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.

 

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When clients stop coming

 

This blog started off as a blog on challenging myself, and I realised that it was somewhat akin to a previous post I wrote in July about my training mid-point, and as I started, I realised that I was thinking about my therapy, so I decided to go there instead.

 

I suspect any trainee or counsellor reading this has had an experience (or several!) where a client who has previously seemed very interested in coming to counselling suddenly stops, with no reason. This is a bit about my own experience (as a client) of that.

I’m a firm believer in layers of therapy (like an onion. Or a parfait). I first went to counselling when I was 19, for a very specific reason. Therapy kind of worked around this issue and when i was ‘better’ I stopped therapy. A few years later I went to see another counsellor about unrelated issues that had come up for me. And there came a point in that therapy where I felt that i was ‘done’. I was there, with nothing really to say, and nowhere to go. So I stopped going to therapy and apart from a brief return when a couple of traumatic thing happened within a week, I didn’t go back.

 

At the start of this course, I had to get my own therapy of course (it’s a UKCP course and that’s mandated). I saw two therapists over the course of a year, but therapy felt like it wasn’t going anywhere. It wasn’t for lack of trying, and eventually, my counselling insitution let me go back to the therapist I was seeing in my early 20s (over 12 years ago). It’s really interesting for me to wee the journey I am on with that counsellor; I was so convinced at 25 that I didn’t have anything left to talk about, and now, a decade or so later, I find that I have barely scratched the surface.

 

I’m fairly sure that my COUNSELLOR could have told me back then that I’d barely scratched the surface – but she like me, is person-centred and that isn’t in her job description. I was at the place I was at, and that place said I was done. I was at a plateau, or a gathering place. I suspect that I’d had quite a lot of restructuring to do in therapy, and that I simply wasn’t ready to start building again – I had to spend some time being the ‘new’ me in the world before I was ready to start building again.

 

Now – I see that I am building again, that therapy is of tremendous use. But the stuff that i’m doing now, I simply could NOT have done then. I wouldn’t have had a place to start even and it would have thrown me into confusion and led to me not coping in life. I was lucky that I was able to verbalise that to my counsellor and we worked together to an ending, but I suspect that there are many more clients who aren’t keen on endings and they just leave, with no warning, and don’t answer calls or return messages. It’s frustrating as a person, but as a (trainee) counsellor I recognise completely that the client is doing what is best for them and that it’t not for me to impose my will onto a client and instead, I wish them well in my head and hope they find what they need in life.

 

 

Person-centred progress

Work in Progress

Work in Progress (Photo credit: blumpy)

 

At the ADPCA conference, there was a moment where someone was talking about the person-centred approach, the true person-centred approach – of not directing the client at all, of letting the client talk about what they wanted, whether YOU thought it was relevant or not. So you might know that a client has been sexually assaulted; that may be the reason they gave for coming to your office, but week to week, they talk about what they have done that week. The person speaking never asked further – they let the client lead the direction, and that was how it went.

 

I had two strains of thought. Part of me was thinking about just how person-centered it was, and part of me was thinking ‘but if you’d just asked the client about WHY they were there, they might have talked about it – they might have moved on from the place they were in when they came’. I was lucky in that the person who was talking wasn’t at all defensive when asked about why, and was able to talk further. I have nothing but admiration for that person, but still couldn’t move that small niggly feeling.

 

Until recently, when someone said to me that they felt it was a good thing that they were going to therapy, even if they were just talking about their week, because just having someone there to talk to helped them to feel better, to know that they were listened to, and it reminded me of Jerold Bozarth’s pre-conference talk about how HE found the person-centred method because he was giving inpatients space to speak, and found that they were getting better ‘of their own accord’ (better in the eyes of the hospital – I’m not making any kinds of claims on what ‘better’ or ‘worse’ might look like).

 

So there – two ‘big’ names in the field, suggesting that ‘giving clients space, *works*’, and now I have my own experience to back that up. And it’s something I need to hold on to, the next time I am with a client and I am inclined to direct the flow in any way; it is person-centred not to direct. I will make ‘progress’ if I don’t direct (even if this is just my own learning).

 

Encountering encounter

To change my wild river?... Never!!! / Changer...

To change my wild river?… Never!!! / Changer ma rivière sauvage? … Jamais!!! (Photo credit: Denis Collette…!!!)

 

Developing the person-centred approach – at least locally!

A couple of things came out of the ADPCA conference for me, but the over-riding feeling was that I wanted more community. I had previously gone to the most local group to me but it’s a way away, and I haven’t made it back. But I decided that what I really wanted, was more of that. So I hope that two things will be happening:

One:

I am creating, together with someone else, a Coventry-based person-centred group. It will run on the second Sunday of the Month and is open to anyone interested in the person-centred approach. It will cost £5 and that will cover room hire and tea/coffee donations, with anything extra going right back in to the group (either to look at paying for other CPD for the group, or in the form of a lending library or similar). Claire and I are trying to run this on person-centred lines and so we don’t want to make a great many decisions for the group without the group. We will run from 10-12.30, but the room will be open from 9.30 for anyone who wants to come beforehand and have a drink with us. If you’re interested, please feel free to comment here and I’ll get back to you 🙂

 

Two:

I hope, in the near future, to hold a national day of encounter. I have an accessible venue (also in Coventry) that I can hire for the day, and the idea will be that there are no workshops, no facilitators, but a day of encountering. At the ADPCA conference I realised that this is what i like most about the approach and this is what I keep looking for, hence the development of the small local group. I like the large group atmosphere also, so would like to recreate this more often than once every two years.  I don’t have all of those details sorted yet – I have in my head ideas of outlays, and I think that I can make it viable, but it will be a definite learning process as I go along. I’m also aware that I’m just a trainee. I’m learning. I haven’t got there yet. I have more reading I’d like to do before I fully commit myself and decide on a date/pay for a room, but in all honesty, I’m 90% decided. I just need to learn a little bit more. There will be 2-3 months’ notice on this, and if it works out, I’d love to do it quarterly – if people will come. I have in mind that there will be two prices charged. One for working people, and half prices for unworking/trainees, with a limited number of free places for people who can’t afford to pay. IF enough people come at full or half price to give me money left over, then I will be able to offer some travel costs too – whether the ‘price’ for that will be asking people to be official volunteers or not, I don’t know, but what is really important to me is that people don’t stay away because they can’t afford it.

If people book far enough in advance it’s possible for example, to get a return train from London for £13.50 and in an ideal world, I’d be able to cover that. I recognise that that’s not the only cost that people have in getting to these events, but this is a start.

As part of the national event, I’d also like to stream one of those meetings. Whether it’s done as a section – we stream a morning but not the afternoon (and not the first meeting!), or whether as a group we decide that we will build up some community first and stream a full day of the third (choosing a random number) meeting, I don’t know.

 

What do you think? Would you come? What would need to happen for you to be interested?

ADPCA – the rest

 

 

 

People have been asking me to write the rest of the conference up, and I didn’t do that last week, as I wanted to write about my mid-training point. But this week’s post is about the rest of the conference.

 

I wasn’t able to go for the first day (my leave year runs August to August and my training takes a LOT of days), and that was the day that things were decided. I was only able to make Thursday, as fri-sun was a training weekend for me.

 

In some ways, I was disappointed. There was one workshop that i REALLY wanted to go to (with many others that I would have been happy to go to), and I emailed the person organising it to put in a request for that Thursday, but for whatever reason it didn’t happen. It might not have happened if I’d been there anyway, but there was a disappointment for me.

 

So Thursday morning I turned up, met a few familiar faces from BAPCA last year, grabbed a coffee and headed in to community. Community was a bit ‘bitty’ – I wasn’t the only person who hadn’t been there the day before, so there were organisational things to share with the group, and feelings to be heard. Early on, someone came in with an idea that I understand didn’t come off, and I have THOUGHTS about (and from), which I’ll share probably next week.

After morning community I went to a workshop. I don’t actually remember which one it was. So I feel bad. I might actually have stayed in community to be honest – I have a memory of three lots of community, and it’s all a bit fuzzy!

After lunch however, there was nothing in particular that I wanted to do, and I ended up wandering around with another trainee (just finished!) and then we met someone else and the three of us sat and talked for a session. It was great. Hard work, but connection (or the attempt to connect) deeply with other people for an hour was good and nourishing. It made me realise that I had been missing something in the morning community, and that was what I had come to conference for. I also knew that there was one other workshop and then as a day participant, my time was up. So in the break I spoke to an organiser and asked if it would be ok if I stopped for dinner and evening community. They graciously agreed I could (I certainly wasn’t the only one, and even then the venue massively over-catered), so I headed to the last workshop, which was about fledgling counsellors and helpful advice. It was a great session and I enjoyed it a lot.

 

Then dinner, and I got speaking to someone who is local to me. We spent dinner talking over various future plans (more of those next week) and swapped details. Then we headed back to community. It was due to finish at 10, but I left at the end at 10.40. THAT was the thing I had been looking for – the connection. It was interesting; I shared something very personal to me, because it became very present and wouldn’t leave, and then I could feel myself disconnect from the group, and then suddenly reconnect some time later, but I felt part of something. I felt like a something that mattered. *this* was the community I was looking for. This was the bit I enjoyed.

ADPCA was a difficult conference for me, as I like to be told what I’m going to and when, and just go. It is an entirely different concept to think about a conference that’s based a) around community and b) that is self-directed. I am trying more and more to come to terms with it, and I think that I am and I think that I like it, but it is taking some getting used to.

 

A couple of future things have come out of it that I look like being involved in, and I will update with those next week 🙂

 

 

 

 

 

Why I decided to train as a therapist

Deutsch: Phrenologie

Deutsch: Phrenologie (Photo credit: Wikipedia)

I had a comment from a reader, commenting that my blog doesn’t say much about me, and asking why I decided to train as a therapist. I originally got interested in eating disorders around the time I was 19. A few years later, I had thought to train as a dietician, and applied to university to do a dietetics degree. At the same time, I spent a day following a dietician in a hospital, and realised form that, that I didn’t want to be a dietician. I wanted to help people with eating disorders, but I wanted to help their heads, rather than their eating plans. I spoke to a dietician I knew who specialised in eating disorders and she said that with very few exceptions, even as a specialist in a subject you could till expect to spend more than 50% of your working time working in your non-specialist subject.

 

That clinched it for me, and I changed my university application to be a psychology degree, with the aim of becoming a clinical psychologist.   I loved my psychology degree, and after I graduated, spent a little while working part-time as a research assistant, whilst applying to assistant psychologist posts. It was just about the time the NHS bottleneck got really bad, and despite having very good marks, and relevant experience, I wasn’t able to get an NHS position. I moved in to other roles – I needed to pay bills. I couldn’t let go of the idea though, and decided that if I couldn’t work in the NHS, perhaps I could work privately. So I did a level two counselling course. Then my life crashed massively and I couldn’t continue for a while. A couple of years later I went to a different college and did my level three. That tutor was going on to run a level four and I considered doing that, but decided I couldn’t do it ethically – I had issues with her teaching, and so I started looking around for other courses.

 

I chose person-centred because the closest course I could do that would let me work full-time had two courses, PC and integrative. The integrative course had too much Freud in it for me to be comfortable with as an LGBT person and I thought that I would find it too easy to retreat to a position of authority on an integrative course (having knowledge and theories to ‘retreat’ to), whereas the person-centred method is decidedly NOT about being the expert. That’s not to say that I don’t think the integrative course has value, just that I think the person-centred method is better (for me, at least!)

And here I am. I’m also about to start a phd in psychology, so I’m going to have my hands pretty full! The plan is to eventually work part-time as a psychologist in research and part-time as a psychotherapist. If I can ‘marry’ the two, even better.   I like people, and feel a desire to connect, although I sometimes struggle with ‘chat’. I know that I can form good and clear relationships with people and that some people find this helpful. This is the kind of people contact that I enjoy and could do a lot more of.

 

I still have that interest in eating disorders, but my interest range is much broader now and covers trauma, dissociation, eating disorders, and LGBT-related issues.

 

So this is what shaped my decision to train as a therapist 🙂

knowing myself

 

Oscar Wilde Be yourself, everyone else is alre...

Oscar Wilde Be yourself, everyone else is already taken up (Photo credit: symphony of love)

 

I was out running yesterday around my local park. It’s beautiful there. The weather was cooler – but just right for me and running in.

 

As I started my second lap, I saw a small child – about three years old and their caregiver. The child had no coat on, and long sleeves and trousers and seemed quite content – my running app tells me it was 18 degrees. But what caught my attention was the caregiver’s insistence that ‘you need to put a coat on. It’s cold and everyone else has one’. The child insisted they were not cold and the caregiver insisted it was cold and so the child needed to put a coat on.

 

Even at my slow speed, I was past this little dyad before I saw the end of that play out, but I imagine that not many three year olds win that battle. And it made me sad. For me, it’s a prime, and very basic example of Rogers’ organismic valuing process (our valuing system). The child is being told that its valuing process is incorrect (MUST be cold) and then (assuming this pattern continues throughout life) learns that many other things that it thinks are somehow ALSO ‘incorrect’. And before you know it, we have clients in our therapy rooms who don’t know who they are or what they feel, or what they like and need.

 

As trainees also – we are confronted with a LOT of things as trainees – from spending days (by the end of training) with each other in group process, trying to manage the way we feel in response to several people’s feels. Yet, when you are told something as basic as ‘You are cold’ and you do not think you ARE cold, how can you trust in yourself for the big decisions, when you ‘know’ you were wrong about the small ones? This follows on to our ‘experiential learning’ also – in may places throughout our training, we are experiencing things that are very different to what we have experienced in our lives so far. In my family, you didn’t talk about how you felt. That’s not going to get me far in counselling training (or in therapy). So in training I am constantly looking at theory, at conversations, and trying to ‘get at’ my feelings around these things, as well as trying to make academic theory make sense, so I am doing ‘double duty’ here (as I suspect, many people are).

 

But this not TALKING about feelings then often leads to not having them, because what’s the point of having a feeling if you can’t talk about it? – if as a small child, you are alone with that feeling, both good and bad. There is a difficulty then as an adult, when people say to you that as you use language like ‘gut feeling’ that you MUST then be having a feeling. In my case, it doesn’t SEEM like a feeling, it seems like knowledge, but just as the small child who was told they were cold, when they did not feel they were, I am told I have a feeling, when I do not feel like I do. I accept that other people in my position might experience this as a feeling, but at the same time, I think that I need to do much more work in my own therapy before I can get to that stage for myself. Unlike that child, I can choose to reject the assertion, and know that their experience of those words is just that, and mine is mine. After all, Rogers – proposition two: The organism reacts to the field as it is experienced and perceived. This perceptual field is “reality” for the individual. I think I just reached a new level of personal acceptance there.

 

“The curious paradox is that when I accept myself just as I am, then I can change”