By: Lisa Baron, MSW, LCSW
I have been a clinical social worker for 26 years. I have seen adults, adolescents, and children in a variety of clinical settings, including agencies, schools, hospitals, and private practice. I have worked with clients who have presented with depression, anxiety, relationship concerns, and many other issues. Many clients come to me hopeful for help, yet somewhat skeptical of the ability to change. Through our trusting relationships, step by step, many clients do begin to make the changes they hope for. Some are quite successful over time, internalizing the work that we do to the point at which they move on from the therapeutic arena.
However, not all succeed. It is in consideration of this second group that I developed some “Tips for New Social Workers,” who come into the field wide eyed and ready to change the world.
Five years ago, I began teaching students at the graduate level. These students are training to be professional social workers or professional counselors. During this time, I have noticed some belief patterns in many of the students I teach. They have chosen a helping profession based on a belief that, with their love of people and good intentions, all clients will benefit from their services.
When we begin to address some of their beliefs, myths, and paradigms, at times it is a rude awakening. The fact is, not all clients change. Not all clients want to change, or they are unable to for a variety of reasons. Maybe it’s too frightening for them to change. Maybe they are not ready. Maybe they are not certain that change is what they seek.
Some students don’t believe that this is possible when they first enter the helping professions. Often, I will have these same students contact me months later, agreeing that this work falls within the context of reality–sometimes wonderful, sometimes hard, sometimes disappointing, sometimes confusing. It is from this perspective that I have developed the following tips.
I would preface this list by saying:
I write this list with your very best interests in mind.
It is a great honor to work with you as you enter a very important career of working with people. That said, people are complex, and you will be amazed, mesmerized, frustrated, disappointed, angered, sometimes all in a given day...yet, for even the smallest changes that you see your clients make, you will be incredibly gratified. Some of your clients will be forever grateful, internalizing some of the hard work that the two of you do together, in order to improve their day-to-day lives. Some clients will not proceed in the way you would hope. However, remember that those clients may have benefited as well, maybe not in the way you envisioned. Change takes hard, hard work. You will touch the lives of all you work with, in different ways. Be realistic about what to expect. Read the list, take it in, try it on for size. Through your own experiences, you’ll be able to add to it, over time.
1. I can help all clients at all times.
This is a fantasy that many of us have when we enter the field of social services. We are ready and willing to embrace whoever and whatever comes our way. We envision our clients being so happy for the help that we offer them that they will be forever thankful. In preparation for the first day of our graduate internship, we choose a special outfit. We have map-quested our destination and arrive 30 minutes early to make sure that we are on time. Upon entering the building, we anticipate the receptionist greeting us with a smile, perhaps giving us a freshly cut bouquet of flowers as a welcome. Although in fact, this might occur, it is unlikely that it will. You may receive a smile and flowers, or you may greet a receptionist who is overworked and underpaid. Your first client may come in cheerfully or could be a mandated client who does not want to be there. Or, your first client may not show up for the appointment at all. The fact is that you can’t help all clients at all times. You can help the clients who want to be helped. Those clients will need to have some level of motivation for change.
2. This work will not touch me personally.
You probably entered this field being a sensitive person. You have probably always been interested in people and intrigued by interactions. You are
most likely a loving and kind person. There are clients who will touch you in a
personal way. Their stories will be sad. Their words will trigger thoughts and feelings in you. You will need to breathe deeply in sessions, so you can keep the focus on your client. It’s important to consider your own personal therapy and to also use supervision to process feelings that clients trigger in you. This is a key part of your work—understanding and working through clinical countertransference.
3. I can find a 9-5 job and always leave my thoughts about work “at work.”
Given that this work may trigger feelings and thoughts in you, sometimes you will take those feelings and thoughts home. It is important to work toward a balanced life, including time for you. However, realize there are times when you will need to decompress and find ways for stress relief. Make time to laugh! Be mindful to respect client confidentiality, and do not talk about specific situations at home–this is what your supervision is for. However, feel free to tell your family and friends when you need down time, delegate tasks, and prioritize. Also, you may be in a job that requires a pager or rotating weekend coverage. Use the times when you are not on call to re-energize. We are so good at taking care of others in this field. Learn to take better care of you.
4. I will like all my clients, and my clients will all like me.
Do you like everyone in your family? Do they all like you? Are there times when you are on a different page? Different chapter? Different book?
Hopefully, you all treat each other with respect. You will feel more of a connection and bond with some clients than others. Some issues will be easier for you to listen to. Some themes will be easier or harder to navigate through with your clients. However, I will share with you one of the most important things I learned when getting my MSW years ago. Find a strength in every person that walks in your door. Once you are able to focus on these strengths, this will enable you to work with your clients to see their own internal strengths, as well. Also, sometimes when we have mixed feelings about our clients, it’s due to countertransference issues that arise. The best use of your supervision will be to look at this closely for each client you see.
5. Once I am done with graduate school, I will have the skills to do this work.
A true professional never stops learning. With 26 years of clinical experience, I can truly say that I learn from my clients every day. The more open you are to learning, the better social worker you will be. People who think that they have “arrived” in terms of their skill development are limited, and this can be of great disservice to clients.
6. I grew up in a great family. Why would I need my own therapy?
I believe everyone needs therapy at some point in their lives. It’s impossible to live a life without some bumps in the road...it’s part of living. Understanding your own vulnerabilities will help you immeasurably in terms of work with your own clients.
7. Therapy is about the words spoken and exchanged. It doesn’t sound that hard to learn.
The longer I have been in practice, the more I realize that silence in the room with a client is as valuable as words. Silence enables a client to listen to his or her own thoughts and feel his or her own feelings. It helps them to learn to trust their own judgment.
One common mistake we all make as therapists is that we talk too much. We tend to direct, give advice, and steer clients in a direction that may not necessarily be the direction that they want to go. Remember that the client is the driver of the car, and we are the passengers. Don’t be a back seat driver, and use silence to help pace the session in the way your client needs it to be paced.
8. Once my client and I set goals, we will work on them, session by session, to get to where they’d like to be.
Some therapists work with goals, and some do not. Talk with your supervisor about his or her theory on setting goals. If you do decide to set goals with your clients, be sure that the goals are the client’s and not your own. You can discuss your ideas for goals with your clients, but let them take the lead. Also, your client needs to pace the therapy. So if one of their goals is to get a new job, this may take them longer than you’d think it would. Maybe the client is very shy and needs to take time before even taking the first step of making calls to people he or she knows. You may do this more quickly or differently. That is one of the issues with goals—a therapist needs to pace progress by a client’s readiness, not the therapist’s.
9. I will be able to diagnose a client in 2-3 sessions. I need to gather the information in my initial sessions, and go from there.
One of the biggest myths is that we should hurry up and fix whatever it is that needs to be fixed. Therapy is not about fixing; it’s a process between two people that is based on a trusting relationship. Development of trust and relationships takes time. Your client is painting a picture for you of his or her life over time, with its themes and patterns. I believe that rushing to make a diagnosis is a mistake. It does not account for some of the things that may unfold over time with your client. Take the time you need to take, as the story unfolds. You cannot rush the process. It’s not meant to be rushed.
10. I love the idea of going into a field in which my colleagues and I will have so much in common. It will be great to be among people who think like I do.
You will meet colleagues with whom you have much in common. You will also meet colleagues who are on a different page. Even though you are in the same field, people are brought to this field for many different reasons. Some of your colleagues will be ethical. Some will see clinical work as you do. Some will not. Walk into your workplace every day with a sense of integrity and honesty.
Uphold NASW’s Code of Ethics. Maintain your strong belief in the right for client confidentiality. This is what your clients deserve.
Lisa Baron, MSW, LCSW is a licensed clinical social worker in Northbrook, Illinois. Lisa sees adults, adolescents, and children in individual, marital, and family therapy. In addition, Lisa teaches graduate students in the Chicago area and is working toward her doctorate. You can read more about Lisa on her Web site: http://www.baroncounseling.com. She is available by e-mail at email@example.com.
This article is from the Spring 2010 issue of THE NEW SOCIAL WORKER. Copyright 2010 White Hat Communications. All rights reserved.