So now it's real

Today was my first day of practicum. I am working a a brief therapy center at a local community mental health center. The population is low income and mostly Medicare/Medicaid patients. Most of the time today was spent going over charts and what needs to be in them. Then I was assigned my first clients. I learned (or had confirmed for me) two facts of life:

1. Insurance companies and secondary payment providers do have an impact on quality of care. We will spend hours filling out charts in order to document in a rdiculous way so payment can be made. And then organization audit the charts and find even more ridiculous ways not to pay.

2. People's lives are complex and can be infinitely sad. That seems like a "no duh" statement. But in my role as a therapist now, just how complex is becoming very clear. I can't tell you anything about my clients or their lives because of confidentiality. but I can tell you that it will be a challenging year.