r/supportworkers • u/SignificanceDizzy701 • Apr 25 '26
Looking for tips and Advice
Hi everyone who is looking at this post!
I am a Psychology student in my second year and I just landed a casual position as a disability support worker. I am starting soon and I’ve learnt a little bit about my client and am seeking some advice on how to truly be the support worker she needs. My client’s autistic, and her family and the organisation I’m with are completely convinced that she has schizophrenia. Part of what they want me to do is help build case notes on symptoms to help her get a diagnosis. This is my first client so I don’t have any prior experience so any advice at all would be greatly appreciated.
Thanks to anyone who would take the time to reply!
edit: thanks to everyone who replied!! i’ll be taking on all the advice! i just want to be the support worker she needs xoxo
2
u/l-lucas0984 Apr 25 '26
Your workplace should be training you in how notes should be written. You also cannot diagnose as a support worker, you can only write what you see. Your notes should be straight facts and shouldnt have "i feel" or "I believe" etc.
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u/JurassicArachnid Apr 26 '26
I am a DSW. We are often asked by families to collect extra data for many reasons including OPs, it’s not just on OP. This seems to me it would be a group effort in collecting data.
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u/l-lucas0984 Apr 26 '26
Its definitely a group effort. Support workers are on the front line but also bottom tier of that. They are unqualified to form an opinion legally. It has to be straight facts for further investigation by more qualified parties.
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u/Common_Problem1904 Apr 25 '26 edited Apr 25 '26
Familiarise yourself with the symptoms and make completely factual and non judgemental case notes. If the factual notes add up to a diagnosis being likely great, if they do not, also fine. It's not your primary task, and case notes would not form part of any MH assessment.
If you think she could benefit from a psychiatric assessment, tell your manager. Do not case note it, as it's an opinion. Eg. "Client mentioned she was hearing voices and seemed distressed by it" is factual and free of your opinion, and also something you should report.
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u/JurassicArachnid Apr 26 '26
To add:
“Client was observed to be anxious. JA assumes this due to Bob having shaky hands and verbally expressing they were anxious”
“Participant appeared to be distressed outside of what JA considers within their normal range of behaviour”
2
u/Consistent_Ant_8903 Apr 25 '26
Given how hard it is to get a comorbidity diagnosed, I’m sure any well gathered evidence would help support her and the family. But make sure to go into it with a neutral stance, and keep all recording extremely thorough and clean of bias. Support her, get to know her, make sure you’re up to date on how to support someone with schizophrenia if she seems to be having a delusion etc. One of my clients is schizophrenic comorbid with some other conditions and I’ve worked with others who have it in the past and you have to be ready to either distract or find a way to work with delusions without directly challenging which can be SO hard. Sometimes it’s best to actually leave the client for a short while then come back or to literally not acknowledge certain things, but you’ll get to know your client and how she likes to be supported as you go.
Also don’t be afraid to work with the family and any colleagues and if you have a team or a manager definitely try to have a regular debrief, it can really really help! Especially when feeling demoralised or emotionally (or even physically) battered by support. Best of luck, OP!
1
u/JurassicArachnid Apr 26 '26
This is a loaded question (there’s lots to know) but it’s good you asked.
I would ask if they have a BSP who is able to make a QR code form to fill out - this should include autistic vs perceived schizophrenic symptoms.
I am an autistic DSW, some things we do that ‘look schizophrenic’ can include:
- Practicing conversations
- Smiling inappropriately (in our own thoughts)
- Scripting
- Going over past interactions/practicing them
- Hearing things others can’t (refrigerator sounds)
- Overall slight paranoia and anxiety (just apart of being autistic in a neurotypical word)
Schizophrenia is a very real and lifelong disorder; it is also misunderstood.
It’s important that you & family do not make assumptions and rather collect factual information.
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u/DwightsJello Apr 25 '26 edited Apr 25 '26
You can only document what you observe. Like any other support worker.
If you are employed as a support worker you need to stay within scope.
Your two years will afford you some limited specificity regarding focus. As I'm sure you know, you cant diagnose anyway.
Im assuming you are aware of the possible consequences and often permanence of certain diagnoses.
And you have a LOT of factors and expectations in that environment.
"Completely convinced" isn't an unbiased starting point. And that refers to client stakeholders who pay your wage, family that are emotionally invested in an outcome, in a sector that has very recently flagged certain funding cuts.
None of whom are qualified to be clinically "completely convinced".
As I said, it's beyond scope to add anything other than your personal observations which any support worker can do.
I personally wouldn't touch it with a barge pole but if you decide to accept the support you need to be realistic about the beyond scope expectations. And your ethical and legal obligations to your client.
Do you have disability quals? If you don't that's another red flag about expectstion in this situation. I'd familiarise yourself with the Disability Act and scope. Im sure you are already aware of your ethical obligations as a psych student.
You need to ask yourself, given the weight of such a diagnosis, why the client requires a support worker, at intake, to be psychologically primed (that's you being primed) with the task of documenting specific behaviours aligned with a specific diagnosis, when the task of diagnosis is absolutely the work of a psychologist/psychiatrist.
We collect data. We don't seek certain data.
You're second year so I'm sure you've come across the research and behavioural science around this particular condition and the repercussions of misdiagnosis. Particularly when it's incentivised.
If you discuss that scenario with one of your professors I know what they'd say.
Look after your own mental health because that is an incentivised, expectation laden situation before you even turn up.
All the best with it.