Posts Tagged ‘competency’

Paranoid clients: Whose reality is real?

Tuesday, August 23rd, 2011

Paranoia is a difficult topic to address in the client context. It is, as you likely know, a disorder in which a person is very suspicious and distrustful of others. MedlinePlus, an informational website provided as a service of the National Library of Medicine and the National Institute of Health, describes the symptoms in this way:

People with paranoid personality disorder are highly suspicious of other people. They are usually unable to acknowledge their own negative feelings towards other people.

Other common symptoms include:

 

  • Concern that other people have hidden motives
  • Expectation that they will be exploited by others
  • Inability to work together with others
  • Poor self image
  • Social isolation
  • Detachment
  • Hostility[1]

 

There is also a type of lesser distrustful behavior that lacks the more psychotic persecutory elements of delusional paranoia. This type is called “functional paranoia” because it serves the function of reducing the sense of vulnerability that often accompanies the loss of independence and control experienced by the elderly. In essence, functional paranoia is a coping mechanism. However, the “distrust, suspiciousness, and blaming of others can take on an angry quality that certainly can be aggravating for others.”[2]

A paranoid client is problematic for legal professionals in at least two respects, (1) they mistrust just about everyone, including the legal professionals who are attempting to help them, and (2) it is difficult to separate out the reality from the unreality of the information they provide. To a great extent the empowered paralegal will already be prepared for dealing with the first of these problems, because the paralegal will already be communicating fully with clients. When the client’s paranoia is functional, full communication can empower the client and diminish their feelings of vulnerability. However, even though functional paranoia fulfills a rational purpose, the paranoia ideation itself is not rational; the definition of paranoia is irrational suspicion. You cannot expect someone for whom paranoia is a coping mechanism to suddenly stop the ideation simply because you are in fact very trustworthy and have only the client’s best interests in mind.

Paranoia is subject to treatment. Counseling in which “an individual focuses on changing negative, self-defeating beliefs or misconceptions, may be useful in treating paranoid older adults who often attribute causality to external factors (e.g., the belief that someone took their pocketbook, that they themselves did not misplace it)”[3]may enable that individual to redirect those beliefs. However, we as legal professionals cannot make it our role to counsel or treat paranoia. Rather, we best perform our role when we understand the paranoid client and use that understanding to better work with the client.

Here are some suggestions for coping with the paranoid client:

  • Do not take his mistrust personally
  • Keep the client fully informed on a consistent, regular basis
  • Speak and write in short, simple, and clear sentences to minimize misunderstanding and misinterpretation
  • While you must check fairly constantly the client’s thoughts and statements against reality, do not constantly confront the client with that reality. Remember, the clients delusions are reality for them. Chose these “battles” wisely.
  • At the same time that you let client statements and ideation pass without openly questioning it, do not indicate that your are accepting or “buying into” the client’s paranoia. Be firm and respectful in protecting and projecting your own reality. (We are, of course, all hopeful that our reality is the reality, but be mindful that each of our realities is, at least, colored by our own biases, prejudices, and suspicions.) Do not see monsters under the bed just to keep the client happy.
  • Be open to the client’s discussion of her mistrust and suspicions. Let her know that she is free to voice them to you. Clarify misunderstandings about your actions or motivations in a non-defensive, non-judgment way.
  • Anticipate events that are likely to give rise to mistrust and suspicions. Explain proceedings and the role of the persons in them well in advance. For example, it is useful for any client to know that a mediator may be meeting with both sides of a dispute privately and that such meetings may not be equal in length, but this is essential information for a paranoid client.
  • Focus on the client as a whole and as an individual. Do not focus on his symptoms.

The empowered paralegal is also well-equipped to separate out legal relevant portions of client reports from the legally irrelevant, and is likely to have considerable practice at separating fact from fiction in the client’s rendition of her side of a case. Our client’s reports to us are always colored by their particular perspective, biases, prejudices, desires, and motivations. Paranoid clients are an extreme form of this. However, they are more than just an extreme form of this phenomenon. Non-paranoid clients, unless they are simply lying, color reality, but do not irrationally misjudge it.

This is a problem for the legal professional because we must make our judgments and recommendations based on the facts. If our clients are showing signs of paranoia, we need to be ever more mindful of our obligation to verify the facts before taking action. Michael Nugent Moore, a paralegal and licensed private investigator located in Boston, commented on this topic in a NFPA LinkedIn discussion thread. He gives this example,

While working as an investigative paralegal, I had a client who was a WW II vet. He believed that someone had stolen stock from him. His mind seemed sharp, but he had bouts of paranoia. I found numerous facts that contradicted his report of the situation and I was informed that paranoia is the initial manifestation of dementia. It was a real strain constantly trying sort out reality.

However, we must also avoid swinging too far in the other direction. There is tendency to discount or even ignore everything a paranoid client says, especially when they are making accusations against people who appear to us to be above such accusations. The sad fact is that all too often an elderly client’s own children, and the nursing home personnel entrusted with the care of the elderly, do steal from, neglect, and abuse those for whom they are providing care. We cannot assume these problems are not occurring simply because the client displays signs of, or even has been diagnosed with, paranoia.

Finally, as is the case with depression discussed previously and dementia discussed in the next section, paranoia provides cause for concern regarding our client’s competency.

 [Excerpted and modified from The Empowered Paralegal: Working with the Elder Client.]


 

[1] Medline Plus, http://www.nlm.nih.gov/medlineplus/ency/article/000938.htm (Last accessed March 17, 2010)

[2] Sheldon S. Tobin, Preservation of  the Self in the Oldest Years, Springer Publishing Company (1999), 14.

[3] Hooyman and Kiyak, 235

Transatlantic Competency Standards for Paralegals

Wednesday, December 1st, 2010

Just yesterday I posted on my meeting with the NYCPA Executive Board at which I learned, inter alia of that organization’s joint project to develop internations competency standards for paralegals. The past couple of weeks have been quite hectic, so I have not had the time to check paralegal related press releases. It was only this morning that I found many of you may have already heard of the project through a 11/22 release on PR Newswire entitled “Project to Create Transatlantic Competency Standards for Paralegals.”

The story states:

LONDON, Nov. 22, 2010 /PRNewswire/ — Many UK law firms have an office in the United States of America, and vice-versa. A significant number of UK and US law firms have merged in a trend that shows no sign of abating.

Typically such transatlantic firms seek to apply uniform expectations and standards to all their fee-earners across the firm. To assist firms achieve this goal, the UK’s Institute of Paralegals (IOP) is proud to be partnering with the New York City Paralegal Association (NYCPA) to produce paralegal competency standards relevant to both UK and US paralegals.

The standards, which will be available at no charge, will assist firms to standardize paralegal recruitment, appraisal, development and competency benchmarks.

World’s First International Paralegal Standards Project

This project is the first by paralegal representative bodies to create international standards. It highlights the growing sophistication of the paralegal profession in both the UK and US.

About the Project

The IOP and NYCPA have formed a joint working party to create competency standards for paralegals working in transatlantic law firms. The Standards will reflect the usual paralegal career structure, being set at introductory, intermediate and advanced levels.

Check the story for more details and contact information.

Release Party Invitation

Thursday, September 30th, 2010

Today is the official release date for The Empowered Paralegal: Working with the Elder Client. Despite my Oxford, Mississippi, connection, the release party will not be of the John Grisham variety. We start with the Philosphy Forum Series on the OleMiss Campus for a lecture entitled “The Authority of Empathy,” then one of the local establishments for a quick pint and other nourishment with the local bar association followed by the 6th Annual Japan Foundation Film Series: Japanese Films of the 1960’s event showing “The Fort of Death.” Feel free to join in the fun

Or you could spend your time productively by ordering a copy of the book. (I know this is simply blatent self-promotion, but what’s the point of having a blog if I can’t plug my own stuff.)

The Empowered Paralegal: Working with the Elder Client
by Robert E. Mongue

2010 • $38.00 • 328 pp • paper • ISBN: 978-1-59460-795-0 • LCCN 2010025542

Order now with 10% Internet Discount

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Elder law is a dual-natured creature and in many ways is quite unlike any other area of law. Substantively the law is law – statutes, cases, rules, and regulations – all of which must be researched, analyzed, understood and applied. Unlike any other type of law, however, elder law is not about something a client is going through, such as a divorce, bankruptcy, a real estate transaction, or even a criminal charge. Elder law is about whom and what the client is – an elderly person. The Empowered Paralegal: Working with the Elder Client enhances understanding of elder law clients, the laws applicable to them, and the issues they face.

The Empowered Paralegal: Working with the Elder Client examines the many influences on elder clients and their families, the deeply personal perspectives which result from those influences, and how they affect the decisions elder law clients make. It focuses on awareness and understanding of the elder client, explaining in clear language the dual nature of the elder client, the physical and psychological changes that occur as we age, and the practicalities of accommodating these changes when working with elderly clients. It also examines:

  • Issues surrounding competency, as well as the need for and methods of documenting competency in the file.
  • Dealing with the client’s family, including conflicts of interests, confidentiality and undue influence.
  • Perspectives, many culturally or religiously based, on aging, death, and dying.
  • Intestacy, estate planning basics, and the use of basic estate planning tools to meet client goals.
  • Advanced directives and other means of planning for end-of-life decisions.
  • Social Security, SSI, Medicare, Medicaid and other public benefit programs and laws directly affecting the elderly.
  • Elder abuse and the conflicts that may arise between the attorney/client privilege and mandatory reporting statues.
  • Ethical dilemmas faced by the professionals who work with the elderly.

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“Mongue’s book does not cover the ho and the hum of regular ‘how-to’ paralegal books. In fact, what he covers should be taught in every school regardless of specialty, profession or even age. Here, Mongue deals with our feelings about aging and the myths, stereotypes, cultural prejudices and extrapolations to the general population based upon personal experience. He draws you in as he explains behavior and the aging process and teaches you how to react as a result. As it turns out, much of what we think about the elderly is wrong, wrong, wrong.” — Chere Estrin, Editor-in-Chief of KNOW, The Magazine for Paralegals and SUE, For Women in Litigation; Chairperson of the Board, The Organization of Legal Professionals (OLP)

“[A]n insightful guide that any legal professional who works with an older population will find extremely useful. Mongue brings his extensive expertise both as a practicing lawyer and a paralegal instructor to the table, and illustrates his points with interesting examples. He discusses the complexities of the law in regard to aging in a clear, direct style that readers of all experience levels will appreciate. This book is a must-read and a valuable desk reference for anyone who interacts with elder clients.” — Lynne J. DeVenny, Co-Author of Workers’ Compensation Practice for Paralegals and blogger at Practical Paralegalism