Saturday, May 21, 2011

Let's Pace this Collaboration

I'm not going to get it all done in a few meetings. Surprise! Yet it took me a long while to truly accept this. I won't be able to resolve 5 issues (may no be able to resolve one if it's complex) a client is dealing with in two sessions.

Some issues are straightforward. People just need help filling out redetermination forms for food stamps. Easy. A referral for a dentist in your neighborhood? OK, well you have Medicaid, so yes, it may take time but we could find a few dentist options. Yet some situations need more than one session to solve. A client gets behind on rent again due to money mismanagement. A client doesn't follow through on referrals yet comes back and says she still needs help. There's a larger issue here and it relates to the client's behavior and choices.

It's unlikely that after decades and decades of habits and lifestyle a client's behavior will change immensely thus guiding us to collaborate smoothly, at the end each of us skipping along on her merry way.

How can I expect people to change their lifestyle quickly when I see how in myself and people close to me that this is difficult to do? This bearing in mind that I and many of my loved ones grew up in a stable household and supportive environment.

Client's established behavior is not the only reason issues take time to resolve. Bureaucracy is part of it. Lack of resources, like when a client asks me about a legal matter but his income is just above the limit for free legal advice. Providers may not be reliable. It's tough being the mediating party between the client and a targeted service.

Not to mention also that clients may not necessarily come to a case manager with one issue. Three or four is not uncommon and each may be related to the other one in some way. Untangling each and working with it independently may be challenging as well. Like, perhaps if a client received mental health services other issues would be easier to deal with. It may not always be quite that simple but sometimes tackling one overarching issue paves the way for dealing with other challenges.

Pacing is crucial when you have a caseload of 40-50 people. Even back when I had a caseload of 30 people I would be quick to schedule a follow up appointment in a week's time even when an issue could wait. I prioritize much better now which gives me a bit more space to breathe. I also continue being better in encouraging clients to try advocating for themselves (perhaps with some coaching) before I step in.

Pacing is something I need to keep working on. I think I need to start thinking realistically about what I may accomplish in a week. There's a set amount of time to work with and typically a few surprises (in varying shades of crises) that come up as well.


Btrflygl said...

Good post!!! I also think it ties in with the fact that many complicated clients with a ton of issues that require follow up, often feel that they are our only priority ;).

Mrs. Pancakes said...

im your newest follower and i cannot wait to hear more about some of your challenges and success!

Anatolia said...

I hear what your saying Btrflygl, sometimes it seems to be the case with some clients who have less complicated situations... :) Though I could see how an intensive client would see the amount of time you spend with her and her expectations would increase.

Thank you for following and commenting, Mrs. Pancakes!