Wednesday, July 27, 2011

Not a Therapist -- When Boundaries Make My Job Easier

A client of mine, Betty, lost a close relative. Betty and I had worked together for a fairly short time but more intensively in the past couple of weeks as the health of the relative she cared for declined.

Betty came in to talk with me and as she sat down she shared the news her relative passed away a day earlier at the hospital. She looked to the side while she talked about some of the details of what happened. I offered my condolences and asked if she wanted to talk with me about how she was feeling and she said no. I answered OK, adding an offer to look into supportive services with her if she'd like in the future, and our conversation turned to working on case management issues. What did she need help with? Burial plans, navigating insurance. Logistics. Betty has a sister but they were on difficult terms and she asked I help mediate between both of them. We did a conference call that went better than anticipated and Betty and her sister made plans to follow up later.

Towards the end of our appointment Betty asked about mental health services. We agreed to follow up to look into different options. After she left I thought that it's sometimes a relief that my job doesn't involve therapy. It may be helpful to focus on one area, particularly when a lot of practical work needs to get done.

It is important to let folks know that support exists beyond case managerial support. Therapy may not be appealing for all but the idea that it's accessible is comforting. Offering support, even in the shape of other agencies that offer more specialized support, also let's the people you're working with know you're thinking about how they may be feeling.

And as important: While it's helpful to review options, it's equally important to let the client lead. What s/he wants to focus on leads the professional collaboration.* This is something I continue and remind myself.

* With some caveats sure, but at its basic level a professional relationship is fruitful when a client's goals align with a case manager's goals.


Btrflygl said...

I personally have never had any desire to do therapy and really like the case management aspect of my job, in terms of being able to refer out and be resourceful with my clients.

It's tough though as many a client while they do not see the need for therapy or mental health services, have the unspoken expectation that this should be our role for them as well.

antiSWer said...

I think it's important that we know our roles and are able to stick to them in order to do them effectively. I worked with a caseworker who thought that "doing therapy" was more important than the work he was supposed to be doing and would really try to engage them in that work, to the detriment of what he was supposed to be providing. It was always very frustrating to hear about.