Flying solo!

Outline of section

Endings | Cognitive aims | Emotional aims | Practical aims | Tasks | Co-ordination | Advocacy | Standards | Evaluation

Endings

The stage at which the client is to 'fly solo' is often determined by the nature and ethos of the project, informed by consideration of needs, and dictated by the contracts or funding requirements.

It is important to look at the profiles of the clients using your project, and decide an appropriate procedure for closing cases. The three choices are:

• fixed term - has clear start and finish dates
• open ended - will continue until the client no longer needs the support
• gradual - a clear start date, with a taper of less support applied as the client gets more comfortable with living independently.

For each client you should have worked out with them a clear way of finishing the support, when that will come and under what circumstances.

While the current situation is that duration of contact and potential referral on to other support agencies, floating support or tenancy sustainment teams it is interesting to consider the Dutch model, as outlined in Resettling Homeless People whereby support is withdrawn only when the client has two positive relationships apart from the worker.

The luxury of such open ended support carries in itself considerations of dependency versus real independence, and as one practioner replied:

"you can know it is over when the aims, as they were outlined by the client, have been achieved."

If the aims agreed at the outset have been met and look to be sustainable, the worker can happily end the intervention.

Seal quotes Meyersohn, K and Walsh, J 2001 in Ending Clinical relationships with people with schizophrenia Health and social work

"Natural unsettling feelings for the client may include sadness, relief, loss, anger, guilt, inadequacy and anxiety...feelings of satisfaction may include pride in accomplishments, an appreciation of the relationship and excitement about the capacity for other attachments. Most clients have mixed feelings, but the worker can frame the ending as a positive episode in the client's management of separation. Near the end of the relationship the worker may share some of his or her own reactions...this highlights reciprocity in the relationship."

As Seal notes, "However, practitioners' experience was...that most relationships ended with either a 'bang' or a 'whimper': The relationship ended after an argument or misdemeanour, the worker eventually stopped knocking, and/or the client stopped answering. A third variation was that the client sought to perpetuate the relationship even when objectively the task was done. Whenever the discussion or plan turned to the idea of the worker withdrawing support, the client presented with a crisis."

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Tasks

• Conduct resettlement closure interview:

1. Review the initial needs of the client, and the reasons for support.
2. Reinforce the achievements of the client, the changes that they have made in their lives, and note the support that will follow on from resettlement.
3. Clearly state the reason for closure; it is important that the client does not feel rejected.
4. List future considerations: rehearse with the client risk or lapse situations, and develop with the client strategies for handling them -looking to refer to alternative support where this is available.

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Co-ordination

• Ensure that any support from other specialist agencies is in place, and that the handover, if any, is smooth.

Advocacy

• If there are problems with referring your client on to statutory or voluntary agency support, ensure that you are a strong advocate on behalf of your client.
• Where necessary, involve other appropriate agencies.

Standards

• The client's progress, distance travelled, achievements and new strategies are reviewed and jointly deemed sufficient.
• Concerns are addressed, the return/dropping in option is discussed and negotiated as appopriate.
• The client is offered ample opportunity to comment on and criticise the resettlement process as they have experienced it.

Evaluation

• Assess and review the case and the difference your involvement has made.
• What have been the outcomes and how could you chart or demonstrate the distance travelled and achievement?
• As above, it is crucial the client has full access to a feedback and evaluation system on the process as they experienced it. You may also want to follow up in six and/or twelve months time and this should be explained.

Next section: Evaluation