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No one at Clarity Child Guidance Center really does just one job.
For instance, while I oversee the clinical staff in the inpatient area, I also have a supervisor role with the therapeutic recreation staff and coordinate with the local Northside Independent School District when kids qualify for on-campus instruction. Working with other department managers on larger day-to-day concerns keeps things interesting.
In the last five years, and in particular during this pandemic, what I and others working in this field have noticed is simply how fragile lives can be in the wake of multiple stresses, not just for kids but whole families.
Clarity Child Guidance Center provides mental health care for children ages 3-17 and their families. A nonprofit, it works with kids and their families to manage mental health conditions ranging from ADHD and anxiety to suicidal ideation, bipolar disorder, and schizophrenia. We have the region’s largest concentration of child and adolescent psychiatrists and serve as a teaching hospital for UT Health San Antonio and Baylor College of Medicine.
I began work at what was then the San Antonio Children’s Center in the mid-1970s, fresh from the Catholic Seminary, having opted to find a more secular way to serve people. I applied for an evening shift position as a childcare worker at the Children’s Center. Soon after I joined the center, a psychologist who would become a mentor predicted that I would “last about three months here and then leave.” I still smile when I recall that comment.
I worked the evening shift, mostly with 6- to 9-year-old boys who were hospitalized for nine months to a year. Evenings were more laid back than days since most of the professionals were there in the daytime.
I worked my way up to being in charge of a single cottage, then to campus supervisor, working more and more closely with teams of dedicated social workers, psychologists, and medical doctors.
Behavioral health care was changing in the 1980s, with shorter stays and more emphasis on understanding the role of brain development and the exposure of early trauma in patients, so I shifted my attention to graduate school and was one of the first mental health track graduate students in the educational psychology program at the University of Texas at San Antonio.
Behavioral health care began to change even faster with a more acute focus. Stays went from months to weeks to days, but the focus for me always remained: How can I reach this person and their family in ways that could make things better?
In the early ’90s, I moved to the center’s second location at 8535 Tom Slick Drive in the South Texas Medical Center area, now known as Clarity Child Guidance Center. The focus was on residential stays, a smaller part of a larger acute and day hospital setting. With a professional license, I could impact the direction of care for entire units while working closely with other professionals and frontline staff.
It was always rewarding to have frontline staff grow in their work with kids and families, and more than a few went on to pursue professional careers because of their experiences at the center. In 2010, I took on additional responsibilities as program director at Clarity, overseeing more clinical staff and units, while still working with direct care in one of my favorite areas, experiential therapy. Experiential therapy involves an activity that can engage patients and staff alike in a problem-solving challenge that provides a large life-skill lesson using the experience of play. The highlight is always that aha moment when a kid would go from struggling to understanding and could more closely work with staff to take the lessons and apply them to real life.
What I have always been struck by is how Clarity staff at all levels and backgrounds share a common desire to do whatever it takes when caring for the patients and families. When running into former patients who are now grown adults, they approach me with a look of recognition and then will go on to recall the names of direct care staff, housekeepers, and cafeteria staff they knew during their time at the center. It says a lot about the impressions and connections that can occur when a whole organization has one mission.
I always tell new clinicians and young staff pursuing their degrees in mental health that inpatient work is the best classroom. You gain more knowledge about child mental health in a few months than any school experience could ever provide.
Having the opportunities to train and develop new clinicians to provide therapy is one of the richest, most rewarding aspects of the job, especially when rejoining some fellow childcare workers from my past who became social workers and counselors. Where I could impact single lives, now I have the opportunity to impact many lives tenfold.
What I have most acutely come to know about my work at Clarity is that there are two sides to my work. The “warrior” side that wakes each morning with a sense of mission, purpose that can keep you going even when the workweek can stretch into the weekend, and the “caregiver” side that has to periodically step back and take care of yourself. We don’t get to make the choices about when one side or the other can get called on to be present, but having both sides available can make the work a challenge worth meeting and renewing.