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Home » Health Professionals » General Information » Difficult Clients

Difficult Clients

 


For anyone working in injury management or in a role where they work closely with people, they will inevitably find themselves having to work with “difficult clients”. These difficult clients can be a source of stress, frustration, anger and a range of other potentially strong emotional reactions. They can challenge our knowledge,  skills and how competent we feel about ourselves as professionals. To learn and grow from the experience of working with “difficult clients” requires us to firstly understand why we see them as difficult.

 

There are a range of situations  that make a client appear difficult. The reasons need not only  relate to the actions of the client we are assiting.  They can occur because of inadequacies in knowledge,and skills as well as the attitude of  the treating or rehabilitation service  provider themselves.  A client / case can also be difficult because the people i.e.  health professionals / insurer case manager may lack the knowlege, skills and attitude that is essential for a balanced perpective to be held on a difficult situation and an appropriate decision made.

 

Some of the difficulties are outlined below :

 

Situational Difficulties 

  1. The situation that you are working in makes it difficult or impossible to achieve the desired outcome, e.g. for change to take place  financial resources may be needed that  are not available.

  2. You have more than one interrelated “client” with different needs and agenda's e.g. an injured worker, treating doctor, and employer.

 

Difficulties with the Treatment or Rehabilitation Provider

 

  1. Skill and knowledge mismatch between rehabilitation provider, treating professional and type of injury, e.g. a rehabilitation provider with a physiotherapy or exercise physiology background is allocated a worker with post-traumatic stress disorder without experience. Alternatively, a rehabilitation provider with a psychology background and limited knowledge and skills in physical injury management is asked to assist an injured worker with multiple physical injuries that he or she knows little about
  2. Role confusion and separation issues  e.g. A rehabilitation providers with a psychology background may be tempted to take on a “psychologist” role when case managing a worker and not know when to cut off with the worker. Boundaries are important.
  3. Problems with rehabilitation provider and treating professionals expectations of self as they may:   

  • Believe they should be able to help every one and get ideal outcomes from every situation.experience transference and counter transference
  • This may be unconscious along the lines that the injured person reminds them of someone that evokes a strong emotional response, such as “my domineering father…or manipulative sister".
  • blame the client and externalise their own inadequacies ie. saying to a colleague “another complaining compo case”.
  • Put expectations on the parties due to political pressures, i.e.   to appease an employer, their  manager,  or to improve return to work rates of a team with little apparent consideration for the complexity of issues involved.
  • Have a lack of resources to help client. These may concern staffing levels  e.g. having a high case load in context of expectations of outcome

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