Ashley and Caroline discussed challenges faced during Ashley's recent home visits with a client struggling with opioid addiction and non-adherence to treatment.
The conversation addressed Ashley’s frustrations, possible implicit biases, and the importance of understanding the client’s wider ecological context.
Caroline encouraged Ashley to reflect on assumptions, adjust her approach, and seek peer support.
Progress was noted during the follow-up, and ongoing support was agreed upon.
Action Items
Before next Wednesday – Ashley: Schedule and conduct a check-in conversation with Caroline regarding client progress.
Ongoing – Ashley: Continue working with the client, remain aware of potential biases, and apply a more reflective approach in future visits.
Ongoing – Ashley: Discuss feelings and experiences related to working with opioid-using clients with co-workers for additional support.
Ongoing – Caroline: Continue to support Ashley and provide guidance as needed.
Discussion: Client Engagement and Home Visit Challenges
Ashley described a difficult home visit with a client who had stopped attending outpatient treatment, appeared detached, and showed little interest in engagement or care for her pregnancy.
The client missed her last two appointments and showed signs of continued substance use.
Ashley expressed deep frustration and emotional impact resulting from feeling unable to help the client and struggling to reconcile the client’s behavior with her own values.
Discussion: Reflecting on Biases and Socioeconomic Barriers
Caroline challenged Ashley to consider the social and environmental barriers her client faces (unstable housing, unreliable transportation) and encouraged awareness of possible assumptions or biases based on socioeconomic status.
Ashley acknowledged she might have made assumptions and was encouraged to step back and try to understand her client’s context without judgment.
Emphasis was placed on the importance of not blaming the client and recognizing the ecological influences on her treatment adherence and living conditions.
Discussion: Adjusted Approach and Peer Support
Ashley reported improvement after reflecting on her own countertransference and letting the client lead the conversation; the client was more open during the follow-up visit.
Caroline suggested ongoing self-reflection, dialog with colleagues about experiences with similar clients, and continued support from supervision.
Both agreed to continue their collaborative approach to better serve the client.
Decisions
Ashley will continue working with the client — with an increased focus on reflection, understanding contextual challenges, and managing personal biases, as supported by Caroline.
Open Questions / Follow-Ups
Monitor progress with the client and reassess if further changes in approach are needed after future visits.
Schedule and confirm the next check-in before Ashley's team meeting next Wednesday.