PRIVATE PRACTICE - A case where I closed consultation

Today I would like to report on my professional private practice

I think that many people have an interest in the way a person who does social consulting ticks inside. Therefore, as long as the episode is still fresh, I reveal a part of my experiences and allow an insight, which seems to be justifiable and at the same time protects the identity of my clients. I see additional protection in the publication in English (which is not my mother tongue).

I start with a letter I left for a client of mine at the reception in one of the three institutions I work for as a freelancer.

„Dear X,
it took me some time to reconsider our encounter and position myself. Now I have found the necessary composure.
It's not complicated at all:
In my shop, I offer schnitzel and chips. Sometimes - if the situation allows it and I don't have any other customers - you get a sausage or a piece of cheese from underneath the counter. Basically, however, there are only schnitzel and chips and no guarantee for the sausage and cheese.

You are now a customer who wants to tell me, a shop owner, that I should please also carry other articles and that I should be familiar with the goods you prefer. For example, chocolate. I told you, I don't deal with chocolate, I don't know about it and I don't want it either. If you get the impression that there is a special customer right for you, I take the responsibility to correct it. My upset reaction and my confusion in the last situation was simply a human reaction because I had the impression that you didn't accept what I had on the shelf. In order to prevent an escalation and because I was in danger of getting mad, I stopped our meeting.

How you deal with this emotionally is not force majeure, but a decision you can make for yourself. It was an opportunity to realize that I have my limitations. I once asked you if a therapist could be weak. You agreed to that. Now you can decide whether you meant it or not. Replace the word "therapist" with "consultant“ or simply "human" and you will know what it is about. It's less dramatic than you might be looking at it. I appeal to you to shed light on your part of the responsibility. I have reflected upon mine in the way I always do.

I like you. That I recommend therapy to you has to do with the fact that I care how you feel and is always a good advice when I realize that my shop is not the right place for it, because I am not a therapist.

Please don't text me, I won't respond. I see further social consulting as counterproductive and I will not do it with you for this reason. You are always welcome as a visitor to the X and I have nothing against a friendly chat in the X, if my time allows.

All the best and heartfelt greetings to you."

There are various possibilities to read this letter.

When you are in a calm state of mind it seems to be a positive effort to create understanding. But if you are not and if your mental state is on high alert, you might tend to misinterprate every sentence. I give you an example of the most worse interpretation to illustrate that.

Why I am doing that?

Because even if I have done my very best to deliver the message, I cannot expect another person to receive it as it was meant. So it tells me that I must let go of control and my wish that everything should be fine afterwards. The outlook on life people develop within their lifes, is given by this excerpt of a book called Systemic Therapy with Individuals from Luigi Boscolo and Paolo Bertrando.

The fact that I can give a misinterpretation of the letter also says a lot about me. I am not unfamiliar with such paranoid attitudes as can be read in the commentary fields. And I think everyone has a more or less paranoid mania in time. My own experience with self-centered thoughts can serve as a reminder for me to be able to understand why a person reacts to a statement from me differently than I would expect it to.

Since there is such a possibility, this knowledge keeps me from stiffening myself to insist on a desired result with regard to an argument or conflict. Therefore, the best way to resolve a conflict is if I have decided for myself not to hold on to it any longer and to make myself independent of the insight of another person.

You may ask why I chose written communication instead a of face to face one. In this particular case I did that on purpose and because I am only once a week working for that institution. The time went by from my client leaving the office and her suffering from being neglected accompanied with her reaction showed me that she believed she was not able to deal with this event on her own. I already left a week go by in order to see if she can handle it and realized that she was not or did not want to. As the spoken form of communication is one part of the problem I decided that a letter might going to be useful.

Role models

When I learned my profession, I was eagerly looking for personal reports of experiences on the consultant side. Also, those who work as therapists interested me in describing their work with clients. How else am I supposed to learn from these people? After all, there is no possibility of participating in the consulting setting. Books have supported me in this, including for example Irvin D. Yalom, a psychiatrist and seemingly a friend of sharing his client experiences. I do not favor all of his notions but his written examples of therapist-client-encounters I do worship a lot.

Side note: While there is a lot going on on the research- and the method-side, there is less available on real client-consultant side in the form of actually presented cases and examples.

The quality of advice only really comes into its effect when it becomes difficult. It is, of course, nice when the cooperation between consultant and client runs smoothly and both are satisfied with the results and findings.
But what if it gets really stuck? What if I run into a person I can't handle? How can I tell if I'm still the right choice for someone?

Self awareness

Self-awareness is a conscious awareness of one’s internal states and interactions with others.

With me, it's my own feelings. That requires that I am skilled to be aware of my own state of mind and emotions in the moment they arise. Such as confusion, anger, inconsistency or despair. If I notice that I suddenly have these changes in the presence of a client, even though I have been relaxed and happy before a meeting, this is an initial indicator that there is something wrong with the communication between me and my client. If this happens only once or rarely, I don't waste any more thoughts on it and chalk it up as a "bad moment". However, if my feelings of this kind accumulate, then I have to start asking what is actually going on.

The best thing I can do is ask for the client's assignment. Which is why he or she comes into my consultation in a very concrete way. What the core issue is and whether we manage to do it in half an hour or whether we might need one or two more sessions. If the client can give a clear answer and we make good progress in the first session and come to an end with one or two more, everything is fine.

Pseudo-convictions

That's what happens when a client is truthful and not lying. Lies are often not a conscious form of communication. Lies come through the lips in the form of pseudo-conviction.

In order to develop a nose for pseudo-convictions, it is absolutely necessary to have fallen for them a few times.

This is not easy to notice, nor can it be recognized in the process of development, but only afterwards. So if my client claims to have an assignment for me and that is "so and so", I assume that this is true. It would also be strange to proceed in a different way. If I suspect that it is not really the real matter of concern when the question is answered, I could draw the frame of my questions a bit larger and want to know: "Is this all? Is there anything more important than you can think of now? What could that be?"

If I am not able to stay calm and I become dissatisfied because I sense that an answer might be untruthful I cannot simply say: "I don't believe you". That is counterproductive and just leads to a back and forth argumentation why I must believe the client from his perspective and why I reject to do so from mine. That happened already and I put it aside as my mistake in consultation.

But even this is not the last word of wisdom. If I have a client of the calibre of multiple pseudo-convictions in front of me and who has read something about "financial loopholes" and cites this as the real problem of his money affairs, I am powerless. At least at that moment.

Persistence in the client

In the case of this particular client, I assumed from a certain moment on that the client's concerns were pseudo-like. I then advised her to seek therapy. I did this quite early on. She asked me if she could come to me in other matters and I replied (not recollecting the exact words but similar to): "Yes, if there are any problems that we can solve satisfactorily here in the course of the consultation". I didn't realize at the time that I should have denied it. She then opened the subsequent open consultation hours with a special emphasis on the fact that she wanted to discuss this or that concretely and that these were obviously suitable topics which would fall within the scope of my offer.

Yes, I know, now in retrospect it's easy to wonder whether I had been slow to understand.

I was a bit uncomfortable with her strange openings, but I wanted to be of good faith. I ignored my very soft warning voices, which signaled something else to me. A slight resentment accompanied the meetings and I mostly felt a bit impatient, for which I blamed myself. My thoughts were: "Erika, be a little more patient. There are people and situations that require it. Besides, you don't usually give up so fast. She's just a challenge and have you ever shied away from it? No! So. Give her a chance and don't be so ungracious." Also my ambition played into it to really be able to help everyone and to want to do this.

Classic helper syndrome, isn't it?

On top of it all, I like her. She is very charming and we laughed together several times. In addition, it was an interesting change of linguistic nature to my other clientele by her meeting my level.

This shows me that I did not only have altruistic reasons to advise her but also some quite tangible egoistic ones.

"Altruistic people, who work hard to help others, should not be sus­pected ipso facto of harbouring ulterior selfish motives. Nonethe­less, the ‘helping pro­fessio­ns', such as nur­sing, chari­table work, the ministry, and psychotherapy, attract people for curi­ous and often psychologically sus­pect reasons.... Such people may be lured, knowingly or unknow­ingly, by the position of auth­ority, by the depend­ence of others, by the image of bene­vol­ence, by the prom­ise of adula­tion, or by a hope of vicariously help­ing them­selves through help­ing others"

^{source: The Magnetism of Power in Helping Relationships. Professional Attitude and Asymmetry- Theo N.M. Schuyt, Vrije Universiteit Amsterdam - quote from Thomas Mae­der on "Wounded Healers"}

Also, I could clearly sense manipulation efforts from my client.

Because social workers in all practice settings encounter clients who use self-serving manipulative tactics, it is vital that social workers discern such tactics and manage them skillfully. Otherwise social workers may unwittingly respond counterproductively to these maneuvers, thereby permitting clients to impair the helping relationship and undermine progress. Manipulative behavior is defined, and its potentially detrimental impact on helping relationships is discussed within the context of communication-interaction theory.

Types of manipulative behavior discussed and illustrated include attempting to control conditions of treatment, avoiding engaging in the helping process, attempting to gratify needs in the helping relationship that are ordinarily gratified from other sources, seeking to avoid aversive consequences of infractions, and seeking to gain unearned benefits and favors. Guidelines for managing these behaviors are presented and illustrated.

^{Source: Abstract of the book Social Work - Managing Manipulative Behavior in the Helping Relationship Dean H. Hepworth}

Self reflection in my role as a social worker

Now that I have made this clear to myself, the next phase follows. Not to accuse me of it and not to make a pit of murder from my heart. Guilt is notoriously bad. But responsibility is something completely different.

In any case, as a consultant for a public institution, I have the responsibility not to treat a client according to my personal preferences and dislikes. I can reject someone most certainly, if I really don't feel a single friendly impulse and for this reason alone would advise this person badly. It is my responsibility to reflect on what happens between a person and me when difficulties arise.

For the simple reason that I learn from it. Everything I learn benefits my clients in return. It is undisputed that sometimes a supervisor could be very helpful to me. It would be highly advisable to give social workers supervision hours. Since this is not possible for various reasons, which everyone can think of and which I do not call, I have to find my own ways and therefore also talk to my colleagues about cases which burden me. This does not always achieve the quality of a professional supervision but is better than nothing. If I get a higher fee, I would hire a supervisor to meet me myself. Basically, every investment in improving the quality of my work is a service to the community, because the actions have all their consequences.

This platform could make such an investment possible. In my view, every form of improvement in the quality of work is worthy of funding and has a significance that goes beyond my own personal attribution.

Interdependence - the great circle of events

To give a vivid example of exaggeration: The young man I am advising today, for example, because we really made progress in ten meetings and I helped him a great deal in his career planning, could one day set up a foundation, father two children and prevent a fight between two business partners, because he remembered the circular questions from our meetings. Those who have been prevented from being divided will then experience the beneficial effects of dispute resolution and apply it with their wives at home. The customers of the wives have to deal with well-balanced people with whom they like to do business. Also mutual children benefit from that. etc.

This overstated example, admittedly, is intended to illustrate the interdependence of all of us and this is meant by saying: "The movement of a butterfly wing in China can cause an earthquake in America." It also shows how many thousands and thousands of encounters a person has in time and space and that each of them has an effect.

I have at least developed the claim to cause as many useful and harmless effects in the world as possible and I use an ethic which is very supportive to me in many parts. It is the systemically integrative view of humanity and life itself, which I suspect to be part of the doctrine of Buddhism and its various sub-cultures.

Final statement

In the work with the client there were both productive and unproductive meetings. The trouble shooting was part of it. In my opinion, however, the client has to work on the foundations of her strategies and she cannot do that if she thinks I can accompany her on this path. I would only foment a dependency that has the opposite effect to what she still has to do in her personal development work.

Exchange of (practice) examples

I am actually on the search for other practitioners and would appreciate a common exchange of thoughts and support. So I am tagging this article with „privatepractice“ (which is btw a series title) and would like you to start a resteem-chain.

If you can provide this community with examples from your work, please use the comment section and link to your article.
I would like to know if you have a story where you supported someone or having been suported by a social worker/therapist or other pro. In case you have a story which shows support out of the pro-context and its a good one, this counts, too (for example a „Million Dollar advice“ from a friend with a certain effect).

Thank you for reading.

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^{To explain my work: I work as a freelancer for various social institutions. The areas include "social counselling" and coaching in the career context of young adults. I also advise private clients who come to me as self-payers. The work in social counselling is limited to concrete aids such as the formulation and understanding of applications for statutory social security systems (health, unemployment and pension insurance). In addition, I refer to offers in the district or in the institution's house if I believe that a problem cannot be solved by my advice.}

^{However, my work goes beyond the mere filling out and explaining of applications, as the clients bring with them all kinds of additional questions and interpretations or run the risk of getting into difficulties as far as they insist on certain strategies and behaviours that have a detrimental effect on them and the systems surrounding them. For example, by ignoring letters from bailiffs, landlords, job centres, etc. due to psycho-social difficulties, or by stiffening themselves to the fact that all these interaction partners want to harm them. My role is to inform the client about the respective functions of the authorities/help offers and to support them in dealing constructively with the demands placed on them.}

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^{Text sources:}

<sup>- Constructive Questions: "How do therapeutic questions work?" - Daniel Raymond McGee B.Ed., University of Victoria, 1979 M.A., University of British Columbia, 1991 Link
- Systemic Therapy with Individuals from Luigi Boscolo and Paolo Bertrando: Link
- Psychiatrist Irvin D. Yalom - Wikipedia
- Eur J Psychol. 2016 Nov; 12(4): 645–658. Published online 2016 Nov 18. PMC Journal Online - Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire / Anna Sutton Link
- The new conversations initiative question techniques
- The Magnetism of Power in Helping Relationships. Professional Attitude and Asymmetry- Theo N.M. Schuyt, Vrije Universiteit Amsterdam - Link
Book abstract - Social Work - Managing Manipulative Behavior in the Helping Relationship Dean H. Hepworth</sup>

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^{Picture sources:}

^{Book1: Photo by Aaron Burden on Unsplash
Book 2: Photo by Mona Eendra on Unsplash
Buddha Statue: Photo by Igor Ovsyannykov on Unsplash}

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