Working with Varied Clients

• Regardless of the clients with whom he or she is working, the human service professional should have the attitudes and beliefs, knowledge, and skills to do an effective job.

Clients from Diverse Cultural/Racial Groups

• Although cultural differences are great among varied groups, some broad suggestions can be made regarding working with individuals from different cultures, those being the following:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with clients from varying cultural heritages by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Encourage clients to speak their own language.

    • Make an effort to know meaningful expressions of your client’s language. When language becomes a significant barrier, refer the client to a helper who speaks the client’s language.

  • Assess the cultural identity of the client.

    • Try to understand the client’s racial/cultural identity. Does the client consider himself or herself to be part of a certain group? Sometimes, clients see themselves differently than their helper views them.

  • Check the accuracy of your interpretation of the client’s nonverbal expressions.

    • Do not assume that nonverbal communication is consistent across cultures. Ask the client about his or her nonverbal expressions when in doubt.

  • Use alternative modes of communication.

    • Use appropriate alternative modes of communication, such as acting, drawing, music, storytelling, collage making, and so forth, to draw out clients who are reticent to talk or with whom it is difficult to communicate.

  • Assess the impact of sociopolitical issues on the client.

    • Examine how social and political issues affect your client and decide whether advocacy of client concerns can be helpful to the client’s presenting problems.

  • Encourage clients to show you culturally significant and personally relevant items.

    • Have clients bring items to help you better understand them and their culture (e.g., books, photographs, articles of significance, culturally meaningful items, and the like).

  • Vary the helping environment.

    • When appropriate, explore alternative helping environments to ease the client into the helping relationship (e.g., take a walk, have a cup of coffee at a quiet restaurant, initially meet your client at his or her home).

Working with Individuals with Varied Religious Backgrounds

• With such large numbers of Americans identifying with a religion or a belief system, it is clear that helpers must appreciate the diversity of beliefs in America if they are to understand their clients.

  • Religion is seen as the road to peace for many but the reason of conflict for some; thus, a client’s religious background and current religious beliefs may hold the key to understanding the underlying values that motivate him or her.

• Some pointers to keep in mind concerning religion and the helping relationship are as follows

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with clients of different religions by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Determine the client’s religious background early in the helping relationship.

    • To assist in treatment planning, know the client’s religious affiliation. Be sensitive to any client who may resist discussion of his or her religious background.

  • Ask the client how important religion is in his or her life.

    • Assess the part that religion plays in a client’s life to assist in goal setting and treatment planning. Do not assume that clients know much about their religion because they present themselves as deeply religious or, conversely, that they know little because they are not religious.

  • Assess the client’s level of faith development.

    • Clients at a low stage of faith development tend to be dualistic and concrete, and they are likely to work better with structure. High-stage clients are often complex thinkers, value many different kinds of faith experiences, and are comfortable with abstractions and self-reflection. Assessing the faith development of your clients will assist you in treatment planning

  • Don’t make false assumptions.

    • Don’t stereotype (e.g., the helper who assumes all Jews keep kosher homes). Don’t project (e.g., the helper who is Christian and assumes that people of all faiths are born with original sin).

  • Become familiar with your client’s religious beliefs and important holidays and traditions.

    • Learn about your client’s religion to show respect and understanding and to not embarrass yourself (e.g., a Muslim would not want to be offered food before sunset during the month-long fast of Ramadan).

  • Understand that religion can deeply affect a client on many levels, including unconscious ones.

    • Some clients who deny a religious affiliation (e.g., “lapsed Catholics”) are still driven unconsciously by the basic tenets of the religious beliefs they were originally taught (e.g., clients may continue to feel guilt over certain issues related to the religious beliefs they were taught, despite the fact that they insist they are no longer affected by their religion).

Working with Women and Working with Men: Gender-Aware Helping

• Whether working with a man or a woman, knowledge of one’s own gender biases, as well as society’s gender biases, can allow a helper to be effective at what some have called gender-aware helping.

  • This perspective views gender as central to helping, perceives problems within a societal context, encourages helpers to address gender injustices actively, encourages the development of collaborative and equal relationships, and respects the client’s right to choose the gender roles appropriate for himself or herself regardless of political correctness.

• It is vital that we separately describe how to work with women in a helping relationship and how to work with men in a helping relationship, as each gender has its own struggles and challenges to overcome.

Women

• Several authors have suggested that women have unique issues to address that are related to the development of their female identity and the oppression they face in society, and based on these ideas, we as professionals should apply the following when assisting women in the helping relationship:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with women by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Ensure that the helping approach you use has been adapted for women.

    • Some approaches to helping are sexist. Take an inventory of your approach to ensure that it is effective with women.

  • Establish a relationship, give up your power, and demystify the helping process.

    • Recognize the importance that power plays in all relationships and attempt to equalize the helper–client relationship. This can be done by downplaying the “expert” role, encouraging women to trust themselves, and practicing self-disclosure.

    • Male helpers should be much more tentative with self-disclosure and be particularly careful not to sexualize the relationship!

  • Identify social and political issues related to client problems and use them to set goals.

    • Help women understand the nature of the problem within its sociocultural context and see how the unique dynamics of women tend to cause them to internalize these issues. For instance, it is common for abused women to blame themselves for the abuse. Help them see that they are not responsible for the abuse and set goals to break free of the abuse.

  • Use a wellness model and avoid the use of diagnosis and labels.

    • Diagnosis and labels can be disempowering to women and tend to direct treatment toward psychopathology. A wellness orientation that uplifts women can help them get in touch with their strengths.

  • Validate and legitimize a woman’s angry feelings toward her predicament.

    • As women begin to recognize how they have been victimized, helpers should assist them in written materials to women, suggesting seminars for them to attend, and offering a list of women’s groups or women’s organizations that support women’s issues.

  • Provide a safe environment to express feelings as clients begin to form connections with other women.

    • As women begin to gain clarity regarding their situation, they often see how society’s objectification of women has led to fear and competition among women. This newfound knowledge may lead to a desire to have deeper, more meaningful connections with other women.

    • Helpers should consider the possibility of providing a women’s support group at this point in the helping relationship.

  • Provide a safe environment to help women understand their anger toward men.

    • As women increasingly see that a male-dominated society has led to the objectification of women, they may begin to express increasing anger toward men. Helpers can assist clients in understanding the difference between anger at a man and anger at a male-dominated system. Slowly, women will see that some men can also be trusted.

  • Help clients deal with conflicting feelings between their traditional and newfound values.

    • As women increasingly get in touch with newfound feminist beliefs, they may become torn between those new beliefs and values and their traditional beliefs and values (e.g., conflict between wanting autonomy and wanting to stay home to raise their children).

    • Helpers should validate these contradictory feelings, acknowledge the confusion, and assist clients to fully explore their belief systems.

  • Facilitate integration of the client’s new identity.

    • Helpers can assist clients in integrating their newfound feminist beliefs with their personal beliefs, even those personal beliefs that may not seem to be traditionally feminist. Doing so enables clients to find strength in their own identity development and no longer need to rely on an external belief system.

  • Say goodbye.

    • As women increasingly feel comfortable with their newfound identities, it is time to let them go and experience their new selves in the world.

Men

• A number of authors have offered ideas that can be incorporated into a set of guidelines when working with male clients, similar to the guidelines developed for working with female clients, and the guidelines are as follows.

  • It’s good to note that there are currently so many more female helpers than male helpers; thus, it is important that all helpers understand these guidelines.

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Embrace the appropriate knowledge, skills, and beliefs prior to meeting with a male client.

  • Accept men where they are, as this will help build trust.

    • Men, who are often initially very defensive, will work hard on their issues once they can trust their helper.

  • Don’t push men to express what may be considered “softer feelings.”

    • Don’t force a man to express feelings, as you may push him out of the helping relationship. Men tend to be uncomfortable with certain feelings (e.g., deep sadness, feelings of incompetence, feelings of inadequacy, feelings of closeness), but more at ease with “thinking things through,” problem-solving, and expressing some feelings, such as anger and pride.

  • Early on in the relationship, validate the man’s feelings.

    • Validate whatever feelings a man expresses, and remember that to protect their egos, men may initially blame others and society for their problems.

  • Validate the man’s view of how he has been constrained by male sex-role stereotypes.

    • Help to build trust by validating a man’s sense of being constrained by sex-role stereotypes (e.g., he must work particularly hard for his family).

  • Develop goals.

    • Collaborate with men and develop goals together. Many men like structure and a sense of goal-directedness, even if the plan is changed later on.

  • Begin to discuss developmental issues.

    • Introduce male developmental issues so a man can quickly examine concerns that may be impinging upon him (e.g., having children, midlife crises, retirement).

  • Slowly encourage the expression of new feelings.

    • As you reinforce the expression of newfound feelings, men will begin to feel comfortable sharing what are considered to be more feminine feelings (e.g., tears, caring, feelings of intimacy).

  • Explore underlying issues and reinforce new ways of understanding the world.

    • Explore underlying issues as they emerge (e.g., childhood issues, feelings of inadequacy, father–son issues).

  • Explore behavioral change.

    • As insights emerge, encourage men to try out new behaviors.

  • Encourage the integration of new feelings, new ways of thinking, and new behaviors.

  • Encourage new male relationships.

    • Encourage new male friendships in which the client can express his feelings while maintaining his maleness (e.g., men’s group).

  • Say goodbye.

    • Allow men to experience their newfound self, so be able to say goodbye and end the helping relationship.

Lesbian, Gay, Bisexual, and Transgender Individuals

• Current research suggests that sexual orientation and sexual identity are determined very early in life, are most likely related to biological and genetic factors, may be influenced by sociological factors, and have little, if anything, to do with choice.

• The following suggestions can help all of us have a better understanding of how to work with LGBT individuals:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with LGBT clients by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Have a gay-, lesbian-, bisexual-, and transgender-friendly office.

    • Make sure that your intake forms are LGBT-friendly. Some helpers may choose to have literature in their office that promotes a gay- and transgender friendly-atmosphere. Others may just want to ensure that there are no heterosexist materials in the office.

  • Help LGBT individuals understand and combat societal forms of oppression.

    • Oppression and discrimination of LGBT individuals continue throughout American culture, and it is important that they understand how it affects them, what they can do to combat it, and how they can gain a sense of empowerment despite it.

  • Adopt an affirmative and nonheterosexist attitude.

    • The importance of adopting an attitude that affirms your client’s right to his or her sexual orientation and sexual identity cannot be stressed enough, as so many individuals (including helpers!) have embedded biases and stereotypes about LGBT individuals.

  • Don’t jump to conclusions about lifestyle.

    • There is no “one” LGBT lifestyle, and helpers should not jump to conclusions about how their clients live out their sexuality or their sexual identity.

  • Understand the differences among people who are lesbian, gay, bisexual, or transgender.

    • Although lumped together here and often confused as embodying many of the same characteristics, great differences exist among LGBT individuals.

  • Know community resources that might be useful to gay men, lesbian women, and bisexual individuals.

  • Know identity issues.

    • Be familiar with the identity development of LGBT individuals, especially as it relates to the coming-out process.

  • Understand the complexity of sexuality.

    • People express sexuality in different ways. Gay and bisexual men, for instance, may be more sexual than some lesbians. Also, the expression of sexuality in men and women sometimes differs, with women being more focused on relationship issues.

  • Understand the idiosyncrasies of religious views of homosexuality.

    • Some religions view being lesbian, gay, bisexual, and transgender as sinful, whereas others are accepting of different sexual orientations and sexual identities. Also, how an individual adheres to the beliefs of his or her religious sect can vary dramatically.

  • Recognize the importance of addressing unique issues that some LGBT individuals may face.

    • Some evidence indicates that gays and bisexual men may face a higher rate of substance abuse and sexually transmitted diseases and that lesbians may face a higher rate of domestic violence, sexual abuse, and substance abuse. Become familiar with the prevalence of these and other issues within the specific population and the unique ways of treating them.

The Hungry, Homeless, and the Poor

• To assist these individuals and offer a bit of dignity and hope to them, a number of unique points should be considered when counseling the homeless and the poor, including the following:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with the homeless and the poor by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Focus on social issues.

    • Help clients obtain basic needs such as food and housing, as opposed to working on intrapsychic issues.

  • Know the client’s racial/ethnic/cultural background.

    • Be educated about the cultural heritage of clients, especially because a disproportionate number of the homeless and the poor come from diverse racial/ethnic/cultural groups.

  • Be knowledgeable about health risks.

    • Be aware that the homeless and the poor are at much greater risk of developing AIDS, tuberculosis, and other diseases, and be able to do a basic medical screening and have referral sources available.

  • Be prepared to deal with multiple issues.

    • Be prepared to deal with mental illness, chemical dependence, concerns about family, and other problems that impact the homeless at high rates.

  • Know about developmental delays and be prepared to refer.

    • Know how to identify developmental delays and have potential referral sources available, because homeless and poor children are much more likely to have delayed language and social skills, be abused and have delayed motor development.

  • Know psychological effects.

    • Be prepared to deal with the client’s feelings of despair, depression, and hopelessness as a result of being poor and/or homeless.

  • Know resources.

    • Be aware of the vast number of resources available in your community and make referrals when appropriate.

  • Be an advocate and stay committed.

    • Because the homeless and the poor are often dealing with multiple issues, and because a high percentage of them have mental illness, advocating for their unique concerns and being committed to them is particularly important, as this sends the message that you are truly there for them.

Older Persons

• There has been an increased focus on treatment for and care of older persons, such as day-treatment programs for older persons; long-term-care facilities, such as nursing homes; housing that is specially designed for older persons; senior centers; and programs for older persons offered through religious organizations and social service agencies.

• Human service professionals need to be familiar with both the unique concerns of older persons and the race, ethnicity, and culture of their clients.

  • Given the high percentage of older persons who have mental health concerns and the relatively small number who seek out counseling, helpers will become increasingly important in treating this population.

• The following guidelines are intended to help you understand some of the unique concerns that need to be addressed by human service professionals when working with older persons.

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • The helper’s stereotypes and biases may affect the prognosis of clients from this population. Be prepared to work with older clients by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Adapt your helping style.

    • Adapt your style to fit the needs of the older client. For instance, for the older person who has difficulty hearing, the helper may use journal writing or art therapy.

    • For clients who are not ambulatory, the helper may need to see the client in his or her home. In addition, know that certain interventions, such as groups and life reviews, seem particularly advantageous with older persons if used appropriately.

  • Build a trusting relationship.

    • Spend time building a solid relationship with the older client. Remember that older persons tend to be less trustful of helpers, having grown up in a generation when such relationships were far less common.

  • Be knowledgeable about issues that many older persons face.

    • A number of issues seem more prevalent among older persons, including loss and grief, depression, elder abuse, sleep disturbance, health concerns, identity issues, substance abuse, dementia, and others. Be knowledgeable of and assess for these issues.

  • Know about possible and probable health changes.

    • Be aware of the many potential health problems common among older persons and have readily available referral sources. Predictable changes in health can lead to depression and concern about the future. Unpredictable changes in health can lead to loss of income and a myriad of emotional problems.

  • Have empathy for changes in interpersonal relationships.

    • Changes in relationships may result from such events as retirement; the death of spouses, partners, and friends; changes in one’s health status that prevent visits to and/or from friends; and relocations, such as to a retirement community, retirement home, or nursing home.

  • Know about physical and psychological causes of sexual dysfunction.

    • Be aware of the possible physical and psychological causes of sexual dysfunction in older persons. As individuals age, it is fairly common for both men and women to experience changes in their sexual functioning. Remember that regardless of our age, we are always sexual beings.

  • Involve the client’s family and friends.

    • As social networks change, it may become important to involve family and friends in treatment planning. Families and friends can offer great support to older persons.

Children

• Like adults, children are not immune to mental disorders, poverty, disease, crisis, or trauma.

• Children are not immune to substance use and abuse.

• Wherever you work, you will be faced with a child who has been a victim of abuse, an abuser of drugs, involved in a criminal act, struggling with mental illness, or dealing with family and social problems. thus it is important to know the following basic guidelines when working with children:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • The helper’s stereotypes and biases may affect the prognosis of clients from this population. Be prepared to work with younger clients by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Know the limits of confidentiality.

    • From the beginning of the relationship, ensure the child is clear about the limits of confidentiality—parents and guardians almost always have a right to know what is discussed.

  • Know developmental theory.

    • Understand biological, cognitive, moral developmental, and lifespan theories so that you can assess if a child is on track in his or her development and so that you can apply appropriate skills.

  • Use appropriate counseling skills.

    • Be child centered, establish rapport, use good listening skills, ask appropriate questions that offer choices for answers, use developmentally appropriate activities, and understand the child’s world, which includes friends, school, and family.

  • Use alternative modes of communication.

    • Have developmentally appropriate toys and art supplies to communicate with children, and choose toys that will allow children to play and tell their story (e.g., dollhouse, puppets, children’s books).

  • Don’t lead the child.

    • Don’t ask leading questions because children are easily influenced by what you say and typically want to please adults. You want to understand their story, not have them answer the way they think you want them to answer.

  • Know relevant laws.

    • Know the laws in your state that apply to working with children. As a human service professional, you are probably a mandated reporter; thus, any information the child shares that indicates he or she is in danger, or someone else in danger, may need to be shared with Child Protective Services or other authorities.

  • Know available resources.

    • Children often need to be referred to doctors, developmental specialists, counselors and therapists, and so on. Have available resources to make referrals when needed.

  • Practice appropriate closure.

    • Ensure that the child knows, from the beginning, how long you will be working with the child, and make sure that you engage in appropriate closure so that the child does not feel abandoned when your time together ends.

Individuals Who Are HIV Positive

• The response of social services to the AIDS epidemic has varied and includes programs that offer support and counseling groups for HIV-positive individuals and their families.

  • Programs that assist HIV-positive individuals with the disclosure process, programs for children who have AIDS, prevention and education programs, programs that help individuals learn to live with a chronic illness, and hotlines to respond to questions about AIDS.

• Some points to consider when working with an individual who is HIV positive include the following:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with HIV-positive individuals by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Know the cultural background of the client.

    • Keep in mind that HIV-positive individuals can be of any gender, culture, race, or ethnic group. Helpers need to remember that a client’s background (e.g., culture, race, religion, gender) may change how the helper works with him or her.

  • Know about the disease and combat myths.

    • Knowledge helps fight fear. Armed with knowledge, helpers can become advocates for the HIV-positive person.

  • Be prepared to take on uncommon roles.

    • Realize that the helper may need to be an advocate, a caretaker, and a resource person for the client—roles in which the helper may not have always been comfortable.

  • Be prepared to deal with unique treatment issues.

    • Be prepared to deal with disease-related problems, including feelings about the loss of income from the loss of work or the high cost of medical treatment, depression and hopelessness concerning uncertain health, changes in interpersonal relationships when others discover the client is HIV positive (rejection, pity, fear, and so forth).

    • You should also know the probability that the client will have friends and loved ones who are HIV positive or have died of AIDS if he or she is from a high-risk group.

  • Deal with your own feelings about mortality.

    • Be able to deal effectively with your own feelings about a client’s health and mortality issues and appreciate how those feelings may raise issues concerning your own mortality.

  • Understand the legal and ethical implications of working with individuals who may pose a risk to others or may be considering end-of-life decisions.

  • Offer a “strength-based” approach to treatment.

    • Help clients focus on what is positive in their lives and the possibilities that exist for them, instead of concentrating on the diagnosis and the dread of the disease.

The Chronically Mentally Ill

• Almost all human service professionals will work with at least some individuals who are struggling with such a disorder (see Figure 10.3); although the vast majority of individuals with mental disorders live relatively normal lives, some find themselves homeless.

• Helpers who will be working with the chronically mentally ill will need to understand psychiatric disorders, psychotropic medications, and the unique needs of the chronically mentally ill, such as dealing with homelessness, continual transitions, difficulty with employment, and dependent family relationships.

• The following treatment guidelines suggest effective ways to work with such individuals:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with individuals with mental disorders by embracing the appropriate knowledge, skills, and beliefs prior to meeting with them.

  • Help the client understand his or her mental illness.

    • Fully inform clients and provide up-to-date knowledge about their mental disorder. Many do not have an understanding of their illness, the course of the illness, and the best methods of treatment.

  • Help the client work through feelings concerning his or her mental illness.

    • Mental illness continues to be stigmatized in society, and clients are often embarrassed about their disorder. Support groups and a nonjudgmental attitude can go a long way toward normalizing the view clients have of themselves.

  • Ensure attendance.

    • Increase the chances of clients seeing a helper by calling the day before, having relatives or close friends assist clients in coming to your agency, or developing specific strategies to help clients make their appointments (e.g., putting X marks on a calendar).

    • Clients may miss appointments due to denial about their illness, embarrassment about seeing a helper, problems remembering, or not caring.

  • Assure compliance with medication.

    • Be vigilant about encouraging clients to continue to take their medication and assess its functionality.

    • Clients may discontinue medication due to forgetfulness, denial about the illness, the false belief that they will not have a relapse because they feel better (the medication is working), or belief that the medication is not helpful for the particular client or the dosage is too small or too large (assess before discontinuing).

  • Assure accurate diagnosis.

    • Accurately diagnose clients to ensure proper treatment planning and the appropriate choice of medication. Accurate diagnosis can be assured through testing, clinical interviews, interviews with significant others, and appropriate use of supervision.

  • Reevaluate the client’s treatment plan and do not give up.

    • Be committed to working with clients and reevaluate treatment plans as often as is necessary. Individuals with mental disorders are some of the most difficult clients to work with. Progress, if any, is slow, and it is easy to become discouraged.

  • Involve the client’s family and other resources.

    • Ensure adequate family involvement and have the family understand the implications of the client’s diagnosis. Families can offer great support to clients with mental illness and can be a window into the client’s psyche.

  • Know resources.

    • Have a working knowledge of resources, as the mentally ill are often involved or need to become involved with many other resources in the community (e.g., Social Security disability, housing authority, support groups).

Individuals with Substance Abuse

• Many individuals with disabilities are feared, ignored, stared at, infantilized, treated as intellectually inferior, accused of faking their disability, or pitied.

• The Education for All Handicapped Children Act of 1975 (PL94-142) and the subsequent Individuals with Disabilities Education Act (IDEA) ensure the right to an education within the least restrictive environment for all children who are identified as having a disability that interferes with learning (U.S. Department of Education, n.d.).

• The Rehabilitation Act of 1973 ensures access to vocational rehabilitation services for adults with disabilities who are in need of employment (U.S. Department of Transportation, 2015).

• The Americans with Disabilities Act of 1992 ensures that individuals with disabilities cannot be discriminated against in job application procedures, hiring, firing, advancement, compensation, fringe benefits, job training, and other terms, conditions, and privileges (U.S. Department of Justice, 2015).

• Some treatment guidelines for working with the individual who has a disability include the following:

  • Have the right attitudes and beliefs, gain knowledge, and learn skills.

    • Be prepared to work with clients who have a disability by embracing the appropriate knowledge, skills, and beliefs prior to meeting with clients

  • Have knowledge of the many disabling conditions.

    • To be effective, a helper should understand the physical and emotional consequences of the disability of the client.

  • Help clients know their disabilities.

    • Inform clients of their disabilities, the probable course of treatment, and the prognosis. Such knowledge allows them to be fully involved in the helping process.

  • Assist the client through the grieving process.

    • Help clients pass through stages of grief as they deal with their loss and move toward acceptance. Similar to the stages of bereavement (Kubler-Ross & Kessler, 2005), it is usual for a client to experience denial, anger, negotiation, resignation, and acceptance.

  • Know referral resources.

    • Be aware of potential resources in the community (e.g., physicians, social services, physical therapists, experts on pain management, vocational rehabilitation). Individuals with disabilities often have a myriad of needs.

  • Know the law and inform your client of the law.

    • Know the law to ensure that clients are receiving all necessary services and that they are not being discriminated against. In addition, clients often feel empowered when they know their rights.

  • Be prepared to do, or refer for, vocational/career counseling.

    • Be ready to either do career counseling or refer a client to a career counselor. Often, when faced with a disability, clients are also challenged with making a career transition.

  • Include the family.

    • Whenever possible and reasonable, include the client’s family in the treatment process, as they can offer support, assist in long-term treatment planning, and help with the client’s emotional needs.

  • Be an advocate.

    • Advocate for clients by knowing the law, fighting for clients’ rights, and assisting clients in fighting for their own rights. Individuals with disabilities are faced with prejudice and discrimination.

  • Empower your clients.

    • Avoid being sympathetic and having low expectations, and listen to and support your client. Assume your client knows what is best for him or her.

Ethical, Professional, and Legal Issues: Competence and On-the-Job Learning

• You must know that we cannot expect to be experts with all clients.

• Some on-the-job training occurs in every profession and is one method of gaining experience and developing expertise.

  • In the human service field, if you end up working with clients with whom you are not experienced, you should do so under supervision, or refer if you think their needs are outside your realm of competence.

• Recall that our ethical code tells us that we need to know the limits of our ability, and to seek out consultation and supervision when necessary:

  • Human service professionals know the limit and scope of their professional knowledge and offer services only within their knowledge, skill base, and scope of practice. (Standard 27)

  • Human service professionals seek appropriate consultation and supervision to assist in decision-making when there are legal, ethical or other dilemmas. (Standard 28)

  • Human service professionals continually seek out new and effective approaches to enhance their professional abilities and use techniques that are conceptually or evidence based. (Standard 31)

• It’s tricky to figure out whether it’s better to learn on the job while being supervised or to refer the client to another helper, and choosing will require reflection.

The Effective Human Service Professional: Open to Continued Learning about New Clients

• The following suggestions, adapted from an article on working with culturally diverse clients, are useful for becoming more knowledgeable when working with a wide range of clients thus consider these options when you want to become more competent in working with a specific client group:

  • Course offering. Take a course on the client group.

  • Workshop. Attend workshops on the client group.

  • Immersion activities. Immerse yourself with the client group (e.g., if you have no experience working with alcoholics, attend AA meetings).

  • Supervision: Obtain supervision.

  • Case studies: Read case studies about client groups.

  • Discussion groups: Find colleagues who have worked with similar client groups and talk with them.

  • Role-plays: Conduct role-plays with colleagues to practice how you would work with the specific client group.

  • Journaling: Write down thoughts in a journal as a way of revealing perceived threatening experiences relative to your fears of working with the specific client group.

  • Readings: Read brochures, books, and other materials about the client group.

  • Videos: See if there are videos of other people’s work with similar clients (it’s amazing what you can find in a good library or even on YouTube).