Relearning the work

I keep a postcard at my desk at work that I got at a conference when I was in graduate school. I've had it for years but I haven't had an office in so long, it's most recently been hanging out in our guest room (to inspire my guests, I suppose). It says: "I cannot learn other people's lessons for them. They must do the work themselves, and they will do it when they are ready." I have read it a million times but I don't always retain it. Do you know what I mean? It's similar to that social work joke (yeah, I'm telling it): how many social workers does it take to change a lightbulb? Just one but the lightbulb has to want to change. Groan away but the point stands. And whether it's a bad joke or my little postcard, I know this lesson to be true. I know it from personal and professional experience. So why do I sometimes forget it?

Here's a good example. When I was a medical case manager I had a lot of clients who were constantly in crisis, usually financially. Every month we would talk about where their money went and how to budget and I would help them fill out forms to get services. Every month I would say, "you should have enough money if you do x, y, and z." And they would agree. Then we would do it all again the following month.

The thing is, I was doing it wrong. I didn't allow my clients to come up with their own goals; I told them what the goal should be. I'm reading about motivational interviewing right now, which is a strategy that can be really useful in changing behavior. One of the tenets about MI that really speaks to me was that no one wants to fail. No one wants to set an unachievable goal but often that's what we're asking patients to do: we've decided what their goal should be so we've also come up with the solution to acheiving it. It's a theme I sometimes saw in hospice too: for months or years, patients had been told to "fight" their disease. Then suddenly, we told them to accept their death. We didn't give them a choice to change their goal so much as tell them the goal had changed while they were doing something different.

I think most helping professionals like to consider themselves good listeners; I know I pride myself on it. But I'm not sure we always hear what our clients are saying. We walk in with a goal already in mind and that leads our visit. Motivational interviewing encourages the practitioner to help the client name their own goal. It's difficult to want to achieve something you have no stake in. Helping clients name their own goals and helping them see what changes they can make to accomplish those goals makes them stake-holders, not just people who get lectured and then feel guilty when their problems don't go away. 

Now, in this new role, I keep looking at my postcard. Not only can I not do someone else's work for them, I can't tell them what the work should be. I became a social worker because I wanted to help people. It's been a long journey of reminding myself that I can only help people who want to be helped. And even then, I can only do so much.