Wednesday, January 27, 2010

Dealing with Demanding Clients

Emotionally demanding clients (to case managers) may behave manipulatively, react furiously if their request is denied/otherwise doesn't go as they anticipate it, or constantly walk in and expect to be seen right away. On a different level interacting with clients with mental disorders like obsession or paranoia may be challenging.

It was humbling to read social worker Amy's "I'm sorry they weren't nice to you." I could see a bit of myself in the nurses' response to a tough client who wasn't appreciative of their services, in fact behaved contrarily so. It's demanding to work with other people without getting some positive feedback. Or just get negative feedback. It's touching to hear a thank you or gratitude from a client but also easy to remember vividly the occasional client who tests your patience with an angry or entitled attitude.

On the one hand,
I am doing my job when I work with a client. My compensation is pay. But it's a lie to say that I haven't in the past expected (and thus been disappointed) not to get some form of gratitude or not expected to be treated disrespectfully. It's a part of what I expect in regular human interaction. 

I've also been particularly protective of other staff in the past, especially when clients have cursed and/or screamed at another case manager. It's not part of a professional relationship, it's not the case manager's role to be on the end of a tirade. An attitude of us (ingroup) vs. them (outgroup) may have played a role in this reaction. 

I've seen my agency not take such instances personally and staff try to work issues out with difficult clients from various approaches when the first few don't work. The goal being that if we can help in some way (while staff safety is not undermined) we'll do our best to work with our clients.

Going back to Amy's post. Her words about changing expectations when interacting with clients are very true and encouraged me to see the other side, not just try and understand limitations of empathy from clients with mental illness but limitations that many people may have. It goes along with keeping an emotional distance from clients so not to take negative interaction personally (though somehow only take positive interaction personally). And too, changing expectations when working with clients.


Pittsburgh Perambulations said...

Thank you for this post. This is probably my greatest struggle in the social services field. Because I believe so much in community, human connection, and common human need, I REALLY struggle with being insulted by a client, having a client angry with me, or ungrateful for something I went above and beyond to do. My belief system of humanity in general is sometimes at odds with distancing oneself from clients and the bounds of professionalism, but it's an important and necessary line. If crossed, I may cease to be a benefit to the client, which is the ultimate goal -- both in my job and in human connectivity.

Anatolia said...

Pittsburgh Perambulations, I (surprisingly) agree with you on the challenge of maintaining a balance of caring and making a connection while keeping a distance and staying professional (though making a connection is part of this profession). It took me time to become aware of how important it is to do this, and I won't lie -- I still need to continuously keep myself in check.

Anonymous said...

I think in the setting where I work, you have to change your expectations for people...when folks are in the hospital, we can't terminate the relationship because of abusive relationship. With that particular client I was working with, if we were in an agency type setting...hmmm...I definitely would adjust my expectations but would certainly have some lee way in not putting up with that sort of abusive behavior. She's come back a few times since then, though, and each time it's a bit of education for the nurses about what to expect.