Ineptitude vs. Initiative

Sometimes I feel totally unqualified to do my job. Feeling incompetent pisses me off, frankly. Truly, I have like ZERO threshhold for sucking at things- when I'm not good, I usually feel so uncomfortable that I quit or else I work really hard at getting good. But working hard to develop clinical skills is not so easy- it takes instinct, theory, and experience.

It's alot of pressure when people are asking for help, and I'm supposed to be "the expert." Seems like I'm saying "it depends," more than anything these days. Can't it ever just be a clear-cut, obvious answer? I pretty much never feel like an "expert." But, the powers that be: specifically, the Idaho Bureau of Occupational Licenses (IBOL), has determined that any individual holding a Master of Social Work Degree (and license) is qualified to be an expert.

::sigh:: (I'm also doing lots of sighing these says) But just because I "can" do something doesn't mean I "should." So what if social workers have power and are legally able to bill for services? That doesn't mean anything, does it?

I was lamenting/griping to a client's service coordinator once. "I don't know if I can help him," I said. "He's developmentally delayed, he has a significant speech impairment, a history of sexual abuse and multiple sexual victims, he masturbates six times per day, and his family wants no involvement with him." I was on a roll by then. "He needs a specialist- I'm not even qualified to treat this kid- it'd be unethical for me to act beyond the scope of my training- yada, yada, yada." And she looked at me and said, "If not you, then who will help him? Can you refer me to an expert in mildly retadarded children with autism presenting with sexualized behaviors and speech impairments?"

"NO." So, I am working on becoming an expert in developmental disorders, speech therapy, and childhood trauma. And that's just one client. I have a LOT to learn.