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Complex clients: how do you gain trust?

19th April 2013

Pregnant-Teen-in-Shadows-001Some of the women our Pregnancy Outreach Workers (POWs) support are what we refer to as “complex clients”. They have many issues – they may be drug users or victims of domestic violence; they may be homeless – and so they tend to have had many interventions, usually over many years, from multiple agencies.

So how does a POW begin to build a relationship with a complex client?

Flexibility, availability, consistency

One of the main benefits of the POW setup is its flexibility. Sarah Samersinghe, a POW who has had some memorably complex clients, explains:

“As a POW, I can go to the client – she doesn’t have to come to me. If it’s not appropriate for me to visit her at home, I can meet her elsewhere, or pick her up in the car and take her out. And I’m always available; I don’t expect to only speak to clients at appointed times.”

Consistency is very important, especially when clients have otherwise chaotic lifestyles. “It’s important to do what I say I’m going to do,” says Sarah. “If I say I’m going to be there, I’ll be there.”

Pitching it right

How does she attempt to connect with women who find it difficult to trust new faces? How does a POW help a frightened woman to make quite dramatic lifestyle changes?

“It’s about trying to read people,” Sarah says. “Pitch it right. Choose your moment. When someone’s ready, they’re ready – you’ll just know. The way I personally do this – and not all POWs do, of course – is to talk about my own family; to find elements of my own life that chime with theirs. It often allows me to identify with the client – to show that we’re human too.”

The flexibility of the role means that the POW isn’t necessarily restricted by a time limit for each case.

“Our aim is a healthy outcome for all concerned,” Sarah says. “So if I can justify it, I’ll keep the case open for as long as I feel is necessary to achieve that. For example, a social worker might have to close a case once a child is placed elsewhere, but I feel fortunate that my role allows me to stay with the mother.”

Case study: Hayley

One of Sarah’s most complex clients is Hayley (not her real name).

“Hayley’s had many issues but, when I met her, the main problem was housing. The flat where she lived was pretty much uninhabitable. It was cold and dark all the time and the building was infested with rats and mice. There was no gas supply, and the wiring was downright dangerous. There was no way of cooking, or even making a hot drink, and there was only cold water to wash in. Not good for anyone, but particularly not for a pregnant woman.”

However, the flat, owned by Hayley’s boyfriend, was her home – and it wasn’t easy for her to make the decision to move away. She was scared.

It took a long time for Sarah to persuade Hayley that she should apply for temporary accommodation elsewhere. One day she finally agreed, largely because the weather had become very cold.

In the video below, Sarah and Hayley are on their way back from the appointment with Housing Services to pick up Hayley’s ID and other paperwork she needed for the move to go through. Hayley reflects on how far she’s come. And, poignantly, she tells Sarah that she thinks this is the type of support she’s always needed.

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