Welcome to this private practice business series post, where I will continue to discuss our commitment to clients in light of the BACP Ethical Framework and how I work in the therapy and supervision space.
Let’s start with respect.
Respect is a basic quality to have in all relationships. It is particularly important in the therapeutic and supervisory profession for a variety of reasons.
Respect for clients will allow me to value the client’s individuality and autonomy, and therefore work towards the main goal of helping them regain the autonomy and self-worth that they might have lost and which might be one reason for them coming to us for therapy.
Respect also means that I will endeavour to keep their data and information they share confidential and private. I make sure my clients know that the only other person I will discuss them with is my supervisor and that this is for their benefit. Unless there are issues that require disclosing such as child protection issues, terrorism related disclosures by the client, amongst others – you can find these in my contract terms.
In the therapeutic relationship, the therapist is the expert – in their field, in the counselling skills they’ve trained for – but the expert in themselves can only ever be the client. Therapy is a partnership and the therapist respects the client’s knowledge and expertise of themselves during the process, by asking questions and helping the client gain a different perspective on their story, feelings and thoughts. – of course there is more to it than that, but that’s the starting point.
Respecting the supervisee is also an important aspect – does the supervisee need more help as a trainee or have they moved from trainee to more competent practitioner and therefore need a more collegiate and collaborative type of supervision?
Being treated as a trainee after years of practice will hurt the supervisory relationship and the therapist might feel patronised. The supervisor airing their personal problems with the supervisee or supervisees is unethical and disrespectful at least.
Both supervisors and therapists/supervisees need to keep these things in check so the therapeutic or supervisory relationship doesn’t get contaminated with stuff that has nothing to do with either.
There needs to be an opportunity to discuss this in supervision, and sometimes maybe even with the client if the therapist feels it is plausible and therapeutic to clear the air and move therapy forward.
Respect, Trust and Partnership are very important for a good therapeutic and supervisory relationship to develop and for therapy to be effective.
This leads to the next point, which relates to building appropriate relationships with our clients.
The ethical framework brings up the following points:
- Communicating clearly what clients have a right to expect from us
Clear contracting is important to achieve this, as well as reviewing every so often.
Clients might come in more aware of their issues than thinking about contract terms or what the counsellor told them about cancellation policies and what therapy is and how it works.
Clients come looking for a solution to their distress.
It is our job to keep the work on track in regards to boundaries and our way of working (chosen modality, interventions, regular supervision, pacing to the client’s rhythm, being compassionate and empathetic…).
It is also our job to remind our clients of what they can expect from us and also what they can’t – contact outside of the sessions to be limited to rescheduling, for example.
A tutor of mine said that disappointing our clients early on is a good thing and it will happen at any point whether we like it or not.
Like the mother disappoints their baby when baby realises “mum is busy with other things and I’m not her only concern”, the therapist must do something similar. This is something that will happen unconsciously and without any planning or attempt by the therapist.
Therapists are human – we might say the wrong thing or yawn or forget a session or something else…
This might be a massive blow to the client and need repairing in the session, or this might help the client realise that making mistakes is actually OK.
Either way, communicating clearly will allow for growth, change and healing to happen for the client.
- Communicating any benefits, costs and commitments that clients may reasonably expect
This links well with what I’ve already said above. Adding to this, some benefits will be the client will be able to speak up to meet their needs and set clear boundaries, the client can ask for letters of support but the therapist will charge for this additional service.
There are so many benefits that clients get from therapy that are only visible once the therapist points them out or after the therapy has progressed and we look back at previous achievements in therapy, or when therapy is over – the therapist might never know how they have impacted the client’s life.
- Respecting the boundaries between our work with clients and what lies outside that work
Boundaries are vital, and we are models for our clients and supervisees in how to keep these in order to safeguard both the therapist, the client and the therapeutic space.
Modelling good boundaries allows our clients to start testing these out in their personal and work relationships.
Contact outside the therapy room should be limited or non-existent. Sometimes this might be impossible – a client might go to a party you are also attending and you find out on the moment that you meet.
Discussing how to address this is important. – If I see you on the street or in town, do I nod at you or pretend you are a stranger and I don’t know you. If we met at a party, would you want me to leave or would you leave or do we just try to not cross each other’s paths. Or is it ok to talk and say hello and carry on like normal.
- Not exploiting or abusing clients
Telling a client that you think they’re doing OK enough to stop therapy but that they can come back at any point in the future – life changes, things change and creep back up – is much better than keeping a client in therapy because they can’t manage to tell you they want to stop even though they know they can go it alone for now or for good.
This point is a huge topic and I won’t have space to talk about it fully in this post. But there are people out there, counsellors, that are unfortunately unethical and breaching the boundaries of the profession and the ethics of it all.
I do hope that it is a small number.
This is a reality in many businesses and services unfortunately, and all we can do is supervise and work to the best of our abilities, within the boundaries of our profession and to the best interest of our clients.
Whistleblowing is also an option.
- Listening out for how clients experience our working together
As therapists and supervisors our first aim is to listen and to provide support in a way that our clients feel heard and safe to work through their distress and issues in the best way possible.
We need to be ready to ask whether something we said might have come out wrong and what does the client need from us to repair and move forward.
We also need to be brave enough to challenge and remind of the contract terms when necessary and be flexible also when necessary.
Questions or comments? Leave me a message and I’ll get back to you!
