Social Work News

"Clients as the Evidence in Social Work"

Written by Jennifer L. Nagel, LMSW
September 7, 2023

Continuous learning is vital to the growth of a social worker. We regularly speak of new trends in trauma-informed care. We discuss the newest psychopharmacological approaches. We converse about the importance of knowing the models, theories, and perspectives that are specific to the field of social work. As a licensed social worker in New York state, I am required to continuously enroll in continuing education classes that will not only allow me to maintain my license, but will allow me to grow as a professional. The courses are approved by the New York State Education Department’s State Board for Social Work and provide social workers with a curriculum that is evidence-based, meaning that it is scientifically shown to provide the best results when applied to our clients. As social workers, we are so programmed to learn from evidence-based perspectives, but are we remembering to learn from our clients? Are we remembering that our clients are the source of this evidence?

If I had not volunteered to become a field instructor for my agency, would I slowly forget about the core competencies of social work that are set forth by the Council on Social Work Education? I surely hope not. Core Competency #2 focuses on engaging diversity in practice, which includes presenting as learners and engaging our clients as experts on their own experiences. We can take multiple continuing education courses over the course of a lifetime from the best social workers in our field, but let’s not forget about what we learn directly from our clients.

Listening for the Evidence

I recently met with a young man who was applying for services with our agency. We provide housing and supportive services to adults with psychiatric disabilities. Our coursework teaches us how to interview our clients, such as how to ask questions, when to ask them, why we ask them, and so forth. However, the most important aspect of our communication is to simply listen. This individual had been struggling with substance use, particularly marijuana. As a listener, my questions were few but always open-ended. I think the most important question I could have asked him was simple. “What made you prefer marijuana over other substances?”

He explained to me that marijuana is a communal drug that brings people together.  This is not new knowledge for me; however, it is knowledge that helped me to understand him as a unique individual, and it led us to a conversation about his feelings of isolation, depression, and anxiety that have haunted him since childhood. He had a need to belong, and even if he did not meet this need in the healthiest of ways, this is what I needed to know to better understand him.

In the past, I had attended Single Point of Access (SPOA) meetings. These are county-wide meetings that bring agencies of similar interest together. Think outpatient clinics, hospitals, homeless shelters, residential programs, and other agencies that develop relationships with one another. The purpose of SPOA is to link high-risk clients to needed supports.

These are clients who are in crisis. These are clients who have a history of homelessness who are shunned by society, but not by you, because you took the time to learn their stories. These are clients with multiple psychiatric hospitalizations who, for some reason, find it difficult to follow through with recommended treatment options afterwards—thus, they find themselves in the Emergency Department at 3:00 a.m. when you may be asleep at home. Perhaps this describes someone you know. Perhaps this is someone you love. Our clients can also be our communities that struggle to stay afloat in disastrous times.

One thing I learned about the SPOA meetings is that some invite clients to attend the meetings. Others simply provide you with a piece of paper that explains the person’s “chief complaint.” There is a difference between reading about someone and seeing the exhaustion and despair in someone’s face when communicating with them face to face.

Clients are experts on their own experiences. This does not imply that we do not need evidence-based trainings and classes, but let’s remember where much of the evidence evolves from. If we can meet clients exactly where they are, they can be the guide that is necessary to successfully navigate through the helping process.

Jennifer L. Nagel, LMSW, is a mother, a wife, a daughter, a sister, and a licensed social worker who has worked for Southern Tier Environments for Living, Inc. (STEL, Inc.) for 17 years, providing social work services to individuals with mental health challenges.  

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This article is from the New Social Worker Magazine, the social work careers magazine.