Hearing Our Clients’ Voice

Introduction

In making the career change from paediatric Physiotherapy to Case Management, I was struck during my induction, and particularly in meet and greets, by the emphasis clients place on their case manager’s ability to ‘actively listen.’  Coming from a clinical background where active listening to children, young people and their parents was crucial, it seemed so simple.  As I gained more experience as a case manager, I realised that while actively listening to clients and their families is simple, supporting clients to develop their own voice sufficiently to ensure that it is heard can be challenging. But it is essential, as this will enable the case manager to advocate for them, as we strive to achieve client centred support.

This can be particularly challenging as our clients approach 16 years old and upwards and may be encouraged to provide their own thoughts and preferences to their case manager and other professionals, if appropriate, in accordance with their capacity.  I have found that how clients and their family members respond to this can significantly impact how case management input progresses.

The Importance of Active Listening and Family Dynamics

I have encountered this first hand with two very different cases.

I recently started to work with a client who had just turned 17 years old.  During the immediate needs assessment, it was very apparent that her parents were very keen to encourage their daughter to have a voice and to be as involved as possible in all aspects of case management support and rehabilitation planning, as appropriate.  Whilst her parents had been the primary carers and decision-makers for their child since birth, they recognised that their daughter had reached an age where she should be more actively involved in decision making and vocalising her decisions. They understood how important this was to develop their daughter’s independence.  The parents recognised that it would be a transitional process for themselves also, and one that they may struggle with, to reduce their control and positively embrace a different role in the support of their young person.  As the parents have naturally allowed my client’s ‘voice’ to be encouraged, my client has been actively involved with each step of the case management process.  As a result, we have been able to put together a multi-disciplinary team that fits my client’s personality and approach preference and have been able to promptly move rehabilitation forwards.  In a short space of time, my client’s skills and abilities have started to develop.  We have progressed with the recruitment of a Buddy, which will also develop my client’s confidence further and allow my client the freedom to develop ideas of how they would like their life to look. This will not be without its challenges, as this will be the first time my client has had this freedom. Therefore, we need to work on balancing this and my client’s expectations with their current capabilities and limitations. However, it is so positive to see what an effect the active participation of a client can bring to the case management process.

In contrast, I am always mindful that for other families transitioning from a position of making decisions for their child to enabling a young person to develop their own voice can be a challenging and emotional journey. This transition can be incredibly complex when trying to hear the young person’s voice, as parents may naturally, and understandably, continue to speak on their behalf. It’s important to approach this with compassion and understanding, recognising the parent’s need for support as they develop confidence in this new role. By delving deeper into the parents’ needs and reasoning, we can gain valuable insights that can help to facilitate this transition. Providing additional professional support to the parent can be crucial to empower both the parent and the young person and ensure that the young person’s decision making abilities and voice are heard and valued.

Conclusion

These experiences highlight the crucial role of active listening and understanding family dynamics in case management. By actively listening to our clients and their families, we can better support them in developing their own voice. This not only empowers our clients but also helps in creating a more effective and personalised case management plan.

As a case manager, it is imperative that we do not overlook the pivotal role of other family members in the case management process.  Each client is an individual, and each family is different, so a one-size-fits-all approach does not work.  We need to utilise our active listening skills to understand our clients and those around them, reflect on what we are being told, and at times, delve deeper into the other issues and dynamics that may be at play in order to identify the best way to work within it.  Only then can we gain a real understanding of our client and their family’s needs to ensure that our clients’ voice is heard.

Author: Imelda Molloy, Case Manager

This article was also published on WWW.NRTIMES.CO.UK on 3rd April 2025