10 Things I’ve Learned From Clients

As a social worker in the medical field, I have spent many hours listening to the words of my clients. Their words have led me to know that they are the survivors of this system we call American life.

These survivors of life have taught me many things. Mostly, they have taught me that surviving is neither easy nor for the faint of heart. Being broke, jobless, homeless, abused, forgotten by family, or in tough relationship situations makes most people learn to live in spite of the odds against them. Here are ten things I’ve learned:

1. Almost no one wants you to solve their problems.

I had been visiting the daughter-in-law of a hospice patient weekly for about a month when she suddenly turned to me and reported that she was very frustrated with our conversations and did not want me to visit there again. As you can imagine, I was shocked! After all, I was an experienced social worker who had, I thought, been able to connect with this family quite well.
However, I had fallen into a trap. As this daughter-in-law spilled out her feelings about her relationship with her husband and his family, I kept offering her suggestions for solutions. I was the “older experienced woman,” and she was a very bright, receptive, talkative woman. Where did I go wrong?
For one thing (and we’ll talk about the other things later), I forgot the nature of our relationship. I began to enjoy my visits at that home and totally put aside the fact that we were not, indeed, equals. I was there as a professional. I was there to listen and to encourage. I forgot to hear myself going on and on and on about ideas that would “help” her. Fortunately, this was a very smart woman. And, she fired me! This was a lesson I never forgot and, to my knowledge, I didn’t repeat my mistake, at least not with a client. Of course, my family may have other things to report.

2. They probably know, already, where to go for a hot meal, a free turkey, and to sign up for WIC and food stamps.

A social worker moving to a new area need not worry about finding local resources. She or he need only to listen to the client. My first real job in human services was with Head Start back in the late ’70s. I was assigned to one particular building that housed four Head Start families, each with a 3-year-old child. I learned more about the resources in that county from those four mothers than I could ever have learned from a referral list.
The mistake inexperienced social workers make is assuming they have to teach clients the ins and outs of the system. Actually, they teach each other, and all we have to do is pay attention so we can put those few clients not “in the know” in touch with the savvy ones.

It’s important for social workers not to think they are smarter than the client. Social workers are mostly more powerful than their clients, but smart and powerful are not the same thing. Try giving up some power in order to get smart.

3. Most people simply want you to listen.

What does it take to really listen? How can you hear clients? When a client talks, do we ask for a clearer explanation? Very few people will automatically spill out what is happening to them. Remember, we’re the powerful ones. They feel powerless in front of us. Do they act angry? Is it really fear? Do they act as though they don’t understand because they are afraid to be embarrassed by us?
Our power can be for good rather than for punishment. We, as social workers, don’t have to maintain a position of power and tension. We can relax and be present for people—even vulnerable—and still not lose authority. Making a mistake is embarrassing for clients and for us. But, we are the examples and need to be able to ask for help without feeling as though we are losing face. How hard it is for someone (like each of us) who is expected to be knowledgeable, but who (like everyone else) has insecurities, to ask for help. We can learn from our clients that people really are open to honest questions.

4. When you have finished listening intently, try not to give advice, as it will frustrate you when they don’t follow it!

Now, you may be saying, isn’t that the same topic as number 1? Probably, but it bears repeating. Empathize, listen, nod sagely, and then summarize, but try to refrain from advising. One day in 2006, I sat with a woman whose story was heart wrenching. She cried, and my eyes filled with tears. Several times as I listened, I was able to direct her to stay on topic and complete her thoughts. By the time she was finished talking, she had figured out what she wanted and needed to do.
As we finished our session, I summarized her dilemma and gave her three directions that involved the safety of the grandchild she was raising. Had I “advised” her on what to do, she would not have been able to “chew” on her problems. Only she knew what would work. I did not live in her world, nor could I walk entirely in her shoes. The best I could do was trot alongside, coaching from the sidelines.

5. After they leave your office, you will need someone to talk to so you don’t carry the client with you. Ask for supervision.
Does your supervisor need to be a social worker? Well, that depends on what your goal is. If you want to further your ability to bill for services, then yes. But what you may be looking for is someone to listen to you.
Sometimes supervisors really want to critique your style rather than teach you to be a better therapist or social worker. Choose carefully the person you depend on to listen to you.

I recently thought that I would be able to receive encouragement during a time of one-on-one case sharing. The more politically powerful social worker instead took that opportunity to make sure I knew that she was higher on the food chain than I. Instead of having left the session with a better idea for serving clients, I left the session with a sense that I was not assessing the client’s motives for seeking assistance.   

The goal of supervision should be three-fold:

    * To relieve the tension of carrying the load yourself.
    * To learn to better serve the client.
    * To have new and fresher ideas as you return to the client the following session.

Be aware of the fact that some supervisors are secure in dealing with you, and others need to have the upper hand.
6. You won’t be able to save anyone. You are not their savior.

Remember, the client is more important to you than you are to the client. When I was 19, I found myself homeless, hungry, and an abused woman. Through the caring ministrations of a person not much better off than myself, I was able to survive. Do I remember her name? Not at all. I can picture her face but have no memory of her name. I was in crisis, and my brain was only able to function in a survival mode. I hope I thanked her. I will always and forever be grateful to her.
It taught me, much later and after much thought, to recognize that in my work, few people will ever have the strength of mind to remember me or thank me. They are surviving. Hopefully, as social workers we can help with that survival. But we are not saviors—we are merely resources for self-direction. Some will choose to grow, and others will choose to languish. It’s not our choice to make.

7. Try not to let clients depend on you, because it will wear you out and not help them.
It’s a lot easier to do for people than it is to give resources and choices. The problem with that is, if you have six clients who depend completely on you to make their problems go away, what do you do with the next six, and the next, and the next?

When we get stuck looking for quality outcomes and statistics to put on paper, doesn’t it look better if we can list all the successes that we, ourselves, accomplished rather than the apparently marginal changes the actual client accomplished? What a trap that is. And we ask why social workers get “burned out.”

The client who is not supported in self-direction never grows beyond the help given. You know the old saying, “Give a man a fish, blah blah blah….” Well, it’s actually true. And remember lesson #2. They already know where the resources are (probably). They just need reassurances from you that they are adequate for the job.

8. You can’t empower anyone. At best, you can encourage the client to empower herself or himself.

Often I hear talk of “empowering clients.” That’s a nice thought, but breathing into a client the will to change is ineffectual. Unless a person is ready to move off of his or her comfort zone and into a new space, the person will just sit there despite the worker’s best efforts. You can’t mandate self empowerment. Remember, you are a coach, a cheerleader, a support for when they stumble.

Take the example of the young woman I wanted so much to see grow and change. She was not ready. She was uncomfortable in her environment but not uncomfortable enough to take the next step. The danger is that the client will try to meet your expectation.

9. Even if their circumstances remind you of yours, it’s not the same situation. You are separate and unique individuals.

Each of us works with individuals who bring to mind the awfulness of times we’ve had in our lives. It can be hard to sort out where we leave off and they begin. But, just because we’ve changed, we can’t expect them to follow us.

Spend time deciding what helped you move on. Figure out how difficult it must have been for those around you to sit back and watch your struggle. Make sure that you have worked out your own feelings.

There are times when we are not the right fit for a particular client because their situation is too close to our own. Don’t be afraid to respect your own uniqueness. Be kind to yourself.

10. Practice a vacation mentality at the end of the day.

When you go home, after you have off loaded your feelings about clients onto your supervisor, lock the office door of your mind, and don’t unlock it until the next time you see clients. Then, open for “business” with a fresh mind and heart.

At the end of the day, ask yourself three questions.

    * Did I do the best I could for the clients today?
    * Did I make notes about what needs to be done tomorrow?
    * What can I do this evening that is fun, just for me?

Remember that as a social worker you are only one person, available to help but not to save, ready to guide but not to direct, ready to work but also to rest. If you remember this, you can continue your career for as long as you wish. Enjoy!

Linda S. Watson, LMSW, graduated from Binghamton University in 1989 with a degree in human services and then attended and graduated from the Syracuse University School of Social Work in 1991. Her experiences include working as a home-based visitor for Head Start and 13 years as a hospice care social worker.  Linda currently serves as the social worker for the WellStar Health Systems Diabetes Services program in Marietta, GA.  Her interests include encouraging the development of social work and hospice care in Russia, where she travels yearly, as well as gardening and reading. She is the mother of two grown sons and has five grandchildren.

This article appears in the Fall 2007 (Vol. 14, No. 4) issue of THE NEW SOCIAL WORKER magazine. All rights reserved. For permission to reprint or reproduce, please contact [email protected]