# 15 May 2001

"Science without religion is lame and religion without science is blind."

Albert Einstein

(continues below)

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# 15 May 2001

Asking About Current "Employment Status"

TISA Description of the Problem: Many aspects of taking a social history, and even questions about demographics, can pose significant hurdles to engagement. A tricky engagement situation can arise when we are asking our clients about their employment. The following set of tips provides some excellent ideas for approaching this common dilemma.

Tip: After the introduction, many clinicians will proceed to ask about identifying and demographic data, prior to starting the chief complaint or taking the history of the presenting problem. Often such inquiries start with questions about living situation and marital status. One area of difficulty is asking about occupation.

For example, for women, I have been taught to avoid asking, "Do you work?" for such a question may imply that a woman, who does not have a "paid" job, is not working. By implying that domestic chores and/or child rearing is not work, the clinician may be inadvertently denigrating the client on a subtle level.

On the other hand, asking "Do you have a job?" or "Are you working?" may tend to alienate any client who is not currently employed outside of the home. Due to this, I have seen some interviewers tactfully ask, "Do you have a job or are you between jobs?" Alternatively, I find the following question to be the most tactful: "Are you working at the moment?" The addition of the words "at the moment" helps the client to "save face."

In the last analysis, because of all of these complexities, I have found the easiest single question to ask is the following, "How do you support yourself?" This phrasing allows for a variety of responses from the client such as: "I'm on disability." or "I work as a teacher." or "My spouse brings in the money for us." From the start, this simple question can provide surprisingly good insights into the employment situation of the client and even how the client feels about his or her current situation.

TISA Follow-up: The above interviewing techniques provide a variety of thoughtful ways for helping clients to feel comfortable when sharing job status. Another nice question is to ask, "Do you work outside of the home or at home?"

Tip provided by:

Michael Cheng, M.D.
University of Ottawa Psychiatric Resident
Ottawa, Canada