chapter  6
Clinical Work in Communities
Pages 51

Clinical work out of the office in the community is nothing new to the thousands of mental health professionals who work in schools and in hospital inpatient units. For these clinicians, and for others in a variety of settings, there may not be a clear demarcation between in-office and out-of-office work. Many clinicians in institutions have an office available to them. Sometimes the office is shared with one or more other staff, so that at any given moment, a therapist and his patient may be scrambling to find space, sometimes during time that should have been within the session. Sometimes, the patient refuses to come to the office, so that the work ends up taking place in the classroom or in the hospital unit day room, or somewhere in between. Sometimes, there simply is not an office assigned to the clinician at all. One week before I began working at Bronx Lebanon Hospital’s Child and Adolescent Psychiatry Outpatient Clinic, I called the Chief of the clinic on some bureaucratic matter. At the end of the conversation, he said, “By the way, you don’t have a desk.” I said, “Oh, that’s okay. I can do without a desk. May I leave my papers somewhere?” He said, “I mean you don’t have an office.” “Oh, all right . . . I guess.” At that point, I had worked for three years as a psychologist in Head Start and was used to catch-as-catch-can space arrangements.