5.3 The Challenges of Working with Clients
Some students have already had volunteer or job experiences that involved working with clients in a human services setting. Many, if not most, have not, so the internship may be the first time they experience direct client interactions as a developing professional. It is important to remember that even as a new human services professional, you are participating in this internship to help the clients of the agency and to work with them. While these duties may involve a lot of new responsibilities, it is important to keep in mind that your previous instructors and coursework provided valuable information and knowledge. These resources, along with your own personality, can now be applied to a real-world professional setting and the clients it serves.
At this point in your education, you should have at least some experience working directly with clients. This may include office visits, home visits, or telephone calls. Working with other adults is always challenging, no matter how much experience you have. Human service professionals often describe the work as unpredictable and different every day. While this can be exciting, it can also challenge us. In the following sections, we discuss three of the most common interpersonal issues that can appear when working with clients: transference, countertransference, and overidentification.
Transference and Countertransference
Transference and countertransference are keywords in human services. Both of these terms come from the work of Sigmund Freud but are relevant to professionals regardless of what perspective they use. Transference involves a client consciously or unconsciously responding to you as a professional in a manner that is based on unresolved conflicts a person has from their past. For instance, if you are in a position of authority and are working with someone who has had conflicts with authority figures in the past, that person may “transfer” their anger or resistance to you.
This transference causes them to react to you in a way you did not intend. Indeed, their reaction often has nothing to do with you as an individual worker. As mentioned, they may feel you represent authority to them. You may remind them of a family member with whom they had a strained relationship. This can result in difficult communication patterns that are hard to unravel. It is important to keep in mind that strong or unexpected responses are often not about you, so do not take it personally. Figure 5.1 shows an adult therapist talking to a younger adult client. There could be the risk of the client “transferring” their feelings about their parent or an older sibling onto the therapist.
If you also have unresolved issues, then you may project your own issues on your client(s), which is called countertransference. Sometimes, the unresolved issues generate positive feelings, and sometimes they evoke negative ones. For example, if a person resists your authority by treating you negatively, they may be living out unresolved conflicts they have with their parents. If you, as a clinician, “like” a client because they consciously or unconsciously remind you of someone you care for, you may become too attached to them and extend extra time or favors to them at the expense of others.
Knowing and setting boundaries are standard ways of managing transference and countertransference in the human services settings. Depending on the type of work your agency does, clients do not typically understand this dimension of their interactions with you. One good indicator of negative countertransference between you and a client is that you find them “getting under your skin.” Another warning signal is finding yourself thinking about them too much. These signs should remind you to bring up the possibility of transference and countertransference with your supervisor or instructor. Doing that early usually helps avoid unnecessary problems.
This dimension of human services work is important to know about because it also involves unconscious feelings concerning gender, race, social class, age, and so on. Example: Sue, a client you have been working with daily, may not view you as part of the professional staff because you are “only” an intern, and she develops feelings for you. If a client asks for a date, remember to remain professional and establish clear boundaries; be firm but polite in doing so. In Sue’s case, you might explain that dating a client is both unprofessional and prohibited by the agency, and you aren’t willing to violate these standards. If the client continues with inappropriate behavior, be sure to bring that up with your supervisor.
When transference and countertransference are at play, dual relationships become a risk. Having a relationship with a client outside of the professional relationship is a cause for ethical concern and will be addressed in detail in Chapter 7.
Overidentification
Another common issue faced by human service workers is called overidentification. Overidentification is when your sense of empathy is so strong that you lose the boundary between what is your role and responsibility and what belongs to the client. It is critical to be able to empathize with your clients, but you must always be aware of your role as a professional helper.
Overidentification can easily happen when there are similarities that you share with your client. For example, you are working with homeless youth. In your younger years, you spent some time on the streets before finding stable housing again. In fact, you may have been drawn to this work because you had a similar experience. You may have thought, “No one was there for me, so I am going to be there for someone else.” Another trigger for overidentification can be if you share a similar cultural background (Urdang, 2010). You may have been recruited for your placement specifically because you share a cultural heritage with the clients.
Overidentification can lead to a loss of objectivity about our work with clients. We may think, “This is how I feel as a Mexican immigrant, therefore, my client must feel the same way.” When you overidentify, you risk becoming part of the problem instead of part of the solution. It is important to understand professional boundaries between you and your clients. This is discussed more in the chapter on ethics. If you have feelings of overidentification, it is important to ask for help from your supervisor or field instructor. We will talk about how overidentification can lead to ethical dilemmas in Chapter 7.
The Challenges of Working with Clients Licenses and Attributions
“The Challenges of Working with Clients” is adapted by Yvonne Smith LCSW from “Succeeding at Your Internship: A Handbook Written for and with Students” by Christopher J. Mruk, and John C. Moor, Bowling Green State University Libraries. This work is licensed under CC BY NC SA 4.0.
Figure 5.2 Young Woman Talking with Therapist by Polina Zimmerman is licensed under the Pexels License.
A credit class in which students apply theory to practice by using what you have learned in coursework in a real-world setting with a supervisor/mentor who is invested in your growth and development (often also referred to as fieldwork or practicum).
a client’s unconscious positive or negative feelings or behaviors triggered by another, often the therapist or clinician. The response often is unrelated to the actual professional, but it due to a previous issue in the life of the client
a professional’s unconscious feelings and behaviors aroused by a client, patient, consumer of services, or even a supervisor. Countertransference is natural and may be positive or negative in its tone. It is often unrelated to the specific client but brought on by some reminder of a previous relationship.
the inability to differentiate between one’s own life, work and challenges and those of a client (or clients).
the verbal, and non-verbal exchange of information between two or more people.
the ability to determine our own safe zones to our emotions. Keeping separate needs, desires, thoughts, and feelings from those of others. In the human services context, boundaries most often refer to keeping our needs and wants separate from those of our clients.
a relationship between a human services worker and another person or group that involves a conflict of interest. Common examples include dating a client, or using a client for the clinician’s own personal or financial gain
Ethics are a code of morals or a philosophy that guides an individual’s behaviors and actions. Ethics also include a set of standards or code of conduct set forth by a company or profession.
situations in which you are faced with unclear choices about how to handle a situation with a client. This may be a difference between your ethical guidelines and another’s, a conflict between your personal and professional ethics, or a clash between two competing ethical standards.