Leonie worked until recently as a Golden Key Service Coordinator, seconded from Golden Key partners One25. In an article published in Agenda, she talks about her work and the importance of holistic approaches and self-care among practitioners.
Here is Leonie's story:
I work with women who experience daily violence, abuse, poverty, homelessness and addiction. I try to help the whole person, potentially with every element of their lives. I know this holistic approach is really valued by our clients, who would otherwise be passed around various services not knowing who they can turn to.
Our service usually provides each woman with one person to support and navigate them through the system. For about 15 women in Bristol over the past three and a half years that person has been me. I have seen all these women go through repetitive cycles of violence, addiction, homelessness, offending and mental health problems.
If they are having a problem with housing I connect them with the services available to help them; If they are struggling with finances, might help them access a food bank; If they have had a run in with the law, I help to ensure they meet with their probation officer once a week.
Often these women are having to access many different agencies and services at the same time, all with different rules and restrictions. On top of this, they may well be ‘sofa surfing’ at the home of a ‘friend’ who is asking them for sex in exchange for drugs. They are working the streets to make some money to feed their drug habit, awake at night, asleep in the day when services are open. How do they begin to join all these different strands together?
Some days I start off by joining the outreach team so I can try to locate one of my homeless women and offer support. Then I might speak on the phone to a client who is very distressed and suicidal. I will listen, talk through what she is feeling, try to reduce her anxiety and lift her mood. I will follow this up with phone calls to the mental health crisis team, and emails to update all the professionals involved with her case.
Next I might support a client at a benefits medical assessment. We may well sit in the waiting room for an hour or more, her anxiety levels rising with each minute, only to then be told there is such a long delay on appointments it would be better to come back another day.
I might have to phone a victim of trafficking who needs to get documents to extend her leave to remain which is due to expire. Then a quick email to confirm my attendance at two multi-agency meetings - one to monitor a client’s level of risk to the public and another to build a joint safety plan to reduce the risk of death or harm for a victim of domestic violence.
I then nip to the office before the end of the day to write my case notes.
Then it’s back home to relax and eat before going out on the outreach van to support women street sex working. Among the women we see is one of my clients who is impossible to find during the day. She is very intoxicated and finding it hard to stand and speak. She manages to tell us about a recent assault she experienced from a customer. We record this and try to get her to eat. She takes some condoms, but does not want to eat, and off she goes back onto the streets.
Many of the difficulties these women face stem from a lack of trusting relationships. The hope is that by providing them with one strong relationship we can then support them to engage with other agencies whilst they go in and out of recovery, prison, homelessness and hospital.
Inevitably, this work requires you to give a part of yourself to each client. For many of them the only positive relationship in their lives is the one they have with you. When you are embedded in people’s lives to such an extent at some point it takes its toll. Sometimes it is hard to establish your boundaries. When do you say no when potentially every problem is within your remit and services have been cut so severely that your role is needed more and more everyday, not just by clients but by professionals too?
Recently I went to my GP and was signed off sick for a month. It had been building up for a long time. My initial response had been to just pile more work on myself and keep going. I had done everything I could to work through it using various forms of supervision (clinical, line management, group reflective practice, peer supervision).
It was hard to express what I was feeling or put into words. I was not coming home everyday in floods of tears. The best description I found was a sense of my head feeling ‘full’ and unable to take anymore in. After being exposed to horrific stories of sexual violence, exploitation, chronic hopelessness and very risky behaviour on a daily basis my threshold for what I found shocking had all but disappeared.
Taking the decision to go off sick was absolutely necessary. It gave me time to reflect and to really look at what is officially referred to as ‘vicarious trauma’. I felt a sense of failure - that by being off sick I was weak and, despite all the supervision I got and the good work/life balance I enjoyed I still couldn’t manage it.
I realised it is not about getting to a point where you suddenly become immune to your clients’ experiences. It is always going to affect you and in fact, if it doesn’t, then there is almost more to worry about. When you are hearing about so much violence towards women, who are often targeted because of their gender, the pain you feel is not just for your individual clients, but for women in general.
I know I am not alone. I belong to a community of practice of about 35 professionals who work with women experiencing ‘multiple disadvantage’. Self care has come up again and again in our face-to-face meetings and our online networking platform. If we as professionals are to have the energy, tools and motivation to help women going through the worst life can throw at them it is essential that staff wellbeing is prioritised. We need working environments which enable us to take time to reflect, define our own limits and unpick the day-to-day buzzing around.
I was lucky enough to have the kind of support which so many people in similar voluntary and public sector roles are still without. Even so, sometimes we need a break, not because we have failed or because we are ill, but because we are human.
One of my clients has passed away and I am amazed others are still alive. I have been through almost every emotion with each and every one of them. They have laughed and celebrated with me at the smallest of achievements; cried and despaired at the lows; and shouted, screamed and sworn at me in the midst of their anger and frustration with their lives.
Despite all the struggles, every single one of them is human like me. They have so much potential and so much to give. They are funny, intelligent and caring. To know them so deeply is a privilege.