What It's Like To Be: A Sociotherapist

When it comes to social workers, a certain stock image is likely what comes to mind: a stern, no-nonsense presence, a clipboard in one hand and metaphorical red tape in the other; an agent of the state, likely with the best intentions but ultimately lacking a certain level of compassion.

Cara Johnson, a social worker around the five boroughs of New York City, is looking to change that. Taking an approach rooted in warmth, empathy, and love, she goes above and beyond for some of the most vulnerable New Yorkers.

Jess Wharton: Was social work always something you were interested in pursuing? I know you went to school for psychology, but was social work always the end goal?

Cara Johnson: I've never been a "know what I want to do when I grow up" girl, but I was finishing my last semester of college and I saw this job posting and it combined everything I love — I loved working at the writing center and getting to work with people one on one, plus it involved the therapeutic model, behavioral analysis psychology, all the things I was studying, all in one job. The goal of my program is to help increase the retention rate of social workers — because it's absolute shit right now — by doing really intense, selective hiring, and really supporting us. So I got into the program, and it was definitely a blessing. I've been doing it for seven months now.

I know in a broad sense that social workers help kids and families. Can you outline a little more specifically what your work concerns?

My actual title isn't "social worker." I'm a sociotherapist in Therapeutic Family Foster Care (TFFC). Social workers have an MSW or a BS, and I have a BA in psychology. I work as a part of a case planning team, and I work especially close with a case planner. We work together to provide kids with whatever help they need.

What's exactly the difference, then, between the responsibilities of a sociotherapist and those of the case planner? Do the two of you share the responsibilities that would typically be the job of one social worker?

Not exactly. I see my kids four times a month to do the therapy work; the case planner sees them once a month. Her responsibilities are to assess the status of the foster home, determine how the child is doing in their environment, making sure all their basic needs are met. She also goes to court and takes care of a lot of legal paperwork.

Another way that we approach social work differently, and mostly what makes my job unique as a sociotherapist, is that we focus more on mental health and medical needs due to past trauma that children might have suffered. We work in a trauma model called Trauma Systems Therapy. Often we deal with children in the foster system who have behaviors that are...you know, kids who are in and out of juvy, have been suspended, that sort of thing. We're essentially saying that those behaviors are largely a result of the trauma they've endured, so we believe we need to treat the trauma of the past if we ever want to address present behavior.

My job responsibilities include a lot of behavioral trauma therapy within schools and foster homes. This mostly means working with kids on developing coping mechanisms, recognizing behavioral patterns, identifying their triggers, stuff like that. A lot of the kids that we work with do have diagnosed mental health issues.

So it's your job to specifically address children with mental health issues within the foster care system?

The idea behind my job is that if we get to the root of the trauma, we'll have a better time addressing mental illnesses and unwanted behaviors. Not all my kids have diagnoses, necessarily, but in the end we always have to engage with mental health to do any kind of intervention. That's why all of our kids in therapeutic, the ones that I work with, are also enrolled in play therapy, music therapy, or psychotherapy, and they see a psychiatrist monthly if they're taking medication. We have all of our stuff in-house; we have a medical unit, nurse practitioners, so it's all in our building, and it's convenient.

So you offer all these different services and kinds of therapy; do you work directly with the people administering those services?

Exactly, it's cohesive. It's super holistic. We all meet together monthly, and I'll meet weekly with the psychiatrist; we talk about our kids, what they need. We have treatment team meetings, so it's a lot of collaboration, and that's kind of the idea. That's what it's all about. We work closely with the foster parents, too. Psychoeducating is a big part of it, so we work a lot with the parents.

How are you assigned your cases? Are you assigned to certain areas of the city, are you assigned to kids who all share specific behavioral needs, do you specialize in a particular age group? Is it random?

Our agency — there are a bunch of foster agencies all over NYC — our agency is huge, and we have a facility in each of the five boroughs. So, the idea is that Brooklyn is kept in Brooklyn, Queens in Queens. Of course, it's not ideal, because each borough is so massive. Sometimes kids transfer; there just aren't a ton of foster parents, so sometimes you have a kid in Queens who needs emergency housing to get out of their house right away, and we have to put them in a home in the Bronx — now your case planner and sociotherapist have to go to the Bronx to see you. Right now I have cases in the Bronx, Queens, and Brooklyn.

My youngest kid is seven and my oldest is twenty. New York is great; you don't "age out" of foster care until you're 21, and even then you can request to be kept on until you're 24. So there are long term kids. We apply for all of our kids to receive section eight housing, or New York housing, where they only have to pay a small percentage of their income for rent; all of our kids are going to be put into that if their goal is ultimately independent living. Or, they'll be adopted, or they'll decide they don't want to be in foster care anymore, which is something that also happens.

So, because the approach is so holistic, once you have a child, you generally stay with that kid's case and follow it around?

Yeah, unless they transfer. Sure, it might be nice to transfer my Bronx case to the Bronx office, just because that would make sense. It can get tricky when you really connect with kids, because in the end, consistency is really what's best, but also, there's so much work to be done anyway that it's impossible to keep up. So having commutes take as short as they possibly can is important; ultimately, I have to see all my kids every week, and they're all in school, so I can only see them after school hours.

Describe an average work day for you.

I wake up — late, usually, because I work crazy hours into the evening, so I'll usually run to work. Or I'll get a call from the school, and they're like, "you have to come right now to pick up 'X,' because they're being suspended," and I'm like, "right now?!" and they're like, "within the hour!"

So then I have to change the plans, don't eat breakfast, run to a different bus, get to the school, pick up my girl, who is rowdy as all get-out, screaming at everyone as she leaves because of course she's Miss Popular, and it's hilarious. And I'll bring her to my office where we hang out all day, and I'm doing paperwork and not really getting anything done because I end up talking to the case planner about the situation; meanwhile I'm constantly calling foster parents, texting the parents, texting my kids about their appointments they have to remember to go to. And then, if it's a Wednesday, I'll go to my youngest kid's house. We might go to the park and play a make-believe game that's really intense, and I'm in character, and I'm low-key enjoying it the whole time, and I'm sweating, and everyone's asking, "are you his mom?" and honestly, I'm not sure sometimes. And then I'll remember that I have to actually do our sociotherapy work, so when we're walking home, I'll squeeze in some therapy time.

Then I'll take the train home and jot down pretty extensive notes about the visit because I have to document everything. That's the craziest thing about the job. And then I'll probably take a nap on the train, because that's what trains are for now.

What does a less average day look like? What's the craziest thing that's ever happened in a day?

I feel like the biggest horror story has come when it's mid-afternoon, you're saying, "I made it through the day without a call from anyone! Yes!" and you're so excited, thinking maybe you might actually be home and, I don't know, making dinner by 6:30!

And then you get a call: "You need to come to school right now, pick up this kid because he just got in a major fight on the front lawn of the school with a kid who might be gang related, AND that kid got away from the police, so we don't know if your child is safe to leave our school."

And you're like, "so... I'm gonna do that. I'm gonna be the one to come help, because I can protect you! I can protect you!" And meanwhile in your head, you're saying, "I...can't do shit, so I hope we make it to the bus on time so we don't get smacked by whatever gang he's managed to upset." So you do that with your case planner, and you're preparing yourself mentally and physically for this fight, and you get to the school. You have many intense conversations with the school staff, who have no idea what to do, because you run into a lot of problems legally in this field — especially in terms of consent when it comes to mental health problems, stuff like that. So we take him, and he has headphones in, not listening, we're chasing after him, looking like fools. Then you get on the bus with the child. You're supposed to get off here, but they don't get off of the stop that you get off, so you have to be on the wrong bus for an extra hour because they weren't listening to you when they got on. And you end up getting off at the train and they just...don't. And you have to go to their house later to talk with this child about everything, but you don't even know what to say! Because you're so stuck on the fact that they kept you on the wrong bus for so long because they didn't listen to you! It's the littlest things that make you mad. That was a particularly hard day.

I saw on your social media the other day a (very heartwarming) post about one of your kids getting adopted. That must feel so rewarding.

Yes! One of my kids was adopted today! It was today! My heart is in the clouds, I'm really proud to just be a part of that. The adoption process is so long and it finally happened.

In a case like that, I imagine that adoption is usually the end goal, yes? What kind of role do you play in that process?

My role was basically supporting the family, so a lot of my job also takes place with the parents. In the end, we have to support the people who are doing the supportive work. This foster mom was just really a total gem, it was a joy to visit her and be with her, and it was really sweet to see that happen today. And it was my first adoption!—and I feel like probably my only, because sometimes adoption isn't the end goal. Like I said, sometimes the goal is to see them through to independent living. But it was really a beautiful thing.

Just in general, this is the most beautiful work I feel like I could ever do, really; I'm so grateful for that. It's really humbling to be able to engage so intensely with people in their lives — and they didn't even ask you. You go in as this outside force that they hate, and then every day you get to work hard to be someone who is worthy of their trust. And that's the hardest thing, but it's really so cool. People are resilient, and kids go through a lot — they go through so much — but they bounce back, and that's amazing to see. So I'm really thankful I get to do this work with them.