What to do

You are probably accustomed to having clients showing up at your organization for the kind of help you provide.

First, greet the client normally and communicate with clients in a way that will establish a trusting and respectful relationship. Help the client to identify the areas of concern that they came to see you about, and plan what you will do for them. You'll use your normal questions, observations, and assessment tools to identify possible presenting issues.

If you are working with clients from another culture, you'll need to fit in with their cultural obligations e.g. family roles.

 

Identify signs of non-presenting issues and make an assessment

You also need to pick up on any non-presenting problems or issues. Part of your role is to identify harm, neglect, abuse, or risk of harm. This is wide-ranging because harm can be physical, emotional, cognitive, psychological, sexual, or financial.

Pay extra attention to the groups of vulnerable people at highest risk. They tend to be:

• People with a disability, including acquired brain injury (ABI)
• Elderly people
• People with mental health issues
• Children and young people, especially babies and toddlers
• Homeless people
• People in unequal power relationships

Look for any signs of harm, neglect, abuse or risk of harm:

• Physical symptoms such as injuries or loss of weight
• Verbal and non- verbal cues
• Impairment to cognitive functioning caused by acquired brain injury such as loss of memory, inability to concentrate, plan or organize
• Reports from the individual, carers or other workers
• Psychological/emotional indicators
• Erratic behaviors

Be aware that those inflicting harm may may be the carers, service providers, the client themselves, family or significant others, or other members of the community,

 

Check your information

If you suspect that the client has other issues, your first step is to check the available information. You can easily check your client files and case notes, and ask your colleagues. Your organization might have procedures for collecting and analyzing client information. They could be either written or oral. Ask about questionnaires, assessment tools and client profile forms

You are looking for information on the client's behaviour, their physical appearance and acuity, their answers to questions, and other information provided by client and information on the client provided by family, carers, other workers, or other agencies

As you go, you might also be able to gather information from the client's family or carers, your files of the clients, your colleagues, or from other agencies with knowledge of the client.

 

Identify the client's issues

Based on your information, ask the following questions:

• What is the range of issues affecting the client?
• How are they affecting the client?
• Is a person the cause? It could be carers, service providers, of family members. It could also be the client themselves.
• What kinds of help does he/she need?
• What is a priority for immediate action?
• What is a priority for longer term action?
• What can you do to address their priority areas? Consider your options and workable strategies.

 

Decide what to do

Use your information to decide on a suitable course of action. First, use your organization's assessment tools to assess the level of risk to the client and others involved. The assessment might indicate that you should discontinue the process.

If you need to continue, consider the following questions:

• What are the client's current needs?
• What are the priorities for meeting their needs?
• What sources of help are available?
• Can your organization meet the range of client needs?
• Can you intervene yourself to remove the risk?
• Should you report it to a supervisor?
• Should you investigate further?
• Should you ask for specialist support/services to come in?
• Should you refer it out to someone with more expertise or another organization?
• What procedures do you have to follow to meet your duty of care and legal requirements?
• How will you work with the client's significant others? (e.g partners, family members, carers or advocates.)
• Can you bring in specialist support and continue to work with the client? (Your organization might have a procedure for doing so.)