The phone in Jamie Lovingood’s office rarely stops ringing. On a typical workday, she answers more than 100 calls. Some come from individuals seeking treatment for recovery from substance use disorder; some from worried family members hoping to help their loved ones; and some from school personnel, law enforcement, or hospital staff who need guidance as they navigate a crisis with someone. Every caller is hoping that Jamie has resources for them—a treatment bed, preferably. As she assesses callers’ needs and tries to match people with slots that are too few to meet demand, Jamie is careful to employ her social work skills, honed through years of direct practice with individuals and families. She listens closely, tuning in to what goes unsaid, too. She knows that the likelihood of turning this call for help into a turning point in someone’s life depends on her ability to build some rapport and communicate nonjudgmental acceptance and real hope. Some calls only last a few minutes, while others—particularly when people are in acute crisis—may last an hour or longer. In either case, the phone is ringing again before she even hangs up.
Jamie’s social work career started with a BSW practicum at a residential youth facility. After graduation, Jamie served there as a case manager, helping connect youth to resources and providing support to families. She was struck, even then, by how many parents had issues related to substance use and by how these problems affected the entire family. In future positions at another mental health facility and in the state’s child welfare system, she saw the same dynamics. This work led her to take a position at ReDiscover’s substance use unit. There, her duties included not only case management but also court advocacy, resource brokering, and group interventions. She found that work satisfying but chafed at funding limitations that restricted the number of people she could help. It was the desire to use her skills to facilitate access to treatment for more people in need that led Jamie to her current role.
Five days a week she answers the phone almost constantly. Her day starts with clearing any voicemails that were left the night before. She sometimes stays until the evening to finish up that day’s calls but, as late as she leaves, she often has calls to return first thing the following morning. She also checks on any openings for treatment beds so that she knows what she has to work with as people call. As part of her work, Jamie has acquired an expert knowledge of insurance rules about coverage for mental health services. She has developed strong working relationships with staff at the hospitals so that she can find quick placements whenever possible, particularly for urgent priorities—those who are pregnant or are using intravenous drugs. When beds are not available, she assesses callers’ need for detox and considers whether outpatient services may be a possibility while they wait.
Throughout each call, she practices trauma-informed care, approaching callers with an understanding that social work is most effective when professionals meet clients where they are and help them develop new resources for meeting their needs. While Jamie’s title is “intake specialist,” she has learned from experience that asking too many questions can trigger someone’s paranoia or lead people to disengage. She does not ask for identifying information and clarifies her commitment to confidentiality, and she avoids stigmatizing terms like “addict” or “substance abuse,” since these can turn people away. She avoids positioning herself as an expert and instead encourages callers so that they can work together to find solutions. For many clients, Jamie’s creation of what she calls a “flat platform” for their working relationship is the beginning of the process of reclaiming control over their lives. While the pandemic curtailed some of the approaches Jamie had utilized to build rapport, such as in-person intakes and deployment of outreach workers, she remains committed to a creative and flexible response to people’s needs.
Looking back at her social work career, Jamie recognizes that she really didn’t know what she was getting into. She remembers thinking that some of the case studies shared in her social work classes must have been exaggerated; then she got into practice and encountered clients with unbelievable experiences of trauma. To sustain her practice in her current role, Jamie has developed effective self-care practices, including frequent consultations with her supervisor, strong connections with colleagues who can debrief after an especially difficult call, and a route for walking around the building when she needs to regain composure. Her most challenging interactions with clients come when she has to tell those feeling desperate that they will have to wait 4 weeks or longer to get the treatment they know they need today, or that their insurance coverage makes them ineligible for free treatment (reserved for the uninsured) but comes with heavy copays that make treatment unaffordable. Jamie hopes the rising demand for substance use treatment, spurred in large part by the opioid crisis, may lead to policy changes that will make services more responsive and accessible. She sees promise in some of the new approaches reshaping the work but is admittedly reeling from the rise in substance use disorders and associated crises, intensified by the COVID-19 pandemic and its imposed isolation.
Jamie cannot remember the moment when she decided to become a social worker. She has vivid memories, though, of occasions when she almost left the profession out of frustration with trying to make do with insufficient resources and inadequate tools. What always keeps her coming back are, unsurprisingly, the clients. When someone calls back to tell Jamie that her help navigating to treatment saved their life, or that they had no idea they could move into recovery and well-being, Jamie is reminded why social work is the perfect fit for her.