Fit to practise!?

[Jenny]

So i'm coming to realise that counselors are human (shock horror!) too and they have feelings (woah)... which leads me to think:

How can a counsellor truly ensure they're always acting in the best interests of the client? I mean, i understand the whole idea of supervision and being self aware, etc. But what if the counsellor is having a bad day? Is it truly possible to leave personal issues outside the counselling room and focus solely on the client?

I understand if the counsellor is feeling ill that they can and do cancel appointments.. but what if their own emotional health is potentially affecting the relationship? How realistic is it that a counsellor can cancel client appointments for days/weeks on end while they work through their own stuff??

I do have my own agenda in asking this question.. i contacted my ex counsellor 5 months ago asking after a bad ending, and she still hasn't gotten back to me. I am wondering if she's taking a break from counselling due to her own issues.. but then how realistic would this be? Surely she has a mortgage, etc. to pay too!

:wacko:

[Cherrypie]

I only have genuine experience of group support just now and unfortunately with one thing and another lately I have certainly had a lot of bad days recently!!

I must admit that when I am with my support group everything in my life does seem to fade away to the edges.. I am very focused on the group and the individuals issues.. so I imagine that what its possibly like one to one too.. I suppose when it starts encroaching is when you do have to consider taking time out but this must be very hard in practice with more attached one to one clients.

You know I see a theme here though Jenny and that is possibly that you do find it really hard to perceive a counsellor as just a regular fallable human being and I wonder why that might be??

I think there is no possibility of 'truly ensuring' anything unfortunately although it does sound like it would be ideal.. I think often you just do your best as a counsellor..yes you learn as much as you can, keep self aware and stay fit to practice etc.. but like a parent you don't have all the answers, you do maybe have to go to work not tip top sometimes but you are there for your client and you do your best..

xcherrypie

[shrinknightmare]

Maybe she does not wish to contact you.

[andyhp]

I believe the issue of whether a counsellor/psychotherapist is fit to practice is far from simple and the 'question' can often be a source of disagreement in the therapy world.

For sure I think anyone can have a bad day. The 'normal' stresses and strains of everyday life can take their toll on any of us and I wouldn't say that a therapist should necessarily cancel sessions due to these. There may of course be times when this is necesary e.g. illness, lack of sleep (new baby!) for, as has been said, therapists are human too!

It's when what is affecting fitness to practice falls outside these everyday matters that it becomes more complex and potentially the cause of disagreements.

My personal feelings are that if a therapist is experiencing psychological 'difficulties' that do impact/encroach on their work with clients then they should be seriously thinking about stopping client work at that time.

The 'problems' here though are pretty obvious I guess. When is a 'diffculty' serious enough to impact and what is a serious enough impact? Does this particular difficulty affect work with all clients or just some? If I am experiencing a difficulty at a particular time am I 'able' to judge these matters?

Supervision, whether 1-2-1, peer or group can be helpful and there will be, and have been, times when the decision will be taken out of the hands of individual therapists. Of course the difficulty has first to be raised in supervision by the 'affected' therapist for it to be heard in supervision and there are many instances when this has plainly not happened. There have also been times when students have been 'advised' not to continue and times when they have been prevented from doing so by their training organisation. It is also not unknown for a therapists therapist to feel so concerned that they 'inform' and again the therapist is prevented from working.

Again from a strictly personal perspective, I am uncomfortable when a therapist continues to work while they are taking anti-depressants. I do recognise that different ad's have widely differing affects and also that these effects in turn vary widely from person to person but they do affect mind state/mood. That's how they work! If the issue is such that they are necessary does that indicate that the therapist should seriously consider stopping working? Also, if a therapist is taking them at what point do they become 'not the best person' to make this decision? I do want to say though that I'm far from rigid in this way of thinking. I have known it happen and all has seemed well. It's not really for me to say is it unless 'something' came to my notice. I'm also guessing that there are some therapists out there who are taking them and are not telling.

None of this exists 'in isolation'. It touches on many other 'linked' issues. Should therapists have to have personal therapy and if so when and for how long? What about the 'wounded healer' idea? Having personal therapy is insisted on on some training courses but not on others and I don't want to get ino that 'debate' but how long should someone continue to 'need' it and how 'fresh' should the wounds of a wounded healer be? It seems to me that there are no easy answers here but it also seems there are going to be situations where some kind of answer is needed both for the wellbeing of therapists and the wellbeing of their clients.

I suppose the big questions are, how psychologically 'stable' do practising therapists need to be and are therapists themselves always the best people to be deciding when/if to stop.

[Cherrypie]

I found your reply fascinating Andy and you have made me think about the topic much more deeply...

Yes it does seem inadequate I suppose that it is the counsellor generally that decides whether or not they are fit and whether or not to disclose to a supervisor. Its actually a very in depth issue isn't it and really quite complicated.

Thankou for sharing some of your thoughts.Its certainly given me lots to think about.

xcherrypie

[andyhp]

Hi Cherrypie,

It is a huge subject isn't it. So many different aspects of it to think about.

A brief look at some of the malpractice cases that are published by governing bodies (e.g. UKCP) would suggest that it is highly unlikely these were presented at supervision or that the therapist in question felt they had an issue.

(BTW I took the love languages test - Bi-lingual, quality time and physical touch)