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DRINK & DRUGS NEWS :: Q&AYou ask the questions - you answer the questions. Please keep your answers coming, and feel free to email a new question. Thanks to this issue's respondents for their contributions. Question:I've just had a bad experience with a service user. On our second
meeting I was trying to explain her options for getting in contact
with services, when she stormed out saying I didn't understand her,
and what was the point. I feel devastated - I've not been in my
job that long, and feel as though I've failed my client badly. Can
anyone give me advice on handling things better in future? [Shelley,
Birmingham] Your replies...Dear Shelley, My experiences with clients within the prison environment have been that they can be notoriously suspicious of my motives as a drug and alcohol worker. This can also make them mistrusting of any services offered. I have found that spending time building up a rapport has led to a more satisfactory working relationship with my clients. Once this relationship has built up, I have my clients meeting me in a more relaxed mood and therefore more receptive to treatment offered. I consider time spent building up an effective working relationship as an investment in developing a client's treatment needs. Ian Bowerman, York
Oh Shelley, you haven't failed anyone. The fact this has caused you so much heartache and soul-searching shows just how caring, conscientious and professional you are. My suggestion is to drop this lady a line and tell her you're available to have a chat when she's ready to talk again. Don't push it - the desire to improve things has to come from her. Handling things better in the future? Sounds to me like you'll do just fine. But remember - you can't win 'em all. Ian, Harrogate
Shelley Familiar? Yes! I think understanding plays a big part in managing such experiences - and experience comes with time. What I would say, is that this rather common outcome would not necessarily be down to anything you did or did not do. So be gentle on yourself, but be open to exploring these factors with colleagues and within your supervision, to find this clarity. Service users can, and will, continue to express forms of anger and upset inappropriately. This too can be fuelled by wanting to or feeling a need to sabotage all things good. Maybe if, or when, this or similar were to happen again, you could reflect on your resource of knowledge and separate yourself enough to be able to encourage them to stay with whatever it may be. Feed back to them before they are able to leave, if you are aware that they have become angry and upset. Suggest that you acknowledge this, but you also would like to understand what these emotions are about. If equipped to do so, stay with it. Alternatively, if not, suggest that maybe you can put them in touch with one of your colleagues. This may or may not work, but at least you have tried to support them with their problems. Good luck, Jason D, HAWKS, Bristol
Dear Shelley I do not feel that you have let your client down. Sometimes in these situations feelings can become a little confusing, especially when your client is involved with substance misuse and has problems. I have had to deal with some similar cases. What you have got to remember is that despite what was said, you have just got to keep working at the relationship and try and find out why she has said you don't understand her. I do know it is hard and I know I take my work home with me sometimes when I feel I could have done more for a client, but one thing you have got to learn is how to switch off from work and the feelings that sometimes affect our lives as treatment and support workers. My coping mechanism is to go for a meal on my own when I have had a testing day. I find that works - you will be able to find one too. Just do not beat yourself up. John, Lifeline, Kirklees
Dear Shelley Firstly do not feel as though you have failed, you have merely
experienced the unpredictable nature of service users. You have
gained valuable information to help you deal with this service user
in future, ie they may not be ready to face the fact that they have
a problem, they may want to discover solutions for themselves, they
may not want someone to point out their failings. You said that you were accused of not understanding her; this seems to indicate that she was looking to build trust with you and to gauge whether you understood her point of view without judging. She may not be looking for solutions at this point, just the chance to communicate with someone. Do not be put off by isolated incidents such as this, particularly as you are just getting to grips with your job. I would recommend gaining some training in motivational interviewing, which can be an excellent approach for situations such as you described. I wish you the best of luck with your continued career. Keith, Service Manager, Kidderminster
Dear Shelley, You're obviously very upset about the reaction of your client and feel that you have failed her. What you have failed to do is give your client exactly what she wanted, and she left telling you that you didn't understand. It can take a while to build up trust and get a good client relationship going and some clients are unforgiving if you don't deliver exactly what they want - but it's not always easy to know what their expectations are. It sounds like you tried to offer options, but she wasn't ready for them. Perhaps what your client wanted was just to know that you understood her - just some empathy. Your response to her talking was an intervention that was perhaps a little early. Often when a client presents with their situation, they just want to talk about it first and offload. They will want someone to listen and they want you to understand what it's like for them. It's a very natural reaction to want to help, but the client may not want help quite as soon as we want to give it. It sounds as though this is what might have happened here. Your client got angry because she didn't get exactly what she wanted, and she failed you; she didn't give you the chance to meet her needs, she judged you and left. If this client has been failed by others, she could have perceived you as the same, and may have come with pre-conceived ideas that you wouldn't be much help - 'another person who doesn't understand her and is giving her advice she doesn't want', which may have led to anger or impatience. She may have arrived with a 'you have got one chance at this' attitude. Sometimes we need to apply our helping breaks, and just listen carefully and give the client chance to say how it is for them. Give them time to explore what they want to do, and when they are ready for help they will let you know. What the client often doesn't voice is 'I don't want the answers, I just want you to listen and understand how it is for me'. I guess this can be the difference between the client staying and leaving. Your client will have taught you something, so it's not all bad. You didn't fail at all - you just may have tried a little too hard. It may be useful to talk with an experienced worker; I find good supervision is essential in restoring your confidence when it's taken a knock. Your letter shows your willingness to learn, reflect, and improve your practice. Well done for writing, and view this as a learning experience rather than a bad one. It's only through our clients and trial and error that we learn what's helpful. Good luck with your casework and don't be too hard on yourself. Mel, Wolverhampton
Dear Shelley I can't tell you how many times this has happened to me in person and more recently to a member of staff I supervise. He took it very personally too, and felt he had no option but to close the case file as his client had stated he wouldn't see him again. I encouraged him to contact him by phone and acknowledge his distress and anger, and offer to sit down and talk with him about what had fuelled this. The client really appreciated the call and even apologised for his behaviour, saying that he was having a really bad day and he wanted to meet again. Our clients so often come with a lot of problems and their lives are often stressful and difficult. If we respond to their anger personally and don't give them the opportunity to re-engage with us, then we have let them down too - and often this just confirms their belief about themselves that no-one can, or will, be able to help them. Give it 24 hours settling time and make contact - it worked in our case! Tina, by email
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