CLIENT AND WORKER RELATIONSHIPS IN EGO

PSYCHOLOGY AND OBJECT RELATIONS

FEATURES OF THE SOCIAL WORKER’S MANAGEMENT OF THE CLINICAL RELATIONSHIP

Attention to:

Transference

Countertransference

Boundaries

Sustainment

Modeling

Balancing support and demand behaviors

SUSTAINMENT

What the Worker Does

Listens actively and sympathetically

Conveys a continuing attitude of good will

Demonstrates consistency in the relationship

Directly expresses confidence or esteem

Non-verbally communicates interest, attentiveness

Realistically reassures the client about potential for goal achievement

Realistically encourages the client to persist

Possibly offers environmental support

What This Technique Does for the Client

Promotes a confiding relationship

Instills a sense of the worker’s competence and caring

Provides an antidote to alienation

Enhances morale and the determination to persist

Inspires and maintains the expectation of help

Creates a setting where confrontation can effectively take place

SELF-DISCLOSURE

Defined as sharing with the client opinions, thoughts, feelings, reactions to the client, and personal experiences

Self-involving disclosure - Commenting on the process of the worker/client interactions

Personal disclosure - Sharing a personal experience that may be relevant to the work being done (this can be risky)

TRANSFERENCE

Defined as all client reactions, conscious and unconscious, to the social worker

These include reactions based on experiences with similar types of people in the client’s past, and on here-and-now characteristics of the social worker

Positive vs. Negative Transference

Positive - the client is attracted to the practitioner, which can facilitate the engagement process

Negative - characterized by such feelings as anger, distrust, or fear that impede the client’s participation in the intervention

Positive transference does not necessarily facilitate the client’s achievement of goals; nor does negative transference necessarily prevent goal achievement

COUNTERTRANSFERENCE

The specific and generally conscious attitudes and

tendencies that a social worker has about a range of

clients (such as being drawn to working with children or having an aversion to older adults)

Common Signs of Countertransference Reactions

Dreading or eagerly anticipating a client

Differing promptness in responding to client’s needs

Thinking excessively about a client during non-work hours

Having trouble understanding a client’s problems

Being bored with a client

Feeling angry with a client for nonspecific reasons

Being unduly impressed with a client

Feeling defensive or hurt by a client’s criticisms

Performing tasks for clients that they are capable of doing for

themselves

Feeling uncomfortable about discussing certain topics with a client

Managing Countertransference Reactions

Be aware of your emotional and physical needs as much as

possible, and be wary of obtaining too much personal gratification

at the expense of a client

Understand the client’s cultural and community standards of

behavior, so as to appropriately assess behavior in those contexts

When appropriate, selectively use self-disclosure with the client to

process countertransference feelings. It is important for some

clients to learn that negative feelings can be contained and

processed

Boundaries

Boundaries are the generally unspoken rules that we internalize about the

physical and emotional limits of our relationships with other people.

They protect our privacy and reflect our individuality.

We differentially construct boundaries to facilitate our desire to be close

to, or separate from, others.

Each person’s boundaries are unique; we covertly communicate them to

suit our assumptions and intentions about particular relationships.

Aspects of Boundaries

Contact time: How much time is appropriate to spend in the company of the client? Will this vary depending on whether that time is spent face to face or on the phone?

Types of information: What is the appropriate range of topics to discuss with the client? Besides topics directly related to the problem area, what about social topics? What about politics, religion, and sex? How much depth can I be expected to provide about these topics?

Physical closeness What are our expectations about personal space when in each other’s company? How closely together will we sit? Can he touch me? What range of non-verbal communications is appropriate?

Territory. To which of my environmental spaces does the client have access? Is he or she restricted from others? Can we only meet at the agency? What about her home, or some community settings? Recreational settings?

Emotional space. To what extent am I willing to share my feelings about sensitive topics with the client? About what topics will we be expected to share feelings?

Benefits to Clients of Clear Boundaries

A relationship in which the client feels affirmed and respected

A predictable environment in which the client is likely to feel more comfortable sharing

personal information

A basis from which to determine whether and when the social worker can cross certain

boundaries. Boundary crossing implies an appropriate efforts to adjust a boundary

toward greater intimacy, while a boundary violation is an inappropriate entry into a

person’s privacy and space.

For some clients the external structure produced by clear boundaries helps to maintain a

clearer internal ego structure.

Benefits to The Social Worker of Clear Boundaries

Role clarity regarding the range and limits of clinical activities

A basis from which to make decisions about how and when to cross physical

or psychological boundaries

A means of preventing burnout by avoiding role overload

Physical safety, when territorial boundaries are maintained

Warning Signs of Possible Boundary Violations

Intrusion into the client’s territory (physical or geographic)

Some types of self-disclosure

Being overly “social” with clients

Investigating certain details of clients’ personal lives

Sharing information about a client with an outside party

Loaning, trading, or selling items to a client

Accepting or giving gifts

(Fluid boundaries between home and work environments may

indicate that the social worker is at-risk for job burnout)

Factors To Consider When Assessing One’s Own Boundary Conduct

The functioning level of the client (his or her ability to use goodjudgment)

The client’s history in relationships (patterns of behavior and judgment)

The history of this particular relationship (what patterns of interactionhave been established, and whether a boundary-crossing activity by

theworker is likely to be growth-enhancing or a setback for the client)

Cultural norms of both the worker and client.

Legal liabilities

The NASW Code of Ethics

Managing Boundary Dilemmas

Set clear boundaries with clients at the beginning of those relationships

Clarify boundaries with the client over time, as they will change

Consider the preservation of the client’s privacy to be a major guiding

value.

Secure the client’s informed consent for all service activities

Use peer consolation and formal supervision routinely