These days, we hear a lot about being “client-centered” in our work, but many folks may wonder, what does that really mean?”
It’s a good question—after all, isn’t all service work client-centered? Client-centered case management sounds almost redundant.
But the truth is, if we want to build that all-important rapport with clients that helps us really connect and make a difference, then we need to focus on empathy—the act of being “other-centered.” Wondering what that means? Here’s how to apply the idea of client-centered case management to your practice.
The Overlap of Motivational Interviewing and Trauma-Informed Care
As with many aspects of human services, client-centered care begins with empathy. In fact, empathy is right at the center of the Venn diagram between Motivational Interviewing (MI), Trauma-Informed Care (TIC), and Cultural Humility to Cultural Reverence (CH2CR). In all aspects of human interaction and service, empathy is critical.
We can break down the idea by recognizing the way we honor served people’s individual experiences. It’s not necessarily about applying a formula or a one-size-fits-all approach to care. As we’ve discussed, there’s no way to “train” someone to be empathetic or to care for others. Everyone already has within them the ability to express empathy. We can support ourselves and each other to slow down and express empathy more and more skillfully.
But when we step back, listen, and recognize an individual’s collective experiences that have brought them to the point of our care, we can start to see who they really are, understand their values, and the things that drive them toward positive and healthy decisions.
When we explore Motivational Interviewing, we highlight values as a powerful driver. For example, by recognizing that a person values being a good parent, we can help connect the ways their behavior may support or interfere with that role. In our conversation, we may reflect those values back to them by saying, “You mentioned that being present for your children is very important to you. How is your drug use supporting you being present with your kids?” These questions that reflect values can help people recognize their behaviors that may be interfering with the areas of their lives they want to improve.
A huge part of MI is building rapport and connection. We build this relationship by expressing empathy and realizing that past experiences and traumas are often the reasons for unhealthy, adaptive behaviors. Nearly every human carries traumas, even though they may not be apparent. Sometimes these traumas are deeply hidden behind a veil of frustration or indifference.
Emotional and psychological trauma are often invisible and unhealed. When people face stressful situations, this trauma can resurface. Sometimes stressors can be as simple as words, images, or interactions. They may not always be directly related to the trauma, but certain feelings, images, or interaction can trigger these deep feelings and cause unhealthy reactions.
Many times, when we’re serving clients, they may come off as aggressive, cold, indifferent, or apathetic. Often this can be protective, and we need to empathize if we want to connect and relate. Empathy is a genuine emotion. It’s not something we can fake. It’s also not necessary to endorse, support, or excuse harmful or destructive behaviors. When we express authentic empathy, we recognize the trauma that may contribute to the behaviors and tap into the reserve of resilience innate to every human being.
In Trauma-Informed Care, empathy is crucial. It’s the ability to deeply understand and demonstrate that deep understanding of a person’s experience and perspective. When we listen with empathy, we can begin to extend a more holistic approach that focuses on the person in their entirety, not just their behavior or the situation that brought them into our care.
Client-Center Care and Holding Space
We frame MI as way of “holding space.” But what does it mean to hold space? After all, it sounds a little nebulous—how does one hold space?
When we share Motivational Interviewing, we often use the analogy of a cast encircling a broken arm. Think of a kid who falls off his bike and breaks his arm. The doctors apply a cast, and then we wait for the arm to heal. Is the cast healing the arm? No. The cast holds the arm in place while the kid’s body does the work of healing.
Holding space is like being the cast. We aren’t there to “fix” the problem or undo someone’s experience. Instead, we’re there to hold a safe, empathetic space where they can process their trauma and experiences that have brought them into our care. We’re giving them the room and stability to do the healing that they’re capable of. It may take time, but by creating that safe space—the cast—we’re offering an environment that can help them move toward wellness.
Client-centered case management and care is the culmination of Healing Focused Care. It’s the integration and interaction of Motivational Interviewing, Trauma-Informed Care, and Cultural Humility to Cultural Reverence, as well as our own wellness as providers. When we bring it all together, we hold space for the people we serve.
It’s our role to listen and learn so we can understand who our client is, their genuine and authentic self. As we listen, we glean information that can help us offer what they need. We can learn their values, goals, and dreams. By holding space and listening, we can learn what they’d like to let go of—what they’d like to change. Then, we can start to guide and evoke as we demonstrate a deep understanding by expressing empathy.
We share Healing Focused-Care as a way of being Trauma-Informed, culturally reverent, client-centered, and person-centered. As care providers, we can support our clients to tap into their own resilience and self-efficacy, encouraging and supporting them to move forward in the world along their healing journey.
Please reach out if you or your team would like more information and guidance on providing client-centered care. We’re happy to share and grow with you!