Introduction Before ending this section of the course, we wish to return to two important concepts, namely time and how close the caregiver gets to the client. Both of these are undervalued and underestimated in their importance, in our view.
As always, please complete the activities suggested. Also, as always, do not reveal any information that would identify any person, as this is unethical.
Time We repeat what we have said in other sections of this course with regard to time, that is, that there needs to be sufficient time for the client to be able to express himself or herself in a manner that is not pressured, and that the atmosphere and environment of the session should allow that.
In general, for an individual client, we allow 45-75 minutes for each session. For a group session, we allow an hour and a half to two hours with a break for about 15 minutes at the half-way point. With some individuals and with some groups, more or less time will be optimal because of the need to go into issues more deeply and because of the personality of the client or group members. Thus, the caregiver must be sufficiently flexible not always to keep to the standard 50-minute hour.
We do not put a limit on the number of sessions in total. We are aware that some insurance companies and some health systems do so. We end the work when the client and the caregiver feel that it is appropriate to do so.
As we have mentioned, we feel that it is extremely important for the caregiver to plan sufficient time between clients and groups. In general, we like to allow around a half hour after an individual client and around 45 minutes after a group. This gives the caregiver time to deflate and to process what has happened, as well as to make a few notes. In the sections on self-care, we will see just how important this is for the caregiver.
Still another point here is planning over the week or longer periods. This involves not putting very difficult or exhausting clients and groups one after the other and allowing time for other activities.
Describe your time allocation of clients. Is this working? Do you have the time for each client and each group? Make suggestions for changing this.
Are there situations in which you cannot plan time for clients in the way that you think best?
Closeness We already have spoken about closeness between the caregiver and the client in the section of this course on ethics. The key is that the caregiver maintains objectivity.
Nonetheless, there are situations in which the caregiver may want to approach the client outside of the usual situation. One example is that caregiver might want to go to the client’s home to observe the situation there firsthand. Another might be that the caregiver might want to attend a social event to see objectively how the client behaves. Particularly in small communities and in situations in which there are small numbers of caregivers, contact may be unavoidable. Again, it is the responsibility of the caregiver to maintain distance and objectivity.
Describe a situation in which there may be advantages to getting closer than usual to a client. What is your experience?
Describe a situation in which you wished to maintain a distance that is further than usual from a client. Describe your experience.
Final Remarks Time and closeness both are difficult for many caregivers. They require, first, determining the needs of the individual clients and groups and balancing those against the needs of the caregiver and the organization for which he or she works and what is possible logistically. We will discuss this in more detail in several places. It also is important that there is space between clients and groups so that the caregiver can work with them adequately. With regard to closeness, the caregiver always must maintain objectivity.