Home / The Caregiver-Client Relationship and Self-Care / The Caregiver-Client Relationship (Part 2) / Responsibility, Control, Giving Permission

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Introduction

In this section we discuss several central points of the transformative process of the client, namely putting the work of it into the hands of the client.

We are now beginning to use another term for therapy, that is, the transformative process for the client, partly to remove the stigma from it and to take it out of the pathological sphere. Also, the term “therapy” is limited legally in many contexts, and we urge you not to use it.

In passing, we have mentioned the points discussed in this section before. We feel that they are essential if the relationship between the client and the caregiver is to succeed and if the transformative process for the client is to succeed.

As always, we ask you to complete all of the activities described. Also, as always, we remind you not to make it possible to identify any person. This can do great damage and is unethical.

Getting the Client Take Responsibility for His or Her Own Life

We cannot stress strongly enough that it is the client and not the caregiver who has the responsibility for the client’s life. The role of the caregiver is to encourage and support the client. In the end, however, it is the client who determines what happens to him or her and what actions he or she takes. The caregiver can point out resources and places that the client can get information and conceivably can assist the client in making connections, but we feel that doing more than that is not in the interest of client. Clients will, of course, make mistakes and will learn from them. Among other things, taking responsibility for the life of the client makes him or her dependent on the caregiver and can give the client a sense that he or she is not capable of living in the real world. Many clients like this dependency and express a desire for it and wish to avoid taking responsibility. Unfortunately, we also know that some caregivers stroke their own egos through taking responsibility for clients. Again, this is a topic for supervision.

In our view, there are very few circumstances in which this principle does not apply. Those are when the client would physically harm himself or herself or another person or an animal. Another circumstance is when the person is a psychopath or a sociopath.

Otherwise, as we have said several times, we cannot and should not control what the client does.

Activities

• Describe a situation in which the caregiver took responsibility for at least parts of the life of a client. How did the caregiver feel? How did the client feel? What happened?
• Describe a situation in which the client took responsibility for his or her own life, perhaps supported and encouraged by the caregiver. How did the caregiver feel? How did the client feel? What happened?
• Are there any circumstances in which the client should not take responsibility for his or her own life? Give your own experience if you have it.

Giving the Client Control

Many clients feel completely powerless to control their own lives, that everything is being controlled from the outside by other people and by circumstances. While some things are, of course, determined, a surprising number of things can be manipulated and changed, even if slightly. Frequently, the client is not used to doing that. This kind of control is extremely good for the self-image of the client and for his or her self-esteem. Thus, it is one of the roles of the caregiver to encourage and support the client in taking as much control as possible. To external people in the client’s life, this may seem like rebellion. Again, it is the role of caregiver to support and encourage the client in this, despite the pushback. Very infrequently, this can go too far. Eventually, a balance will be reached with the client having as much control as possible. Of course, this is very individual.

Activities

• Describe a situation in which giving a client more control assisted the client. How did the process go? What was the final balance that was reached?
• Are there circumstances in which the client should not have control?

Giving the Client Permission

Many people feel that they don’t have permission to have certain feelings. One example is that men in many cultures cannot be “weak” or cry or get angry toward relatives, friends, or others. In difficult situations, frequently, people feel that they must be strong. Another situation that we have seen frequently is that of being angry at and/or not loving an abusive parent or other relative or someone else who has influence in the client’s life and not having the permission to express that, feeling that it is “not right”. In some places, even speaking against the government or “authority” in general is not permitted. In our view, one role of the caregiver is to give the client permission to have such feelings and to express them. To be clear, the feelings are present in any case. Getting them out and taking action about them both internally and externally is an important part of the transformative process for the client.

Activities

• Describe a situation in which a client did not have permission to express his or her feelings. What behavior did the client show?
• Describe a situation in which you gave a client permission to express his or her feelings. What happened then?
• Are there situations in which it is not good for a person to express his or her feelings?

Final Remarks

Taking responsibility for one’s own life, taking control and power and not feeling powerless and having the permission to express feelings are extremely important for the transformative processes for every client. It is the responsibility of the caregiver to facilitate these processes.