welcome to hn330 unit 3 seminar
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Image from: http://www.drjohnmurphy.com/culture.jpg. Welcome to HN330- Unit 3 Seminar. Competences, Boundaries, and Problem Ownership.

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Last week we discussed the ecological model and the 4 Steps of Assessment. Briefly describe one new thing you learned that you think you will use in your practice.
cultural competence
  • Our perceptions and attitudes are influenced by our own culture.
  • Ethically we have a responsibility to become acquainted with cultures that differ from our own and with which we have extensive contact.
  • The only way to work with people from different cultures is to see them as unique individuals and make every effort to perceive them accurately.
  • Do you know what your cultural values and beliefs are and how they might influence your work with clients?
where do our differences lie
  • Cultures - Generally refers to an entire society within a specific political boundary wherein the citizens share a common understanding.
  • Subcultures - Within a society are smaller groups who hold the dominant culture but also hold specific ideas and beliefs that may differ from the dominant culture in some ways.
  • Race and Ethnic Groups - Societies can have different races and ethic groups within them. Race refers to a group who are biologically similar while ethnic group refers to a group of people who share a common cultural heritage.
  • Do you identify with a particular race or ethnic group? You don’t have to share this unless you choose to, but please think about how this might influence your work with clients.
we versus them attitude
  • We learn who is in our in-group and who are in the out groups through our socialization.
  • In-groups are seen as acceptable. They are seen as being more like ourselves.
  • Out-groups are generally groups with whom we do not often interact and with whom we feel uncomfortable
  • We often describe in-groups favorably while we are often suspicious of the motives of out-groups.
  • We-Versus-Them attitude develops when we use our own culture to judge the culture of others.
  • Have you experienced “we-versus-them” and how did it make you feel?
  • When we meet people who do not think, act, or believe as we do we often find them strange.
  • Often their ways of thinking and acting are unfamiliar to us.
  • It is always the dominant culture that defines who is a stranger.
  • As the world becomes more global we are likely to encounter people who are different from ourselves.
  • It is often up to the human service worker to help immigrants make a smooth adjustment to a new culture. Immigrants who become competent in the dominant culture are healthier.
  • Can immigrants gain competency in their new adopted culture without giving up their traditional values and beliefs? As human service workers how can we help with this?
anxiety and uncertainty
  • It is common to feel anxious when we attempt to interact with individuals from different cultures.
  • We need to manage those feelings so they do not impede our communication with others.
  • In order to feel less anxious we may interpret the stranger’s behavior or beliefs through our own culture.
  • The more we can feel the person is like us, the less likely we are to feel anxious.
  • What can we do to reduce our anxiety about people from other cultures?
obstacles to understanding
  • Stereotypes - assumptions about people from a particular group and we do not question these assumptions.
  • Ethnocentrism - we use the standards of our own culture to judge the behavior and culture of other people.
  • Prejudice - based on a stereotypewe avoid or deny certain things to people from this group.
  • Conflict - cultural misunderstandings turn into hostility and conflict.
  • What can you do personally to reduce or eliminate stereotypes and prejudice?
  • Attitudes we hold about other people are bound to be communicated to them one way or the other.
  • Positive and supportive attitudes foster rapport.
  • Superior or disdainful attitudes are bound to be communicated to another no matter how we try to hide them.
  • If you forgive yourself for your mistakes and troubles and see these as part of growing, it is easier to understand and support others through their own mistakes and struggles.
  • Good attitudes begin with being tolerant of yourself. It you see yourself as basically okay you will see others in that light as well.
  • Have you looked at your attitude lately? Try asking someone you work with or a friend how they would describe your attitude toward people that are different. What do you think they might say?
basic helping attitudes

There are three basic helping attitudes

  • Warmth - In your presence clients feel valued, worthy of being understood.
  • Genuineness - you are open, truthful, an authentic person.
  • Empathy - you are able to put yourself in another’s shoes; or better yet imagine what it is like for them to be in their shoes. You can accurately communicate to clients an understanding of their underlying emotions.
  • Which of these three do you think describes you the best, why?
on being judgmental
  • Because you are the worker and the clients are clients does not make you a better person than they right?
  • Judging people by your own standards is not helpful.
  • Comparing your life to theirs, your choices to their choices, is again not helpful and puts you in the “expert” role.
  • When you sit in judgment of another person you erect a barrier to real understanding, rapport; and the opportunity to be of real assistance.
  • What can you do to reassure a client you are not “judging” them? Can you name a specific behavior which conveys understanding and acceptance versus judgment?
  • All of our clients will not be cooperative and grateful.
  • It is unrealistic to expect that clients will be, if everything was wonderful in their life they would not need our help.
  • What are some things human service workers might do that discourage clients instead of encouraging and empowering them?
how clients are discouraged

There are many ways clients become discouraged by workers

  • Telling clients “how you did it” or “how you succeeded”
  • Pushing or shaming a client into working on a goal
  • Focusing exclusively on mistakes
  • Demanding unrealistic things
  • Intimidating the client
  • Failing to notice positive change and client strengths
  • Not listening or acting bored
  • Discouraging clients from trying new things
understanding boundaries
  • There are boundaries between clients and workers that prevent ethical violations and facilitate the helping relationship.
  • It is the worker who is responsible for maintaining boundaries.
  • In addition to boundaries human service workers need to understand the concept of transference and countertransference
  • What are some of the ways we might cross boundaries if we are not careful?
understanding boundaries1

Ways we cross boundaries:

  • The client reminds us of ourselves (countertransference).
  • The client is dealing with a problem we once had (inappropriate self-disclosure).
  • We are using our work with clients to resolve our own issues (inappropriate countertransference).
  • We want the client to use solutions we used to solve a similar problem in our own lives (ego power trip).
  • We want the client to use a solution so that we appear more effective and competent as workers (unethical and manipulative).
  • Transference is a collection of feelings and attitudes the client holds about you.
  • Accept transference when it exists. Transference is neither a good thing or a bad thing.
  • Sometimes we remind clients of someone they knew in the past.
  • Clients may only be dimly aware of that. They just know that you remind them of someone.
  • Positive transference occurs when the client likes you.
  • Negative transference occurs when the client does not.
  • When clients act in unexpected and somewhat inappropriate ways do not take it personally.
  • Reflective listening creates a safe environment.
  • Countertransference occurs when the worker projects onto the client emotions and attitudes.
  • It occurs because the client reminds us of someone in the past or because the clients issues remind us of our own.
  • Countertransference can be negative or positive.
  • We may give good service to someone who reminds us of a dear aunt, while giving poor service to someone who reminds us of a bully.
  • It is important to be self-aware of our feelings about another. It is not acceptable to allow them to interfere with our service to others.
  • Countertransference feelings may signal we have old issues that need to be resolved.
case study of the proud case manager
Case study of the proud case manager…
  • Elana is feeling very proud of herself. She talked to a client who had many problems a lot of stress this afternoon. Elana put everything down on paper, while her client sat quietly by the desk and sipped a coffee. Then Elana decided on the best course of action for this situation and told her client what they needed to do to feel better. The client finished their coffee and said “I understand, it looks like everything will be fine now”; and left Elana’s office.
  • What do you think? Were any boundaries blurred here, how would you have handled this situation?
the case of the excited dv worker
The case of the excited DV worker…
  • Peter was living in a very abusive relationship with a woman he met in high school. He had been raised by his parents to never hit a woman, and he often found himself on the receiving end of brutal emotional attacks by his girlfriend and was victim to several serious attacks, one with a knife left him seriously injured and scarred for life. After several years of this violent abuse, he finally went to see a counselor. His counselor, Mary, specializes in domestic violence, in fact she was a survivor of domestic violence herself, but finally escaped and now has a relationship with a peaceful and supportive man. Mary believes Peter needs to leave right away, and find a new life just like she did. She shares details of how bad her abusive relationship was and how wonderful it is now and encourages Peter to go home today, pack, and leave to start a new life.
  • What do you think? Were any boundaries blurred here, how would you have handled this situation?
clarifying who owns the problem
Clarifying Who Owns the Problem…
  • When working with a client, it is important to establish “who owns the problem”.
  • The person whose NEEDS are NOT being met owns the problem.
  • It is not our job as case managers to “fix” our client’s problems.
  • Why is it important that we know who owns the problem?
why knowing who owns the problem is important
Why knowing who “owns the problem” is important…
  • You will know who is responsible for solving the problem.
  • Meddling is disrespectful
  • The client loses opportunities to grow.
  • Keep your clients in a position of authority over their lives to the greatest extent possible.
if the client owns the problem
If the CLIENT owns the problem…
  • Listen rather than providing a solution.
  • Give the client options.
  • Ask the client for ideas.
  • Just become someone tells you about the problem does not mean you must solve it.
  • When you allow clients to work on their own issues and problems, you respect their right to privacy and self-determination and provide them with a growth opportunity.
it s a strategic decision
It’s a strategic decision…
  • How do we decide how involved to get when assisting a client with a problem?
  • How does the case management role differ from the friend role when working with someone to solve a problem?
  • Use your knowledge of the client, assess their strengths and limitations.
  • Sometimes solving the problem for the client and doing the footwork for them is easier, but it isn’t always “better” for the client.
  • As case managers, we are a great RESOURCE to our clients.
if you own the problem
If YOU own the problem…
  • If you are having a problem, that is, your needs are not being met, you will understand that the resolution of the problem is ultimately your responsibility.
  • What might be an example of a situation where YOU might own the problem?
  • You invite the client to assist you in finding a solution to the problem at hand.
  • How might you handle it if the client was not interested in helping arrive at a solution?
if you both own the problem
If you BOTH own the problem…
  • Sometimes the problem will lie with both the case manager and the client.
  • These are opportunities to negotiate.
  • When you work on a solution collaboratively with the client, you provide the client with an important experience in problem solving.
  • Working on a problem together can help save rapport and also build trust in the relationship.
let s give it a try who owns the problem
Let’s give it a try…Who owns the problem…
  • You work at a victim/witness resource center where you assist the victims of crime to handle the emotional and technical ramifications of the crime before they go to court. The husband of a victim, a woman who was carjacked by a teenager one night, takes you aside and asks you to persuade his wife to drop the charges. He tells you confidentially that it would be better for his wife if “she did not have to go through this”. Who owns the problem?
  • A woman you have placed in temporary housing is angered by the loud music of her neighbors. She appeals to you to do something about it. Who owns the problem?
  • Your client consistently arrives 15 minutes late to all of her appointment. This causes your schedule to be thrown off the rest of the day. Who owns the problem?
an exercise in strategy
An exercise in strategy…

Situation: Hannah recently went blind due to an accident with chemicals at the company where she worked. She is asking for a service plan that will help her regain some independence.

Scenario #1: Hannah is a PhD chemist with the corporation where the accident occurred. She has received a huge settlement from the corporations insurance company. The corporation has said she can coem back to work if she can be retrained in some way, possibly with computers. Hannah has a supportive husband and many close friends. How do you help?

an exercise in strategy1
An exercise in strategy…

Situation: Hannah recently went blind due to an accident with chemicals at the company where she worked. She is asking for a service plan that will help her regain some independence.

Scenario #2: Hannah is a student working on a chemical engineering degree. She worked part time to pay her school expenses at a large chemical corporation. She wants to remain in school. Her family is supportive of this, but they live in another state. Hannah’s roommates seem hesitant about her returning to live with them in their downtown apartment now that she is blind. How do you help?