting offended and discouraged, which caused some issues in our relationship. Fortunately, the SIFI instructor who taught my class was incredibly smart, experienced and interactive and helped me formulate more sensitive and appropriate ways for me to convey feedback to my student in a helpful and positive way.
[OnlineMSWPrograms.com] Why did you decide to become a field instructor, and what steps did you have to take to become a field instructor?
[Samantha Roberts, LCSW] I was made aware of the opportunity through my supervisor and jumped on it. I had always wanted to give back after being in the field for a fair amount of time, and I wasn’t burnt out yet, which you always hear about. So, I felt this was a good time to take advantage of this opportunity. It was also through a very reputable school (Columbia University), which made it an easy decision for me.
I was required to interview with the Assistant Director in Field Instruction to discuss my experience and to see what kind of student I would work well with. I had to go to a field instruction fair at Columbia and set up a table to talk to prospective interns about our program and what they would be doing if they chose to work with us. Then I had to interview students, along with my supervisor, to see who would be a good fit in our clinic. I also had to commit to 6 months of bi-weekly classes and assignments, in order to get my certificate and be allowed to supervise students in the future.
[OnlineMSWPrograms.com] What are some of the main questions and concerns students have when preparing for and completing their field education? How did you help your student address these concerns?
[Samantha Roberts, LCSW] I can only speak from my personal experience as a student and as a field instructor, and I’d have to say the student that I supervised was very different than I was. I ask a million questions, sometimes the same questions twice, until I am confident that I know the answer and the reasoning behind what I’m doing. I’d like to think that my student didn’t have very many questions due to my extremely thorough explanations on everything, but I know better. My student was very shy and had difficulty, at times, expressing herself without becoming emotional, which made answering her questions and addressing her concerns more challenging for me.
In regards to the questions I had as a student, there were many. Initially I remember them being about documentation, since that is so important in our work. Every agency has a different system and usually a different electronic health record, which could be a challenge if you’re not adaptable to different computer programs. So, documentation was first for me. For my student, she had questions about this as well, as the electronic health record we used at Odyssey House was not very user friendly. This was understandable and to address these issues, I would ask her to sit in on assessments that I did and have her watch me navigate the system while sitting with the client. I asked that she write down any questions she had and then we would review them in supervision. We did this a few times until she felt comfortable doing an assessment on her own, where I would sit in. This was very concrete and not something I thought would be an issue, but my student was not detail oriented and would, in almost every assessment she did, have to go back and correct something, which I think she found very frustrating because it had nothing to do with the actual “work.” I encouraged her to write down all the steps to the intake and have them there as a safeguard if she needed them.
Another important question she had was about how to relate to these clients in a group setting without crossing any boundaries and revealing anything personal or something she was uncomfortable revealing. She was dealing with an extremely difficult population and the clients were nothing like her. She was a young woman from Maine, who at first glance, you might think had a typical childhood and young adult life. Her clients were individuals living in poverty, usually in a single parent household or with another relative or foster parent as a caretaker and whose parents/caretakers themselves were in drug rehab programs or in jail. What was interesting and compelling about this student, is that she actually related to these clients more than any of them knew, having had a father who was an alcoholic and in and out of jail throughout her life. She felt very strongly for these clients and clearly wanted to help them in any way she could. I felt that, in some ways, she identified a little too much with them and needed to really work on her countertransference before being able to successfully support them. Since supervision can only cover so much and I was careful not to cross any boundaries myself, I discussed my concerns with her and suggested that she consider dealing with them in her own way, maybe in her own therapy.
I think transference and countertransference are important and common issues students have while preparing and during their internships. Depending on students’ relationship with their supervisor and their level of self-awareness, these can be very important issues to tackle during their time in graduate school. I tried my best to help my student address these issues in a sensitive way and in a way I would want someone to address them with me. I can only hope that my tactics were helpful.
[OnlineMSWPrograms.com] What did you enjoy the most about mentoring your MSW student?
[Samantha Roberts, LCSW] I remember being a student and finding out things through other students or by overhearing things and thinking, “I wish someone would have told me about this!” So I loved answering all of her questions and telling her about a lot of the things no one really discusses with you, like filling out your application for the state to get your hours or things to remember when studying for your licensing test. I wanted so badly to give this student a great experience and one that she would find valuable, so I did my best to make myself as available as possible and tried to relate to her more as an experienced peer, than a supervisor. I relayed to her my experience with my internships and supervisors, which were not perfect by any means, and tried to instill in her and help her recognize the amount of strength it takes to do this job and the amount of strength she already had to pull from to get this far. We all go into this field for a reason, and although it might not be comfortable or appropriate in some cases to discuss those reasons with your supervisor, I tried to express to her how important it is to remember those reasons and look at them as they come up for you. Essentially, be as cognizant as possible about your countertransference and use it to your advantage. My supervisors shied away from that and focused more on concrete clinical interventions, which are extremely important. But, I promised myself I wouldn’t do that if I was ever a supervisor, and that I would, of course, have appropriate boundaries, but not be rigid.
[OnlineMSWPrograms.com] Field education is a major component of MSW programs and requires a significant time commitment from students. How do you recommend the students balance field education with other responsibilities?
[Samantha Roberts, LCSW] Field instruction is where you learn the most. As important as classes and papers and exams are, you get hands on experience when you’re in the field. Everyone is different when it comes to time management, but this is the time to shine and I recommend putting your field placement first when it comes to level of importance. My field placement became my first job out of grad school and I worked there for 3 years. It’s where I got my clinical hours for my LCSW and learned the most about working with severely mentally ill clients. It’s also where I got my letters of recommendation for the jobs I applied for in the future. If the field placement you chose is something that interests you and a place where you think you’d want to work, then remember that your internship is like a yearlong interview. Not much more I can say about it than that.
[OnlineMSWPrograms.com] Can you describe the importance of self-care in social work? How do you recommend students manage their own self-care, both during their MSW program and beyond?
[Samantha Roberts, LCSW] Self-care is essential in every job–work/life balance is important. In social work, I feel that it is part of the job. If you don’t care for yourself and address your mental and physical needs, the probability of burn out will be high. Social Work is an extremely difficult career that requires giving a lot of yourself, emotionally, to your job and to your clients. Everyone that takes this path clearly cares about the community/population that they work with and wants to help them. If you don’t help yourself, you can’t help your clients in the best possible way.
There are many social workers who will be matched with supervisors that they don’t “click” with, and therefore, don’t feel comfortable expressing themselves to or talking about their weaknesses or anxieties. It is crucial for you to find another way of processing through all the emotions that you feel if you cannot do so in supervision. Personally, I had a male supervisor in my second year internship, who was brilliant, clinically very experienced and whom I learned a great deal from. However, there were some issues he could not relate to and was not comfortable speaking on when it came to a woman working with male clients in custody. I found it helpful for me to journal my experiences throughout this time and, when I was ready, find someone that I trusted to talk about these experiences with. That could be a therapist, a friend or a relative for some people, but it is important to assess and examine how you feel, not only internally, but also with one or more trusted individuals, because we all know how important it is to allow someone to lend you their judgment; especially someone who is not emotionally invested in the situation.
Throughout my career, I have used different tactics to process through my emotions and deal with my stress and countertransference. Whether it is yoga, or some form of exercise, or crossword puzzles or some kind of distraction that allows for you to use other parts of your mind, it is and has to remain a priority, in my opinion, while doing this work. Do what you tell your clients to do and take some time for yourself, even if it is just five minutes. You deserve to be cared for and to be thanked for the hard work that you do day in and day out. Just a heads up, the thanking part doesn’t happen often, so you have to praise and reward yourself for the things you work hard for.
Thank you Ms. Roberts for your time and insights into social work field education.