My role at my agency is effectively case management. I ensure that our youth clients are compliant with the required immunizations, physicals, dental and eye appointments set forth by the public school system. I research information on programs for those graduating with intellectual disabilities. I help young adults create resumes and find after-school jobs. I coordinate a lot of back-end work for other agency employees. Yesterday, it was clear that it was past time to file a myriad of papers and documents in the Youth Program. The catch-all space was overflowing, and I was tasked with alphabetizing intake forms and filing other assorted documents away in individual client folders. I set my Spotify account and got to work, hitting a nice rhythm. Suddenly, one of my more complex clients came into the office. I knew she had been there that day using our computers to job search, but I was not expecting to meet with her. She sat down quietly, and I chatted with her as I continued to file. Her one word answers and unusual affect quickly hit me. I needed to stop filing.
Sitting down with her, holding out a box of tissues, it became clear that this girl was in some serious distress. Her case is complex and heartbreaking, and my co-workers and I often say that her life story could be a tragic coming-of-age film. She is the first client I have had that keeps me up at night, who got my cell phone number, who I set aside my old clothes for. I care for her deeply. Until yesterday, I had been responsible for managing pieces of her life. And as she sat with me and I tried to ascertain through a heavy accent and language barrier how worried I should be about what she was describing to me, I couldn’t help thinking, “This is why I do not want to be a therapist.” And then I thought, “Well, I’m not a therapist. And yet, here I am.” And, far too long into the exchange I finally thought, “I should get my supervisor.”
My supervisor is wonderful. With almost a decade of experience in refugee resettlement work, she is a wealth of information on the topic. She is kind, compassionate, and children who have never met her nor share her language take to her immediately and effortlessly. She always makes herself available to me. Yet, confronted with a client in crisis, I began to go it alone. My mind began to race through everything I had learned in my first year coursework. “Find out if she has an actionable plan! Ask her ‘The Miracle Question’! Make sure you case note everything you said and did when this is over!” I wanted so badly to “be a social worker” in that moment that I nearly forgot that the most responsible thing for me to do was to involve someone who knows more than I do.
My supervisor was better able to navigate what my client was trying to tell us. My client, conversational, but not completely fluent in English, was choosing words that seemed odd to me to describe how she was feeling, and my supervisor was able to help pinpoint what she was trying to say, and helped me assess her risk of self-harm. She provided examples of other refugees to my client from her years in the field, showing her that while it was difficult now, it was possible to make a better life for herself. She connected the dots between her current problem and past issues. She was able to do so while also respecting some of the deep cultural differences this client has from the two of us. Suddenly, all of the cultural competency talk during my first year of coursework became extremely relevant, and I also realized how impossible it is to prepare MSW students for every possible situation they may encounter in the field.
And that’s why we have supervisors.
After we came to a decision about the client’s safety and took our necessary steps, I immediately went back to my filing, not wanting to leave my carefully arranged stacks of papers for the next day’s intern or the overnight cleaning crew to disturb. But my supervisor followed me, and said she thought it would be a good idea for us to de-brief. And of course, once I began talking to her about everything we had just heard, I realized how badly I needed to process it. How badly I needed to process my months there, and the stories I had heard, the case histories I had read. Working with refugees is a strange mix of helping the individual, but having a sudden awareness of the global politics, war, and famine that has brought your client to you. The weight of it all suddenly fell on me last night.
I should have been talking about this with my supervisor months ago, but I think many of us in social work wear our poker face, our unflappable cool, as a badge of honor. While we insist to our clients and those who judge them that asking for help is not a sign of weakness but one of strength, we seem to be doing the opposite sometimes.
By Mary-Margaret Sweeney
SJS Student Liaison
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Awesome work for society,
I am completely enthrall by your stories. As a BSW student in my last year, I was a little confused by the part mentioning your cell phone number. We are told to never provide our personal numbers to clients because of client-SW boundaries. Is there a time when it is okay to give a client your cell number? I’m assuming it must vary by agency.
Hi, Sarah. Thanks for reading, and commenting. What you bring up is something I have struggled with, and actually intend to write a post about at some point in this series. When I began my first year MSW courses, I am unpleasantly surprised by all of the boundaries set on the client/social worker relationship. Of course some are obvious, like not becoming romantically involved with a client. I was really dismayed–my undergraduate education had been very academic rather than practical, but I studied social movements and social change. From this, I wanted a career where I would be working with people truly side-by-side. I actually began doubting that social work was the right choice for me, based on just this one thing. Yet, my work with refugee resettlement is exactly what I wanted social work to be (if only we all were so lucky to feel this way about field placements!). To practice with any cultural competency, many of these boundaries had to go out the window. Creating distance, especially with someone who says they care for you and are there to help you, is very Western. And, out of necessity, sometimes case managers need to answer their phones late at night–the client’s carbon monoxide alarm is going off, and they don’t remember from orientation what that is. Everything is unfamiliar, they often don’t know anyone else in the country, let alone their apartment building. But keep in mind too that those boundaries are one model. There are many ways to do your work. For example, DBT practitioners have very little boundaries on “business hours,” for example, as a part of the therapeutic process. It is up to each social worker to discuss with their supervisor and agency leadership what is appropriate for all involved.