By Emily Nash

At the Medicare Rights Center, I provide counseling over the phone to Medicare beneficiaries. Often, upon picking up the phone, I am flooded with details of the client’s story: dates, names of insurance companies, government agencies, medical terminology, and threaded throughout all of this, a general tone of exhaustion, frustration, and confusion. My challenge is to pull out a resolvable problem from a non-linear story and to relay a solution to the client in a counseling message.

Recently, New York City corps members had the privilege of talking with Dr. Jacqueline Mondros, the Dean of the Hunter School of Social Work and an AVODAH board member, about the client-social worker dynamic. I presented my challenge to Jacqueline. How do I understand the client’s issue when I am inundated with information? How do I allow the person to tell their story while maintaining a focused counseling session? How do I calm and counsel exhausted, frustrated, and confused clients?

Several questions from other corps members were raised about the challenges of client interactions, so Jacqueline offered a few pieces of insight. She describes the initial client interaction as “strangeness” – a feeling by the client of uncertainty about the person from whom they are seeking help. Who are you, and can you help me? Can I feel comfortable asking you for help? Can I trust you with personal information?

This uncertainty and discomfort is amplified by an interaction that is solely over the phone. I am physically separated from my clients; they have only my language and tone to make inferences about me. Layered on my clients’ confusion about Medicare is often confusion about who I am and my role in assisting them. Who is this person on the other end of the phone? With whom is this organization affiliated? What environment is this person in? What is her physical appearance? How old is she? What is her body language? Will she hang up the phone and be unable to help me?

Whether you are a once-a-week volunteer or a professional provider of services to clients, grappling with the ‘strangeness dilemma’ and establishing trust is critical to partnering with individuals to make sure they receive the benefits they deserve. Jacqueline‘s advice:

When asked about yourself, offer a few pieces of information about yourself, while keeping the conversation focused on helping the client. Jacqueline suggested dialogue such as, “It sounds as if you’d like to know a little bit about me. My name is Emily, and I recently moved to New York City from Rochester to work here at the Medicare Rights Center.” You should only do this if the client asks something personal (e.g, How old are you? Do you have any kids? Have you every tried drugs). If the person you are working with doesn’t ask, don’t tell.  Always start off by telling the individual what you are able to do to help them, or what you need to find out in order to be able to help them.

Define your role to the individual from the beginning. “Let me ask you some questions to see exactly how I can assist you. I will do my best to provide answers to Medicare-related questions and provide you guidance on accessing your Medicare benefits. If I don’t know an answer right away, I will do further research and talk with my supervisor to find a solution.”

Offering information about ourselves and defining the role keeps the client-social worker relationship transparent and authentic. Transparency can help to establish trust, an essential component in our role as advocates, counselors, community organizers, and educators. Authenticity also establishes trust, making clear what your role is, for example, “I don’t know if I can help you, but I will try.”

Finally, practice patience. The challenge for myself, my fellow corps members, and I imagine for many individuals who are committed to fighting poverty and injustice, is to practice patience with our clients, our organizations, and ourselves. Establishing trust requires patience with the person with whom you are working. Learning how to communicate with clients effectively and empathically requires patience with ourselves. Learning where to find answers to clients’ questions requires patience with ourselves and our organizations

Individuals will continue to come to us filled with uncertainty about who we are and often about their future; practicing patience is essential in overcoming their uncertainty. Most importantly, practicing patience helps answer the question of  “who am I?” by sending the message: “I am an advocate for you.”

Emily Nash is currently serving as the AVODAH corps member and Client Services Associate at the Medicare Rights Center.  She is passionate about helping individuals access affordable health care and seeks to pursue a life-long commitment to social justice through a career in medicine.  She is excited to have the opportunity to share insights, experiences, and challenges of her AVODAH year of service with a broader community.