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Social Work and the Business of Change

06 Jul

When I was doing my undergraduate degree in Social Work, all of my professors referred to Social Workers as change agents. We were supposed to work with individuals, groups and families to effect positive change. This has always been the motivation for my practice. This has always been the reason I wanted to be a Social Worker. However, as much as we may learn about the process of change, as much as we are told that “we need to meet clients where they are,” I think we have some over inflated, over exaggerated expectations of clients when it comes to change.

Just to revisit it quickly, the stages of change from the Transtheorretical Model (Prochaska, 1977) are pre-contemplation (not ready for or considering change or seeing a need to change), contemplation (recognising the need for change and considering it but not sure), preparation (ready to change and trying to change), action (actively taking steps to change), maintenance (staying on track; maintaining changes that have been made) and relapse (regression to previous stages; falling back into old behaviours). You learn that, as a Social Worker, you have to assess at which stage your client finds himself/herself and actively try to move them through the stages. There are websites that give prompts as to how to support clients at each stage of this process. I think it is important to understand that relapse is part of this process and what is needed is support at this time as well as encouragement to start again, empowering them with the fact that they have done it before.

I think, as practitioners we forget 2 very important facts when working with clients. First, we forget that our clients are human. Second, we forget that we are human. In so doing, we begin to think of our clients as “the other”. I am in no way advocating crossing professional boundaries. I am saying that we need to understand, especially when it comes to change, that life is hard when you are entrenched in a way of living or behaviour that has survived everything else that has come and gone in your life.

Let’s do some self-reflection for a moment. Think about all of your bad habits and consider the following:

          How many times have you tried to change?

          How many times have you failed?

          What worked to help you stop?

          What helped you change the behaviour?

          What hindered you? What were the triggers to this behaviour or habit?

          Did having someone harp on and on about how much you need to change help you at all?

As professionals we have the privilege of knowing that there are numerous tools or techniques out there designed to help us kick bad habits and change behaviour. Our clients may not; or there may be a reason they are not seeking help. It doesn’t help when Lord or Madame Social Worker enter their lives and make them feel even worse for not doing the things that they know they should do. Change is hard. It is made even harder when you have people telling you to make changes and you have no idea where to start.

And I can hear all the Social Workers out there saying “we do the referrals all they have to do is attend the appointments.” Really??? Really??? Most of the problems we deal have been in existence for our clients longer than we have been involved so they are changing an ingrained behaviour. Not to mention the fact that these behaviours or habits may be coping mechanisms. Trust me, I am an emotional eater and an emotional shopper and yes I know I need to change but I just LOVE shoes and carbohydrates!!! So we are asking people to stop doing things that make them feel better at the worst points in their lives without giving them anything with which to replace it. It is a lot more beneficial to teach them more appropriate coping mechanisms alongside the changes. It makes them just a tad more palatable.

When you practice, remember your own experiences with what you are asking of your clients where applicable. Where you do not have the experience, and even where you do, ask them what it is like for them. Find out when the behaviours started and what they mean for the person/family. Find out what else can be used to replace the behaviour that needs to be changed. Find out what the current triggers are because these may be different from what contributed to the start of the behaviour.

We need to work within the client’s exiting life circumstances. I’m not saying be naïve; you need to challenge your clients and their excuses as to why they can’t or aren’t changing. They also need to understand where there are consequences to not changing. What I am saying in we need to get back to the original person-in-environment and strengths based models.

We need to see clients as individuals no matter how many times you have seen a similar set of circumstances or addressed the same issue(s) previously. Every problem is different because every person is different. Every person brings a different set of beliefs and circumstances to your desk. See your clients as people who need help. Some may need more help than others, where you’re not sure, ask.

Change is a process. It doesn’t happen quickly and it doesn’t happen easily. It may even cause more problems. But, as the professional, it is your job to be monitoring the change process and having regular input to address whatever may come up.

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Posted by on July 6, 2013 in Social Work Practice

 

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