my clinical counseling interns and I were reviewing the chapter titled “The Hazards of Practice” in Carl Goldberg’s classic, “On Being A Psychotherapist” .? For new professionals the challenges of psychotherapeutic work is often overlooked by the anticipation of finally getting to work with clients.? The list below left the group more somber and reflective than usual.
Yet every coin has two sides and every one of your clients in the criminal justice system has the opportunity to create their lives in valued directions.? It also challenges you as a professional to recognize the limits of your abilities and embrace your humanity in that recognition.
- Expose you to your own psychological issues and mental health vulnerabilities.
- Compassion fatigue.
- Vicarious trauma.
- Feeling impotent in the face of deep suffering.
- Routine confrontation and affronts to your moral or spiritual (or lack of spiritual) beliefs.
- Erosion of confidence with repeated no-shows and unplanned terminations.
- Risk of violence and boundary violations to yourself, family, and friends.
- Those seriously mentally ill sometimes identify as a professional to deny their illness.
- Becoming more invested in the client changing or getting better than the client themselves.
- Unwitting use of clients to satisfy deep unmet needs that minimize feelings of worthlessness.
- The weight of wearing the professional mantle of counselor, psychotherapist, healer.
- The burden of holding secrets, exciting and positive as well as disturbing and frightening.
- The demands that life be made painless and that success is measured by the absence of distress.
- The pressure to serve as secular priest and social control agent for the majority society.
- Regular demands to maintain competence and to continually expand the breadth of expertise.
- Dissolution due to client?s inability to use the tools and experiences provide during treatment.
- General defensiveness and reluctance of clients in examining their own role in their problems.
- The lure of intimacy in treatment as compared to one?s own life.
- Crises and emergencies with the risk of inevitable bad outcomes.
- Dealing routinely with difficult, manipulative, or dangerous clients.
Rebecca Regnier,?The host of 13abc’s Full Plate?and former anchor of Good Morning?stopped by this week (and Brian behind the camera!) to talk about the impact of support from others when?beginning?a change in your life. ?She just?finished?her new book, Your Twitter Diet: How I Used Twitter to Lose 20 Pounds & You Can Too!??
We spoke about change, support from others, and how social media has changed the landscape. ?To change you need to recognize the gap between where you are and where you want to be. ?Be it your health, finances, or relationships.
That gap is your motivation to make the decision to change and start planning how you’ll go about it. ?Planning is how you’ll succeed and an important part of that plan is support. ?While you’ll need to know exactly what steps to take to achieve your goal and what the barriers and challenges will look like, it’s key to choose the right type of person to support you.
They’ll need to be those you love–like family members; or who actively care about you–like friends who really know you; and those you respect–like members of a support group or?colleagues. ?Just announcing your plan to supportive individuals builds motivation for you to carry through–now it seems real and they can celebrate with your success and encourage you during difficult challenges or setbacks that are a normal part of the change process.
But that’s not enough. ?You’ll need to find a way to make?your?support part of you change plan. to help you accountable. ?For example, you could give a friend a meaningful sum of money in the?beginning. ?If you fail to achieve your overall goal, they can send it to an organization you hate; that’s strong motivation! ?Of?course?they’re also there to remind you of why you’re making this change and cheering you on to success.
Not everything you want to change has the same level of?difficulty–and support from others won’t change that. ?But it’s possible to change your behavior and with motivation and?encouragement?from others these?tasks?are more likely to?succeed.
Keep an eye next week on 13abc for more on Rebecca’s new book and her segments about making life changes in the new year.
I’ve posted a book list elsewhere; Darren W. Love’s Blog.? What would your list include?
So you have been asked to admit a new client to your sex offending treatment program.? Only problem is s/he is in a pre-trial status, or even voluntarily seeking admission at the advice of an attorney or after a search warrant or some other legal action has been initiated.? With no conviction or pre-sentence report to justify admission, what are your options?
First, it is the standard of care to only admit into sex offender treatment those who have been proven or admit to such behaviors.? Completing an actuarial risk assessment is also considered accepted practice.? Neither of which can ethically be done without some third-party corroboration; namely the criminal justice system.? This is because the law requires mental health professionals to work in the best interest of the client.
When receiving funding from the criminal justice system an agency is also signing up to work in the best interests of the community.? To balance these will require the mental health professional to have a clear sense of the legal and ethical (not always the same thing!) responsibilities involved.
So, what is the answer?? There are two stages.
One approach that is used in our program is to never have the client work against his/her own best interests.? The client signs a confidentiality waiver releasing our staff to talk to individuals in the criminal justice system about what s/he says concerning any sexual offending behaviors s/he may have ever engaged in.? A discussion ensues about their rights and our responsibilities to them and to the referring agency.? If the client does not want to sign the release, we are unable to proceed with the treatment.? The client has rights and we can?t violate those rights in an attempt to shoehorn a client into the program at an outside organizations request.
Once the waiver is signed, it is explained to the client before any assessment that s/he has the right not to incriminate himself and should not reveal anything illegal to us without understanding it will be reported to the criminal justice system as they have just released the agency to do so.
2. Providing Services.
If the client has chosen to admit to sexual offending behavior voluntarily and prior to arrest and/or conviction, then s/he is admitted into the treatment program.? This is quite rare except when a plea bargain has been arranged and the client is certain it will be accepted.? This is often done much later in the pre-trail status of the client.? So initially, you will most likely have a client who is not admitting; and ethically can?t be compelled to do so.
CDTC has developed an education track within the program to allow for such situations.? Many of the?requirements of the treatment program are removed and the client is free to be apart of group working on a separate curriculum.? The education track exposes the client to many important concepts including criminal thinking errors, sexual offending cycle, relapse prevention skills, and the stages of change model among other things.
The client and referral source are given letters explaining the procedure and emphasizing that this service is in no way a substitute for treatment and does not mitigate in any way the client?s risk for re-offending in the community.? Unfortunately, most referral sources are referring clients to sex offending treatment programs to do exactly that; to mitigate their liability while the client continues to reside in the community.? However, it does allow the funder some recourse by referring the client to mental health professionals who will take what actions are ethical and legal concerning the client.
What do you think?? How would you handle this situation?