What You Put Into It is What You Get Out of It

As a correctional social worker at a prison, I find myself saying the title "What you put into it is what you get out of it" a lot.  We no longer do groups, so we give out written material to patients, with information that would be discussed in groups if we did them. Our job is to encourage the patient to become motivated to read through and use the materials to their advantage.  We call it the "In Cell" program, because that is where the patient studies the materials.

I have recently started physical therapy, and I have taken the attitude of "what I put into it is what I will get out of it," so I am trying to do well in the sessions, and follow up using the materials and exercises I am given for out side the sessions.  Somethings just will not happen, like not getting rid of my overstuffed sofa, but I am trying. 

I am realizing how much I appreciate the positive and supportive comments of the various therapists in the session. And, how it makes me want to try harder.  A student intern helped me today. He was helpful, supportive, encouraging, informative, interactive.  He did a really good job. I need to tell the therapist about that.

I try to be that kind of social worker for my patients at the prison: encouraging and supportive. I have found myself, though, sometimes being more assertive and confrontational with them.  I think that is because so often, we suspect our patients are not as sick as they would have us believe and are using the hospital setting for secondary gain.

When someone is truly doing well, though, I do try to encourage and support them.  Today, I had two very interesting sessions with patients. One told me that "I know this stuff, but I guess it does no good if I don't apply it."  We were able to talk about his barriers to application, and we may want to focus on that again.

The other patient commented that he wants the staff to know that he is trying, but he feels like he will fail, and he has no positive expectation for a good result.  We discussed his attitude, and how that kind of attitude will lead him to failure.  We also talked about no "magic  cures," no expectation for dramatic and overwhelming change, making one step at a time, doing one step at a time, and how he has years of habits (his age) to undo and redo.   Ultimately, I told him that there is no "right or wrong" in terms of his efforts and outcomes, but the "right or wrong" is in terms of what he expects to achieve. And, if he is satisfied with less than more, we will not judge him on that, except in terms of if he needs to be in an inpatient setting.  I think this patient "got this." 

I think for most people who enter therapy, be it physical or psychological therapy, the hardest thing to accept is that it will not happen over night.

We are an instant society: instant gratification, immediate pain relief, 60 minute problem solving of crimes or other life sagas.  

I do not look forward to weeks or even months of doing exercises at home, even after physical therapy has ceased.  However, years ago, I had an arm problem.  The doctor of osteopathy that I was using as my primary care physician at the time sent me home with a prescription for 30 days worth of Vioxx, and an exercise sheet. The exercises took about 20 minutes, and I was supposed to do them twice a day. I was about 90% diligent with the exercises.  After the medication ended I went back to the provider.  We were now into the "Vioxx scare" so he did not want to renew it.  But, I could tell the exercises were more valuable than the medication. After several months, my arm felt better, and I finally stopped the exercises. I have kept the sheet, and even shared it with a coworker who told me it helped her.

Sometimes, there really are no "magic pills."  It is about  change for the better, doing what we should ido nstead of what is easier, and remembering that what we put into it is what we get out of it.