Home / The Caregiver-Client Relationship and Self-Care / The Caregiver-Client Relationship (Part 2) / Some points about language and getting to know the client

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Introduction

In this section, we’ll look at a few more basic factors that assist with the caregiver-client relationship, these with regard to language and the way that you work with the client. Some of these may seem obvious to you. However, these are things that we frequently forget or assume that we’re doing. Our point here is to make you aware of them and to encourage you to carry them out. It takes experience to do all of this in a way that works. Also, each client – and each caregiver – is different.

Please be sure to carry out the activities. You don’t have to reveal your answers to anyone. Also, please remember again that, if you do post answers, do not reveal any information that may make it possible to identify a client.

Using Language that the Person Can Understand

Using a language that the client can understand doesn’t have to do only with a language or dialect or accent that is foreign either to the client or to the caregiver. It also relates to words that are within the experience of both people. This has to do with the education, social class, occupation, and other points in the lives of both. It is important to realize that this can go in both directions. It also is important to respect the cultures of both people. This can be a minefield. We can give a few examples here. A doctor we knew once asked a woman to pronate her arm (to extend it and raise it with the palm in front of her). Of course, she had no idea of what he was talking about. Another time, one of us, a male, used the word “luv” in the British sense to a woman with whom he was friendly, not in the sense of wanting to have a relationship with her but as a synonym for “mate” or “friend”. She interpreted this as offensive and their relationship was ruined. Especially with the complex histories that are a large part of the work that we are doing, this kind of thing can lead to serious problems.

As we’ll see a little further on this page, it is a rule to ask for clarification of what you don’t understand of what the client is saying and to tell the client that it is fine for him or her to ask if he or she doesn’t understand you or if he or she doesn’t know why you’re asking. If communication is not possible or if there are misunderstandings, we urge you to get an interpreter. We will discuss this issue of the use of language, and of interpreters, in great detail in the course on communication.

Activities

• Describe one or more situations in which there were problems in which two people didn’t understand one another.
• Describe a situation in which people thought they understood one another but didn’t.
• Watch these two classic videos which illustrate the point.
  https://www.youtube.com/watch?v=pV1IP4N9ajg
  https://www.youtube.com/watch?v=B3Vx0VvcQyY

Taking the Time and Getting As Much Information as Possible

The more information that you have about a person the more you can assist. Getting that information may not be an easy process for a variety of reasons. One extremely important aspect of this is gaining and maintain trust. We will devote another section of this course entirely to that issue. Obviously, the relationship between the caregiver and the client is important in getting this information, and that is one reason for this course. Another aspect is knowing what is relevant to ask. We will devote several sections of the courses on communication and psychology to that. Still another aspect is the skills of communication of both the caregiver and the client.

Our experience is that getting sufficient information about a person to meet his or her needs takes time and energy and patience and persistence. It cannot be done quickly under most circumstances. Unfortunately, the workloads of many people doing this kind of work are overburdened and thus don’t allow the caregiver to do the job properly. Our advice is figure out how much time you need and to discuss this within your organization if you need to. Otherwise, you are doing half-work.

Activities

• Describe a situation in which the relationship between you and the client didn’t allow you to get the information you wanted.
• Describe a situation in which you didn’t know what to ask the client.
• Describe a situation in which other factors got in the way of your getting the information that you wanted from the client.
• Describe a situation in which you didn’t have sufficient time to work with a client properly. What happened? How did you feel? How did the client feel? What were the consequences?
• Are there circumstances in which it is not important to get sufficient information about a client or when time isn’t important?

Clarification

It is essential that the caregiver and the client understand one another as well as possible. Even though, as we have said, the main role of the caregiver is as a listener and facilitator, each must know what the other is saying, thinking, and feeling. Thus, it is important for the caregiver to ask for clarification when necessary and to let the client know that he or she can do the same. Furthermore, asking for clarification can encourage the client to go deeper.

There are a number of aspects on which we can and should ask for clarification.

Feelings

The questions, “How do you feel now?” and “How did you feel then?” probably are the most important questions that we can ask. One of the points of working with traumatic events is the release of feelings. There are many reasons that people don’t express them and even deny that they have them. One is feeling that the person must be strong. This particularly applies to men. This also may be cultural. Also, we have had the experience that, in war and other disastrous situations, there is a collective societal desire to be strong. Furthermore, a person may feel shame and/or guilt about his or her feelings. To be quite clear, a large part of the healing process for any traumatic event is the expression of feelings. Thus, one of our tasks is to give a person permission to express to express feelings and to be there for the person during the process.

Activities

• Give a situation in which feelings were not expressed. What happened to the person?
• Give a situation in which feelings were expressed. What happened to the person?
• Are there situations in which feelings should not be expressed?
  ​

Motives

It also is very important to clarify the motives for actions. Why did the client do what she or he did and/or why is he or she doing it now? Did the person learn the action somewhere? Were the actions for the good of another person? Is it revenge? Is it out of guilt and/or shame? Is it for profit of some sort? Are these motives part of the past or are they also relevant now? Again, the clarification of motives is part of the therapeutic process, getting the person to realize what is going on. The motives may be quite complicated, hence the need for clarification.

Activities

• Describe one or more situations in which the motives for an action were unclear. How did clarification assist the client?
• Describe a situation in which the motives for an action were part of a past pattern that was no longer justified.
• Describe a situation in which motives were purely for profit.
• When is asking for clarification of motives not justified?

Interests

Interests and motives are similar but not the same. Interests generally involve something that will profit the person in some way. This profit need not be financial. One example is what is known as the profit of illness, that is, to gain attention by being ill. Another interest of a person might be to be in a social situation or just the opposite, that is, to escape from a difficult situation. Again, there may have been interests that were relevant for the past but no longer are so now. For the therapeutic process, it is important for the client and for the caregiver to realize what the interests of the client are and deal with them.

Activities

• Describe a situation in which interests played an undesirable role for a client.
• Describe a situation in which interests assisted a client.
• When is asking for the clarification of interests not justified or important?

Content and Its Interpretation

A situation can be perceived and interpreted in many different ways. People see situations according to their own views of things. Both facts and perceptions are important in facilitating work with traumas and it is important to ask clients to clarify both. A large variety of factors, including virtually every factor considered in this section and more can contribute to that perception. Thus, feelings, motives, interests, assumptions, prejudices, expectations, personality, education, experience, and many more factors can play a role. It is important for both the caregiver and the client to understand as many of these as possible to be able to deal with the situation. Again, we stress that it is important to continue to ask to get as clear a picture as possible. Again, this can be a very time-consuming process, and patience and persistence with it are essential.

Activities

• Describe a situation in which the client’s perception played a significant role in his or her description of the content of an incident or a situation.
• Are there situations in which it is not important to ask for the clarification of content?

Assumptions

The assumptions of the caregiver and those of the client may be very different. This applies to virtually every situation imaginable. Thus, it is very important for the caregiver to find out what the assumptions of the client are and thus to ask for clarification of them. Frequently, these assumptions will need correction or modification. This can apply to the process of giving care as well as to situations within the life of the client. Work with these assumptions can be a fundamental part of the process of transforming the life of the client. They also may very significantly affect the relationship between the caregiver and the client.

Activities

• Describe a situation in which the client’s assumptions played a significant role in his or her perception of a situation in his or her life.
• Describe a situation in which the client’s assumptions played a role in the relationship between them.
• Describe a situation in which the caregiver’s assumptions played a role in the relationship between them.
• Are there situations in which it is not important to ask for the clarification of assumptions?

Prejudices

Prejudices are very similar to assumptions. Like assumptions, we all have them, including us as caregivers. These may have to do with race, religion, occupation, social or economic class, national origin, sexual orientation, etc. There is no one who doesn’t have them to one degree or another. Again, it is very important to clarify them. They may arise unexpectedly in the course of a therapeutic process. As caregivers, they may arise in relation to our reactions to certain clients.

Activities

• Describe a situation in which the client’s prejudices played a significant role in his or her perception of a situation in his or her life.
• Describe a situation in which the caregiver’s prejudices played a role in the relationship between the caregiver and a client or another person.
• Are there situations in which it is not important to ask for the clarification of prejudices?

Expectations

Both clients and caregivers have expectations of one another. It is very important to clarify these at the beginning of the relationship and throughout the relationship. The clarification of expectations also is important for the client in the sense of what the client expects from other people and groups – partners, friends, a state body, an institution, as examples. Another aspect of this are the expectations that the person has of himself or herself. The expectations need to be realistic and need to be corrected if they are not. The expectations may be too high or too low. This coming to reality is an important part of the therapeutic process.

Activities

• Describe a situation in which the client’s expectations of the relationship with the caregiver were not realistic.
• Describe a situation in which the caregiver’s expectations of the client were not realistic.
• Describe a situation in which the client’s expectations of a partner, friend, institution, etc. were not realistic.
• Describe a situation in which the client’s expectations of himself or herself were not realistic.
• Are there situations in which you feel it is not necessary to deal with expectations?

Generalizations

Generalizations are similar to assumptions and prejudices. Almost always, they get in the way of coming to the real issues, which, usually, are very specific. Getting to the specific and “individualizing” the client’s statements is the heart of the clarification process with regard to them. Frequently, the use of generalizations has to do with the way that the client thinks, and this also is a process on which the client and the caregiver can work together.

Activities

• Describe a situation in which the client made generalizations that got in the way of the process. How did you work with that?
• Describe a situation in which you made generalizations that got in the way of the process.
• Are there situations in which it is not necessary to clarify generalizations?

Some Final Remarks

In this section, we have tried to give some points about the use of language and about how to get to the core of what the client is feeling, not only what he or she is saying. We emphasize that this is a very individual process for each client and for each caregiver. We repeat that the relationship between the caregiver and the client is the key to the kind of work that we’re doing. We also repeat that it takes experience to do this well and that even people who have a great deal of experience don’t always get it right.