Six weeks into my new job and I am still greatly enjoying my new position as DBT Program Specialist. Today a new organizational chart was introduced to clarify for myself and everyone else what exactly I can do in that role. The organization of Te Whare Mahana has grown by leaps and bounds in the last few years and because of growing pains and normal staff turn over they have been chronically understaffed for quite some time up until just today when we are finally fully staffed again. Thus, the new kid on the block has looked pretty attractive for filling in all sorts of gaps, any of which I am happy to do, but all of which I cannot. So as it seems now, I sit on the management team, oversee the residential treatment team, do program development, see a couple of clients as their individual therapist, provide clinical supervision to staff, provide DBT orientation training, provide emergency consultation back up to the house staff one weekend a month, am the external liaison with related health care professionals, coordinate discharge planning, and participate in applicant selection and intake (a process which is pretty thorough). I sit in on hours and hours of meetings every week as information is communicated up and down the organizational chart in a pretty egalitarian system.
My co-workers are very compassionate, and dedicated souls who really take DBT to heart at their various levels of interaction and understanding. The organization is well run by a board committed to their mission and values and regularly reviewed strategic plan. TWM is managed by a very competent woman who has been doing so for the last 12 years. We have a fabulous clinical director whose clinical insight I greatly respect. This program is regarded as one of, if not the, best treatment program for people experiencing personality disorders in the country. Because they are committed to excellence they invest in training the staff and have brought high level DBT trainers from the States to keep the staff tooled up for their jobs. In fact they are sponsoring bringing Robin McCann, one of the top 5 DBT trainers in the 
The residents come to stay at TWM for up to a year and participate in daily skills training modules, and community groups that focus on processing issues of daily living while using the DBT skills. When someone is immersed in the DBT method of therapy it is amazing to witness the change that can occur in their lives. Every meeting, whether it is for residents or staff, begins with mindfulness practice, respectfully led by any member of the group. People take this seriously and come prepared to lead or participate fully in each group and/or meeting. I am learning a lot.
In addition to the residential treatment program, TWM also has an employment program that focuses on both training folks for work and in giving them real work opportunities matching their areas of interest while being mentored and supported, kind of like an employment incubator. The team leader is extraordinary in his vision and skills at empowerment. The third branch of TWM is called Outreach. It provides 24 hour crisis services to the community at large and offers some outpatient rehab services as well. I feel lucky to be working with such a great group of people in such a beautiful setting.
The residential program is situated in a large house that used to be a convent. It has heavy wooden doors and floors, and a stone patio/entry looking out to the front at a large lawn with gardens surrounding. There are gardens and fruit trees in the back yard and several small associated buildings on the same property which house the administrative staff, my office and the group rooms. We are just completing the construction of a yurt in the backyard to become 
another group meeting/educational classroom. My tiny little office has large picture windows on two sides framed by grapevines and looking out to a large pasture. The pastoral setting is very private and soothing. The grounds are situated right in town on the main street, directly next door to the police station which has proved handy at times when staff have been dealing with some extreme behaviors. However, many people don’t even know we exist because the front is so lush with vegetation on the street side they can’t see what’s behind. We are within walking distance of the doctors offices which is also handy at times when we need to have a resident seen for the results of self harm or to be evaluated for a hospitalization. TWM also owns and manages a fourplex of apartments, one of which we keep accessible for visiting family members of the residents, and for occasional respite purposes.
TWM is unique in the country as it is a NGO (non-government organization) doing the work normally operated by the District Health Board. Many years ago TWM was begun with volunteers who simply wanted to care for their community members at home with compassion. It has been effective in developing from this heartfelt start. There is a small hospital of sorts in the Bay for emergency care primarily I think, but if someone needs psychiatric care they are transported “over the hill” to Nelson, a drive of about 1-1/2 hours. This Hill, which I scoffed at before arriving here thinking “it’s just a hill for crying out loud”, actually made me carsick because it is steep and has more curves than a roller coaster (over 360 curves in a 45 minute drive over the pass), and it is the reason Golden Bay is not more populated. The Hill keeps the idea of long distance commuting to Nelson out of most people’s minds. The Bay is, however, where everybody and their mother come to spend the weekend or a holiday as it is beautiful and the weather is fine.
It’s been interesting that more than once when a stranger asks me what brought me to New Zealand and I explain I am here to do mental health work, they have personally welcomed me to the country and thanked me for offering my skills to their countrymen and women. People seem to take the issues of health care for one another personally. So, to make this long story shorter, I am feeling appreciated, supported and like I can make a difference here, all of which is very satisfying. And it doesn’t hurt that Tom and I can walk on the beach in front of our rented “bach” every night wearing sandals.
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