Messing up

 

 

We all mess up when we see clients. And to prove it, I’ve asked around a couple of trainee friends and acquaintances to share some of their experiences with you. I’m naming no names, and I’ve changed details if people are possibly identifiable, but you’ll see from the list that the mess ups go from ‘inconsequential’ to ‘something that was talked about in supervision’. Some of them are mine, some aren’t. I’m not sharing which are which. But this is for students not yet in (or just starting) training – we mess up! It’s usually not the end of all things!

 

1: when getting up to show out a client, I stood up and immediately fell over. My foot had gone to sleep and I hadn’t noticed.

 

2: I wore my top inside out for the whole evening, only noticing on my third client.

 

3: I once didn’t turn the handle to the waiting room properly and as a result, walked into the door, and then the waiting room with a very red face.

 

4: Checking my phone between clients I realised I’d not put it on silent. Lucky for me, no calls came in!

 

5: I got in to my client room to discover the clock had been taken away and I wasn’t wearing a watch. I managed to time it JUST right

 

6: On an evening placement, I became aware the cleaners were cleaning as I was seeing my client and I had forgotten to flip the ‘counselling’ sign to ‘in use’. I felt my heart pounding as I tried to decide what was best to do. It seems daft now.

 

7: I asked for some fairly low-key advice on a client thinking they had left, but they hadn’t. It wasn’t anything that broke confidentiality, but I feel mortified.

 

8: Seeing a client for their second session I went in whilst they were getting a hot drink and started to say hi but they ignored me. As they turned around I realised it was a friend of the client’s and the client was there waiting for me.

 

9: One of my clients always has squash. All the others have water (squash is an option if asked for but they are the only person to ask for it). Last week I was flustered with the client before and I forgot and put water out. I felt terrible when they asked why they had water.

 

10: My files are anonymised. I had two new clients lined up to start in two weeks. When I went in to start, I didn’t have a record of what their names were. Luckily for me, they were recorded on an old version of the spreadsheet for the placement. It took me about half an hour to find the names. (They both DNAed).

 

So there you go. Random things trainees have done and had it work out ok.

 

What things have readers done?

 

 

Wondering what you’d like to know

 

 

I’ve been writing blog posts on and off (mostly on) for just about 18 months now. In that time I’ve gained over 100 followers that I can see on wordpress, and others who have signed up via RSS (and I have no idea about. Hi! *waves*).

 

Often times I don’t know what I’m going to write about until I sit down at the computer on a Tuesday afternoon, desperately trying to come up with something. Often something from a client session will trigger something (even if not directly related) that will give me a topic, so I’m usually glad to wait until the evening after I’ve seen at least a client or two that week, but sometimes, like today, nothing immediately comes to mind. As I was walking back to my counselling room (having brought my laptop in case a client DNAed) after a client DNAed, it occurred to me to wonder – is there anything people reading would like to know?

 

Whether it’s been a long time since your training (or whether you’ve had no training), or whether you’re in training and you want someone else’s opinion on something around training, or being a trainee, and how that relates to anything in the journey. Or whether you’re a client, and you want to know something from (albeit a trainee’s) point of view about counselling. I’d be happy to answer things if I can – with the understanding that I’m just one person, and it’s just my fledgling opinion and experience..

 

So – I’m signing out, wondering ‘what do you want to know?’ Comments go up with whatever name you please, and I’m happy with anonymity, so please ask. It would be a lovely change to answer something, rather than just send myself out blithely!

Dual roles and ethics

 

 

The thing my counselling course is so hot on (understandably!) is.. ‘ethics’. Speaking as a student who was unable to get permission to do a piece of work with their cohort on the training experience because of the issue of ‘dual roles’, I have come ‘up close and personal’ to this issue a number of times.

 

As a person counselling in a small community, I have (inevitably perhaps) bumped into ex-clients at events. As a (trainee) counsellor with some minority interests, I have met other counselling professionals unexpectedly in some quite intimate venues. Both of these things are things you often can’t (or don’t) legislate for in advance. As much as I might talk to a client about the fact we might bump into each other at an event, I don’t always hold in mind that I could bump into ANY client at ANY event (although when I put the bins out in my PJs the other day it was definitely top of my list of thoughts).

 

But something that is rarely talked about and (by my institution at least) is something that I know has been an issue for at least one other trainee, and that is when your supervisor is also your placement co-ordinator. How do you manage that? It is probably fine when all is going well, but what if you have an issue with your placement outside of supervision (say you have a particular area of expertise and your placement is less than expert on the matter and you want to raise it)? What if your placement has an issue with you? Normally this would not be necessarily dealt with in external supervision – procedural issues would be addressed in placement, and if YOU felt it was an issue, you could decide to take it to supervision. When your co-ordinator is your supervisor this separation may not be possible.

 

It’s something that’s recently become more relevant for me because for the first 15 months of seeing clients I was running my own placement. Now I am in a second placement where my supervisor is the placement co-ordinator and I am having to negotiate where something is one thing and where it is another. My advice would be to have something concrete set up: we’ll have supervision X times a month, but it may be that I need to talk to you about procedural things outside of that and we will do that outside of supervision. Or: we’ll mix the two. It doesn’t have to be one way or the other, but until I was in this position it never occurred to me that without those boundaries I would suddenly be experiencing contact with my supervisor that did not feel like supervision, but was perhaps, billed as that.

 

From all I can see, we hit dual roles all over the place. A friend recently asked me if I could recommend a counsellor for them. And i can. But only because I know the counsellor. If i didn’t know them, I wouldn’t be able to recommend them. So now my friend may be seeing my friend who is a counsellor (I haven’t, and won’t ask. But if they say they are, I will negotiate that. But it’s still a dual role: friendship/professional relationship). I co-run a person-centered group locally. Trainees and trained counsellors come. Some of whom I am aware of from other services. Some of whom I know from my life before. It’s a dual relationship. I work with someone who is related to a friend. These are all dual relationships that we are expected to manage, without even really a passing word. Whilst I could not get ethics approval to write a paper about the student experience (because it was a dual role), I will be allowed (or at least, in the past others have ben allowed) to interview potentially people from my cohort for my dissertation. It’s a dual relationship. As are all the others. But in the others, it is a given that I will be expected to manage that.

 

Frames of reference, and forgetting yourself. 

It occurs to me recently that during sessions I am quite good at putting my own frame of reference aside and being with the client’s frame. But to some degree, because that frame isn’t ‘what I would feel in your position’ I forget that ‘what I would feel in your position’ is actually a valid point. I forget myself in the room. 

This leaves me, in session, trying very hard to ‘be with the client’, but it means I Struggle to recall afterwards. I think it was made much worse by the fact that my last supervisor* was often asking me things about what I thought my clients meant when they said or did X, and that never felt useful to me, because it had been through so many iterations (a client experienced a thing and communicated it – imperfectly – to me. I then experienced that imperfected communication and communicated it imperfectly to my supervisor. Who then experienced the imperfected communication about the experience of the imperfected communication of the original experience (lost yet?!) and on the basis of that, asked me a question about ‘why?’. And I didn’t know. I am not in the client’s head. And sometimes I might clarify about what something means but the imperfections remain. So for several months my supervision was less about encouraging me to stay with my client and more about encouraging me to dissect my client. Fred would never have done that, and I miss him a lot. Maybe next year if I get paid more, I might be able to go back. Let’s hope. 

That dissection, that ‘why’ I realise, means that often when a client occurs to me outside of a session, I’m looking at it from a critical frame of reference ‘well why DONT they do that?’ And it wasn’t until very recently when I was with a particular client that I caught myself stepping into that and stopped myself and thought to REALLY see it from their point of view, and considered the words they were saying and how those might map on to my experience, that I realised just why they might be doing a thing. Of course then, if I wish, I am able to gently check that out (go me with my ‘use of self’). Or not – it depends. 

*I did realise back in December that that supervisor was bad for me and stopped seeing her, but I have had tribulations finding a new one. I start seeing someone new Thursday- John. I have told him I need to be challenged to be a better therapist. I think he’s ok with that and I hope he can. 

what makes a good supervisor?

There’s been some discussion recently on the facebook trainee group about what makes a good supervisor, andI realised that I’d never really posted about my supervisor experience.

 

I’ve had two supervisors and am on a hunt for my third. My first supervisor, Fred, was great. I’ve spoken about him here. I felt challenged by him, with regard to my practice; my way of working; my way of being. He was able to use person-centered theory to challenge me. Usually I would take a ‘thing’ I was concerned about, and we would discuss whether it was person-centered, what my motivation behind the ‘thing’ was, whether THAT was person-centered. I enjoyed working with Fred very much. We had a big problem back last summer where we seemed blocked over an issue (and I felt like I was being chastised for something I couldn’t help), but after 3 weeks I eventually spoke to him and it turned out that he had been doing his own thinking and realised that he needed to let me be on that front; that my way of working wasn’t ethically or theoretically wrong, it was just different.

 

Unfortunately, Fred was too expensive for me to maintain, and he is also based in an awkward location, so I had to stop seeing him. I began to see a new supervisor. I did not feel challenged. I never really heard the words ‘person-centered’ come up, but I DID learn a lot about that supervisor’s previous places of work and what they thought of those. The one time I asked for direct support on an issue my only response was ‘what do you think you should do?’ and when I tried to talk through it ‘You should do what feels best’. Well; yes. I’m aware of that. However, I’ve been doing this a year only and would appreciate some support. So I’m now looking for a new supervisor. So far I’ve had one disastrous interview with someone that felt actively dangerous, and another one coming up this week (fingers crossed).

 

A good supervisor:

 

  • Will set good boundaries, in advance, so you know when you can call, or text, and what (if anything) payment for that extra contact will be.
  • Will hear the problems you need to raise
  • Will challenge you – to a level that you are happy with, or will be open to discussion about being more, or less challenging. The challenging will be aimed at making a better therapist out of you, rather than browbeating you.
  • Will be able to engage with you on a theoretical basis – there is no point picking a modality-specific supervisor if your supervisor isn’t working within that modality, especially as a student, when we are learning how to work within our modalities.
  • Will be talking to you about how YOU feel in your sessions, not about how your client might feel (or worse, how your client’s (for example) non-present partner might feel) – there is little to be gained in asking you to infer what someone might be inferring about someone else, especially when there ISN’T follow up about you in that session.
  • Won’t spend much time talking about their other work. Both Fred and my second supervisor talked about other places they had experience. The difference for me was that Fred seemed to be using it to illustrate his point to support me, and my second supervisor was using it to illustrate her (mostly) frustrations about certain environments.
  • Will be open to challenge. It was hard for me to bring my issue up with Fred. It took weeks. That’s mostly about me, not him. But I did feel I could. I didn’t feel like I would gain anything from bringing it up with my second supervisor, so I just left.
  • Will be open to learning new things. It’s possible that your client group or relevant life experiences won’t immediately be familiar to your supervisor. That’s fine – we all have clients who have something outside of our own experience. But your supervisor shouldn’t be relying on your to teach them about those things. They should be prepared to learn for themselves, although they might also ask you for good recommendations – websites, books, etc.
  • Finally, hopefully your supervisor would be on the same kind of academic level that you are – I have seen form fellow students that it can be helpful to get a supervisor’s opinion on academic work (especially where it involves things that were talked about in supervision), so if your supervisor is able to work at the same level, that can be enlightening. It’s not always necessary; I’ve never asked a supervisor for that feedback (and Fred had previously taught on a university counselling degree), but if it’s important to you – ask.

What other things would people add?