Is it normal to feel helpless as a provider when working with people who are in ongoing traumatic situations, like war? In my opinion, absolutely yes. As providers, we are trained to help alleviate problems and suffering. But that isn’t usually possible when someone is in an ongoing situation.
A few months ago, I was treating a patient with PTSD, but after greater exploration of his distress, which included guilt, shame, and feeling betrayed by his military boss, we fleshed out that moral injury was a salient part of his clinical picture. Currently, there is no consensus in the field on the exact definition of moral injury, but one I like refers to it as “enduring psychosocial and spiritual harms following exposures to high-stakes events that involve transgressions of one’s deeply held moral convictions or beliefs of right and wrong through one’s own or others’ action or inaction, or perceived betrayal by those in positions of authority or trust” (Phelps et al., 2022).
The confidence to effectively treat comorbid substance use disorders and mental illness has always eluded me. I can competently explain the rationale for treating both concurrently and I happily collaborate with providers who can address significant substance use concerns. But the task of becoming familiar with effective treatments (such as medication-assisted treatment) feels overwhelming to me. This is unfortunate because the need for such expertise clearly exists.
Like many of you reading this, I am a mental health provider. I have worked with a wide variety of clients dealing with a wide variety of challenges–successfully and competently (or at least I hope). I have had the privilege of bearing witness to and helping people navigate some of the darkest, soul-crushing experiences, sometimes supporting them, sometimes helping them approach rather than avoid, sometimes grieving with them, and always cheering their successes and their strengths. Last fall, I found myself on the other side–well, not exactly.
Guess who's back? Back again… We are excited to announce that Practical for your Practice (P4P) Season 5 launched this week! Your hosts are excited to kick things off with a reveal of this season’s theme. On P4P, we believe in the importance of relating to each as a behavioral health podcast community. So in that vein, for Season 5 we will be asking our guests, “What is your why?” What drew them into the field of behavioral health and the specific slice of the field that they're in?