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Tuesday, July 13, 2010

"Fix her for me, will you?"

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It seems like the general public’s perception of the social work profession is that we are around to solve everyone’s problems. I can’t tell you how many times a nurse has wandered into my office, handed me a patient’s file, rattled off a list of problems, and wandered back out. I don’t mean to be critical of nurses or of anyone else in these helping professions; Heaven knows we are all overworked and exhausted. But I am getting tired of the idea that I am the resident problem solver. This guy needs Medicaid, get it for him; this lady needs to stop spending her money on cat food and start spending it on medicine, make her do that (and get her the drugs she needs in the meantime); this family needs to pay their mortgage, get them the money. And be sure you do it by today because they might be dead by tomorrow.

I love the concept of Social Work. I love the idea of helping people acquire the resources they need to improve themselves. What I can’t figure out is how to navigate between coworkers expectations of “help” and a client’s idea of “help.” They are two different things.

Many people seem to think that a social worker is not doing a good job if a client still has a messy house, still lives alone, still has denial issues, still has an unpaid mortgage, etc, even whilst working with a social worker. What is not taken into account is the will of the person. I’ll happily help a client make arrangements for a housekeeper or a sitter, or I’ll help a client apply for financial assistance or Medicaid if they would like. But I can’t just go into their home and wave my magic wand and solve their problems for them. And even if I could, there is no section of the Social Work Code of Ethics that give us permission to use magical powers. If no one is in immediate danger, there is not reason to solve problems that clients don’t care about. On the contrary, social workers “enhance clients’ capacity and opportunity to change and to address their own needs.” (NASW Code of Ethics)

“Address their own needs.” Not address the needs that the nurses, the chaplain, or even the social worker think are important. But the client/family’s own needs. What has the client identified as important? What does she need help with? And what effort is she willing to make to get there? If I give her the resources and the support, can she give the effort? Those are some of the questions I ask myself when I am assessing a client.

Empowerment. Sometimes we forget this concept. Or maybe sometimes we think that to empower someone is to make them like us. To introduce them into our culture and our reality. To make them give high priority to the same things that we give high priority.

That doesn’t seem terribly effective.

2 remarks:

Anatolia said...

'And even if I could, there is no section of the Social Work Code of Ethics that give us permission to use magical powers.'

Hehe. A lot of great thoughts in this post. Addressing clients' needs is right on the money. Thinking about their values vs. our coworkers' values or even our own is another great point of discussion.

It's also a greatly underrapreciated fact that any change takes *time*. Yet expectations of social workers are that they help bring it about very quickly.

Becky said...

What about the people whis decisions are harmful to themselves and anyone who visits them. Example: a patient who has poo on all his walls and floors and doesn't seem to think anything is wrong with living that way poses health problems to himself, nurses, family members who come to visit... How do you make someone care? and should you?

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