Fundamental Skills, Chapter 3, "Responding With Empathy"

As important as listening to the client is, it is equally important to know how to respond to them.  Responding in an empathic way builds the relationship with the client by letting them know that you hear and understand what they are saying and how they are feeling.

Reaching For Feelings
A client may tell you about an event without mentioning how they feel about said event.  Sometimes they may have trouble identifying exactly what it is that they are feeling.  Reaching for their feelings means bringing the conversation to a more emotional level by helping them talk about their feelings.  If a client's feelings seem to be near the surface, as an open-ended question to get them to open up about them.

Dealing With Silences
Do not let silence make you uncomfortable or anxious.  Sometimes the client needs a few minutes to think about what they are feeling.  You will usually get cues from the client as to what they are feeling (tears, facial expression, posture), but if it is unclear what they are feeling - ask.

Acknowledging Feelings
You can help your client feel less alone and more understood by acknowledging their feelings.  Start by making a statement about their feelings.  This let's them know that you understand.  Next, validate their feelings by stating how you can understand them feeling this way.  This let's them know that their feelings are acceptable and valid.  Finally, let the client know that what they are feeling is normal, and that they are not weird or crazy for feeling this way.

Articulating Feelings
Communicate empathy to the client by letting them know that you can imagine how it must feel to be in their shoes.  This communicates understanding.  There is no way that you can "know" how another person feels because everyone is different, but you can imagine how you might feel under their circumstances.  Never try to tell a client what they "should" feel.

For more information on how to respond to clients with empathy read the article:  "Listening and Empathic Responding."

How would you empathically respond to a statement with which you cannot relate whatsoever?

Women's Rights

Do women have equal rights with men in the United States?  Yes and no.  All 50 states have legislation that prohibits discrimination based on sex, but the Constitution of the United States does not protect women from sex discrimination.  In 1920, the 19th Amendment to the constitution was ratified which guaranteed women the right to vote, but that's as far as it goes.  In 1923, a woman named Alice Paul introduced the Equal Rights Amendment (ERA), which would have guaranteed equal rights for women and prohibited discrimination based on sex.  The ERA was finally passed by congress in 1972, and sent to the states to be ratified...but it never was.  Only 35 of the 38 states needed actually ratified it.

So why is this important?  If every state has laws that protect women's rights, why do we need a constitutional amendment to that end?  Laws can easily be changed or completely overturned, that's why.  Also, by making an amendment to the constitution it becomes the supreme law of the land, able to be upheld by the highest court in the country - the Supreme Court.  Furthermore, what kind of message does it send to young girls and women that their state doesn't feel that it is important to secure their rights for generations to come?

For more information on this topic visit www.equalrightsamendment.org, a project of the Alice Paul Institute.

Something to think about:  The states that have refused to ratify the ERA are all predominately right-wing republican states.  Could their unwillingness to ratify the ERA be tied to their apparent desire to control women's bodies and strip them of their own bodily autonomy (i.e., birth control, abortion, rape sentencing etc.)?

Resource Notebook

Hawkins County Department of Human Services

4017 Highway 66 S, Rogersville, TN  37857

Phone: (423) 272-0715

• ·      Families First
• ·      SNAP
• ·      TennCare
• ·      Subsidized childcare

Of One Accord Ministries

306 E Main Street, P.O. Box 207, Rogersville, TN  37857

(423) 921-8044   Email: ofoneaccord@yahoo.com     Website: www.ofoneaccordministry.org

• ·      Emergency food pantry
• ·      Church Hill Medical Mission
• ·      Thrift stores
• ·      Neighborly Meals
• ·      The Lunch Box
• ·      Free WIFI access
• ·      Christmas for the Children
• ·      Good Neighbor Home Repair
• ·      Global Missions

The United Way of Hawkins County

101 W Broadway Street, Suite 1, Rogersville, TN  37857

Phone: (423) 272-7379    Website:  www.unitedwayhawkins.weebly.com

• ·      Free clothing
• ·      Help with utilities (with cut-off notice)

Neighborhood Service Center Hawkins County (UETHDA)

904 E Main Street, Rogersville, TN  37857

Phone: (423) 272-2830

• ·      Child Care Resources and Referral Center
• ·      Child Care Certification Program
• ·      Community Services Block Grant Program (CSBG)
• ·      USDA Commodity Program (TEFAP)
• ·      Head Start Program
• ·      Low Income Home Energy Assistance Program (LIHEAP)
• ·      Retired and Senior Volunteer Program (RSVP)
• ·      Senior Community Service Employment Program (Title V)
• ·      Weatherization Assistance Program (WAP)

Hawkins County Habitat for Humanity

310 Colonial Road, Rogersville, TN  37857

Phone: (423) 272-1830

• ·      Habitat uses volunteer labor and donations of money and materials to build simple, decent houses in partnership with low-income families
• ·      Home Repair Program

Boys and Girls Club of Hawkins County

1604 E Main Street, Rogersville, TN  37857

Phone: (423) 272-5656    Email: info@hcbgc.org Website: www.hcbgc.org

Offers a safe place for youth after school, during the summer, and on holidays.  Members pay a yearly fee of $10.

• ·      Character and Leadership Development
• ·      Education and Career Development
• ·      Health and Life Skills
• ·      Sports, Fitness, and Recreation
• ·      Arts and Crafts

Hawkins County Health Department

P.O. Box 488, 201 Park Blvd., Rogersville, TN  37857

Phone: (423) 272-7641  Fax: (423) 921-8073

• ·      Basic Prenatal Services
• ·      CSS Children’s Special Services
• ·      Community Development
• ·      Dental Services
• ·      Epidemiology Services
• ·      Environmental Services
• ·      Family Planning Services
• ·      Health Education Services
• ·      Immunization Services
• ·      Tennessee Home Visiting
• ·      WIC (Women, Infants, and Children)
• ·      TENNderCare
• ·      Primary Care

 Rogersville Housing Authority

902 Locust Street, Rogersville, TN  37857

Phone: (423) 272-8540

• ·      Subsidized housing for low income families

Salvation Army

P.O. Box 2280, 505 Dale Street, Kingsport, TN  37857

Phone: (423) 246-6671    Fax: (423) 246-9787   Website:  salvationarmytennessee.org

• ·      Rental assistance
• ·      Utilities
• ·      Food
• ·      Clothing
• ·      Emergency shelter
• ·      Veteran’s Grant Per Diem Program
• ·      Soup kitchen
• ·      Referrals to other helping agencies
• ·      Counseling

First Tennessee Human Resource Agency (FTHRA)

704 Rolling Hills Drive, Johnson City, TN  37604

Phone: (423) 461-8200    Fax: (423) 461-8228    Website: www.fthra.org

• ·      NET Trans (rural public transit)
• ·      DUI School
• ·      Adult Day Services
• ·      Foster Grandparent Program
• ·      Meals on Wheels Program
• ·      Safe Passage Domestic Violence Shelter
• ·      Probation Programs
• ·      Personal Support Services
• ·      Senior Employment Program
• ·      Child Care Food Program
• ·      Day Reporting Center

Hawkins County Mental Health Center

101 Lena Drive, Rogersville, TN 37857

Phone: (423) 272-9239    Website: www.frontierhealth.org

• ·      Adult Outpatient Services
• ·      Case Management
• ·      Women’s Recovery Services
• ·      Children & Youth Services
• ·      Psychiatric Services
• ·      Psychotherapy
• ·      Project BASIC

Fundamental Skills Manual, Chapter 2: Effective Listening

Good communication skills are necessary to build and maintain a positive relationship with the client.  No one wants to open up to someone they're not sure is even listening, and you will not be effective in helping a client if you do not listen carefully to their problems.

Effective listening is not passive, but active.  Active listening involves trying to understand what the client is communicating, then letting them know you understand by accurately reflecting their thoughts and feelings back to them.  Nonverbal cues that you give the client such as eye contact, posture, gestures, etc., also tell your client whether or not you are listening.  You can convey interest in what your client is saying and encourage them to keep talking by giving short verbal prompts such as "uh huh" or "go on."  Asking opened ended questions helps you to understand the client by getting them to elaborate.  Closed ended questions can be useful also if you only need a yes or no answer to clarify something they have said.  Paraphrasing or restating what your client has said in your own words is an effective technique to let your client know you are paying attention, and to make sure you are understanding accurately.  When the client has finished speaking, summarizing what they have said not only conveys that you have heard them, but helps them to see the "big picture" of what they have told you.

The case manager's own emotions and thoughts can get in the way of effective listening, so it is important to be mindful of this fact.  Interrupting, daydreaming, and being judgmental are all examples of ways the case manager could become ineffective in listening.  Once the client feels they are not being listened to, they may "shut down," and progress becomes impeded.

The following article from Psych Central elaborates more on the process and techniques of active listening -  "Become a Better Listener:  Active Listening"

Something to think about:  What technique could a case manager use to maintain active listening if the client's speech is genuinely uninteresting and boring?

Native American Lives

News flash...before Christopher Columbus "discovered" America, this land was already inhabited by many tribes and nations of people.  We call them Native Americans, or American Indians.  They called themselves by such names as Cherokee, Sioux, Cheyenne, etc.  Some estimates have the Native American population as high as 12 million around the time Columbus first set foot on American soil.  About 75%-90% of them died from diseases (smallpox, influenza, whooping cough, etc.), for which they had no immunity,  brought here by the European settlers.  Many were murdered. Many more died during long, perilous journeys as they were continually pushed westward while white people took over more and more of their land. By the turn of the 19th century, there were only around 250,000 Native American people living in America.  The United States government has entered into more than 500 treaties with Native Americans, and has either violated in some way or broken every single one.  Today there are around 5.2 million Native Americans in the U.S., and about 22% of them live on reservations in third-world-like conditions.

In July 2016, approval was granted for the construction of an oil pipeline that would stretch from North Dakota to southern Illinois.  The pipeline would cross the Missouri River only half a mile upstream of the Standing Rock Sioux reservation boundary.  This obviously creates the potential to destroy the Standing Rock Sioux nation's water supply in the event of a spill.  Furthermore, the construction crew bulldozed through one of their sacred burial grounds.  The Standing Rock Sioux have been protesting and blocking construction since July, along with the support of many Americans of all ethnicities from all over the United States.  Many protestors have been arrested by local law enforcement, and some have been shot, or attacked with dogs by private security forces.

Why does corporate profit always take precedence over human well-being?  Why doesn't our federal government step in and rectify this situation?

Transgenderism

This is Laverne Cox.  A transgender woman, and Hollywood celebrity

 before and after her transition from "male" to "female."

In order to understand the term "transgender," I think it is important to first define the terms "sex" and "gender."  Most people use these terms interchangeably, but they are not the same. Sex refers to the genitalia.  Although a small percentage of the population are born with both or ambiguous genitalia, most people are born with either a penis or a vagina, and labeled male or female, respectively.  Gender, on the other hand, is mostly a social construct based on cultural norms that specifies how each sex is supposed to behave.  I say, "mostly," because there are some biological differences between males and females besides the sex organs which are the results of different hormones that they produce (i.e., facial hair, development of breasts, muscle mass, etc.).  

A transgender person is one who does not identify with the gender role assigned to them by the culture, based on their genitals.  In other words, someone who is born with a penis, but who identifies their self as a female, would be considered transgender.  Their personality and behavior more closely resembles that which is traditionally thought of as pertaining to the opposite sex.  Many transgendered people describe themselves as a "man trapped in a woman's body," or a "woman trapped in a man's body."  Their sense of who they are does not match what society dictates it should be based on the sex organs they possess.  Science does not offer any one reason that someone would be transgender.  Many biological and environmental factors may play a role in making a person transgender, and the experience is different for every transgender person.

Transgender people have no rights guaranteed to them by the constitution of the United States based on gender identity.  As a result, discrimination against transgender people is rampant.  Transgenderism is difficult to understand, and people are generally afraid of, and often hate, what they don't understand.  Transgender people are often the victims of violence, and even death.  They are bullied, and made fun of.  They are refused basic things "normal" people take for granted, like dressing the way they are comfortable for a driver's license photo, and using the public restroom of the gender they identify with.  They are often treated like freaks of nature, and ostracized by society and even their families. 

I personally believe that everyone should have the inalienable right to pursue happiness in whatever manner they want, as long as they are causing no harm to others or infringing on the rights of others.  More scientific research needs to be done in this area, and the public needs to be educated better on this topic in order to eliminate the stigma of transgenderism.  As far as I'm concerned, you can identify yourself as a reptilian overlord from the planet Zenu, and I will still treat you with respect and dignity as a human being, and afford you every right as such because I'm not a dick!

For more information on transgenderism see the articles: Transgenderism 101, and 

Transgender People, Gender Identity and Gender Expression.

Something to think about:
Why are people so afraid of those who are different than themselves?  Why do people feel it necessary to divide themselves into categories and apply labels to everyone?

Fundamental Skills Manual - Chapter 1 - Developing Relationships

Resiliency
The resiliency approach emphasizes the strengths of the client, and stresses the vital role that caring adults can play in a young person's life.  A caring adult can be what is referred to as a "turnaround person" to the young person.  A turnaround person can help a young person by showing them care, compassion, and respect; maintaining high expectations and encouraging them; and helping them feel needed by linking them to jobs, activities, and other interests.

Stages of the Relationship
Stage 1- Current State of Affairs - Clients tell the case manager their story.  The case manager listens and assesses what the client believes the current state of affairs to be, how much insight and maturity they possess, who, if any, are their main sources of support, and any other information that could help to build a good relationship with the client.

Stage 2 - Preferred State of Affairs - The case manager assists the client in identifying their goals and developing hope that some of their problems can be solved. 

Stage 3 - Strategies For Action - The case manager helps the client come up with strategies to meet their goals.

The First Meeting
It is important to make a good first impression on the client during the first meeting, as this will set the tone for the rest of your relationship.  The case manger must build rapport with the client by making them feel understood and excepted.  Show them you are genuinely interested in them by asking questions like:  What do you do for fun?  How do you spend your free time?  What places do you like to go? Find out what you have in common with the client.  Clients will also feel more comfortable if they have a good understanding of what your role as case manager is, and how the process works.  So take time to explain, and make sure they understand these things.

Client-Centered Case Management
Start "where the client is", and try to see the world through the client's eyes.  Do not give unsolicited advice, but rather help the client come up with solutions of their own.  Try to understand the client in the context of their culture.

Self-Disclosure
Avoid expressing personal feelings that are not helpful to the client.

Stating Personal Opinions
Consider how your opinions might affect the client before you share them.  Always allow the client to reject your opinions in favor of their own.  The case manager may be an expert on the process of case management, but they are not an expert on anyone else's life.


For more information on this topic, read the article:  6 Tips for Building Lasting Client Relationships.  

One question I had while reading this chapter was:  What do you do if the client resists every effort you make to establish a good relationship?