Switching Gears: From a Therapist to a Case Manager

And why I have no regrets whatsoever.

As of last week, I’m no longer an unemployed bum.

I was offered a position as a case manager at an agency that serves the homeless, and I couldn’t be more excited!

I’m happy to have a job again. I’m happy that it’s at an agency that has such a good reputation in the community. And I’m especially happy that I will be doing case management and not therapy.

Not all my friends understand.

Don’t take me wrong, they are glad that I’m no longer unemployed. (And probably relieved I won’t end up on the couch in their living room with my two dogs and one cat in tow.) But they don’t quite get why someone with a master’s degree, a counseling license, and ten years of clinical experience would “demote” herself to a job that doesn’t require either.

When I was in Chicago last weekend to celebrate my birthday, I had a conversation with my friend and former coworker, Jen Lo. I don’t remember exactly what we were talking about, but I remember saying at one point, “Technically, I’m not a therapist anymore.”

Jen Lo gave me a reproachful look and replied with a great conviction in her voice, “Margaret, you will always be a therapist!”

I mean, she is not wrong. My clinical skills are not going to evaporate into thin air just because I have decided not to do therapy for a living anymore. It’s just that being a therapist has never been a huge part of my identity. I like having a job where I’m helping people, and I don’t care much whether it’s as a therapist, case manager, youth counselor, or a crisis interventionist. In fact, I find almost any job more fun than traditional therapy, which is the reason why I have never wanted to work for a private practice.

I do find it ironic, though, that I was pushed into a career change when “career doubt” was probably the only midlife crisis symptom I did not have. Until things went south with my previous employer in September of last year, I was convinced that my career was my anchor; the only thing in my life I didn’t have any doubts about.

Only after I was forced out of my job (I resigned voluntarily, but it was one of those situations when I genuinely believed there was no other choice) did it dawn on me that maybe things weren’t as rosy as I had always believed.

When I was driving home from the juvenile detention center after saying good night to the kids for the last time, my heart was broken — but I also felt a strange sense of relief, like a massive weight was lifted from my shoulders.

It wasn’t easy, and it didn’t happen overnight. Still, eventually, I was able to admit to myself that my clinical work with at-risk youth, while rewarding, had been draining me emotionally and mentally, and that I perhaps hadn’t been as immune to vicarious trauma as I had always believed.

I was hurting when my clients were hurting, and my clients were hurting a lot.

And that wasn’t even the worst part.

The worst part was the helplessness.

I knew the kids better than anyone, but no one cared.

A judge will always listen to a juvenile probation officer over a therapist, even though the former has no background in mental health and little to no understanding of how complex trauma impacted their client’s choices. A DCFS caseworker will always have the final say, no matter how ignorant they are and how much harm their decisions cause. A nurse in a psych hospital will always have the power to administer a shot of a tranquilizer, even though every idiot can see that the patient is responding well to the therapist’s intervention and doesn’t need it anymore

And witnessing staff in juvenile detention centers and jails blatantly abusing their power, and not being able to do anything about it, is just a cherry on top.

At this point, you might be wondering why working with the homeless would be any different.

The answer, at least for me, is that it’s easier and more rewarding because a case manager actually gets to do things. I can’t erase my client’s traumatic childhood or change the poor choices they had made as a result of their trauma, but I can make damn sure they won’t miss any more meetings with their probation officer, that they will pay rent on time, and that they will be able to keep up with their medical appointments because if they don’t have transportation, I can give them a ride.

I might not be able to solve all their problems, but I can make their lives significantly better.

So no, I don’t see my new job as something “less”. Case management is just as valuable as therapy, if not more, and to be honest, it’s a much better fit for my personality.

I have a feeling that I’m going to have a blast!