Lived experience 'helps me go to the darker places with families'

By Louise Kinross

Holland Bloorview social worker Val Lusted has spent almost 20 years working with youth with brain injuries caused by illness or trauma, and those hospitalized for rehab after bone surgeries or spinal-cord injury. Of course, that also meant working with parents who were under extraordinary stress and emotional upheaval. Val has always been a dear friend of mine, and I recall several times when, at my urging, she stepped out of her comfort zone to do live TV interviews about brain injury on behalf of Holland Bloorview. Thanks Val! With Val retiring next week, we took a trip down memory lane.

BLOOM: How did you get into the field?

Val Lusted: I knew I wanted to be in the helping professions during my high school years. I just had a sense that my personality was such that I liked and enjoyed being in a helper role.

BLOOM: I understand your first job here was in a different capacity?

Val Lusted: When I was in my undergrad at Ryerson, I had a part-time job as a therapeutic recreation staff at what was then the Bloorview Children’s Hospital. Back then it was a chronic-care hospital, and I worked on the weekends. I ran different programs for adolescents. One was a baking group to help the kids work on their fine motor skills. I remember one day we were trying to bake bread and we didn’t allow enough time in between to let it rise, and the bread came out only a couple of inches high. We also took the kids swimming in the pool. I had my F-class licence so I drove the Bloorview van when we’d take the kids to Fairview Mall to practise independence.

They knew I was studying to become a social worker, and they informally shared that they didn’t have a lot of respect for the profession. I think they felt abandoned by their families at this chronic-care institution, and they didn’t feel that their social worker had leveraged any other life for them.

I took it to heart as a challenge about really being able to connect with my clients down the road, so I could understand how I could best be of service to them. It didn’t dissuade me from my professional path, but it highlighted for me that it wasn’t going to always be easy to engage clients in a meaningful way.

BLOOM: What areas of the hospital did you work in as a social worker?

Val Lusted: For 15 years I was with the family support service, working with adults over age 16 with acquired brain injuries in the community. It was a very tight community and a very unique setting to be able to go into people’s homes or schools or places of work to help them carve out new meaning after rehab discharge. When that program ended, it was a real loss to me and my identity. For the last four years I’ve worked with inpatients and day-patients on the SODR unit.

BLOOM: What is a typical day like now?

Val Lusted: One of my primary roles is to chair family team meetings, to offer pre-admission orientations to families, and to provide individual counselling sessions, often for parents at the bedside around caregiver coping. Occasionally I also work with the teens. The other general function is offering various groups and workshops for clients and parents.

BLOOM: What were the joys of your work back on the family support service team, and now?

Val Lusted: In the family support service you could establish a really intimate relationship, because you had the privilege of coming into people’s natural environments. It’s also a different lens when you offer psycho-social support by following people over a long period of time.

On SODR, I work with some clients with pre-existing disabilities, and some who have new diagnoses or traumas. The joy for me is being able to walk that part of the journey with them. They often come in to the unit shell-shocked and overwhelmed, and some start to feel trust in the therapy team as they progress through rehab and they start to explore what I call their new normal. I would be lying if I said everyone walked out emotionally well-adjusted to their current state, so I seek out other support in the community for their journey after discharge.

I want to give a shout-out to the SODR team. It’s a very busy unit with high volumes and increasing complexity of children’s medical, therapy and psychosocial needs. It’s a very dedicated team of clinicians and being able to witness true collaboration in working with these complex demands is also a joy.

BLOOM: What were the greatest challenges of each area?

Val Lusted: On the community-based side it was the traffic [laughs]. As the service delivery model changed, when they brought in centralized scheduling, the clinician lost some of their autonomy at being able to manage their caseload priorities and appointments. They were evaluating the usefulness of the service based on a clinic model with productivity targets.

On SODR, I would say the challenge is the volume and complexity of clients vis-à-vis the existing psycho-social resources. 

BLOOM: What emotions come with the job?

Val Lusted: Inspiration, gratitude, humility and kindness. There is also the heaviness of the work—call it vicarious trauma if you will. Sometimes feeling overwhelmed, sometimes feeling powerless, sometimes feeling frustrated—more with systems gaps than with the client or families themselves.

BLOOM: How do you manage the heavy emotions?

Val Lusted: I try to practise work-life balance, some days more effectively than others. I go out with friends and family and have activities and interests with them. I have a ladies walking group in my neighbourhood. Watching my son on the ice at the hockey arena gives me joy. I’m not very good at meditation. Music is my meditation, and I have gone on a few spiritual retreats. These aren’t religious. I’m seeking out a more grounded spiritual connection, most of which is my church is nature, time in nature.

BLOOM: Nature is healing. Have your ideas about disability evolved over the years?

Val Lusted: I have a personal, lived experience with the world of disability related to my husband Rick, who has been a quadriplegic for many years. I also have a son who’s adopted who has some invisible disabilities. I would say that those two have been my greatest teachers. 

That lived experience helps me be more compassionate, and it helps me to go to the darker places with families. Families need a safe place to go deeper. Some clinicians choose to stay at the surface out of self-protection, in my view, but it’s also a function of the faster pace of the work. If you have to see a client and get on to the next one in 35 minutes or less, you can’t open a can of emotional worms because you won’t have time to process it.

BLOOM: What have you learned from families?

Val Lusted: Resilience, in a word. The families that are able to explore their inner strengths, as well as their ability to reach out for help from others when needed, are the families that model resilience every day for me.

BLOOM: If you could change one thing about rehab for children, what would it be?

Val Lusted: It’s a metaphor—the mushroom needs to be turned upside down. It means the funding needs to be more adequately allocated to the community side of life, in order to support a longer-term rehab journey within a natural environment.

The other thing I’ve been thinking about a lot is that when the disability world can touch the mainstream world, that’s when we’re going to change the world, and create real opportunities for inclusion and belongingness. Instead of communicating to the converted, we have to educate people out there. The Dear Everybody campaign, if we can get that out in the mainstream, is a fabulous initiative.

BLOOM: What skills does someone need in your role?

Val Lusted: I think I started off as an optimistic person, and as I matured and gained various professional and lived experiences that touched the world of disability, I think of myself more as a realistic optimistic.

BLOOM: Do you mean that initially you were somewhat naïve?

Val Lusted: Yes. Green and naïve. 

As a clinician, you also need to be able to read and respond to the intense emotions of others, while being self-aware and reflective about how the work is impacting you, and being able to prioritize. There’s a certain level of flexibility and pragmatism that’s needed, and an ability to network and collaborate with others—both informally and formally.