Ethics_in_Counselling_&_Psychotherapy

ESSAY ETHICS IN COUNSELLING & PSYCHOTHERAPY In Britain, Counselling Supervision is considered to be essential for practising Counsellors’. It is obligatory for Counsellors continued accreditation with BACP. Explain why this is so and if possible, include reflections on your own experiences of Counselling Supervision to support your points. WORDCOUNT: 2278 INTRODUCTION This essay explains why Supervision is essential for the practising Counsellor, also why it is obligatory for a Counsellors’ continued accreditation with BACP (British Association for Counselling and Psychotherapy). Supervision over the past 30 years has become more accepted as an integral part of ethical practice and as an essential support for the therapist. All practising therapists are required to be in regular Supervision throughout their Counselling career, it is a requirement of BACP that Counsellors accredited by them have regular Supervision from a qualified Supervisor McLeod (2009). Ethics, contracts and boundaries will be the main focus of any Counsellor, as they would ultimately feel responsible for their client’s welfare. In any Supervision relationship where the person-centred approach is used, the relationship can be theorised as a parallel process to the client therapy relationship; where the counsellor becomes aware of the processes taking place not only in herself, but in the relationship with the client therefore assisting and empowering the process and allowing herself to be more congruent in the relationship with the client. The Supervisor would accept the Supervisee as a person in process and trusts in their potential for growth; a person-centred counsellor who is enthusiastic and willing to engage fully with the client will be changed by the experience of which the Supervisor is a witness to the change Mearns & Thorne (2005). The Supervisor and Supervisee relationship is an ultimately professional one for the purpose of upholding good practice, professional development and personal support, which is critical to the safe, ethical, and effective practice of care towards the client. A psychologically safe environment is essential in Counselling and Psychotherapy, as well as being confident that the service a therapist is providing is ethical and effective. Central to the profession is trust, as clients may have feelings of vulnerability, or if a client feels that a therapist is authoritative in relation to them BACP (2010). Counselling can be a very demanding profession where extensive demands are put upon Counsellors who can sometimes without realising become over-involved with a client, be ignorant to some important points, become unsure and confused as to what is taking place within a client, or challenge their own abilities about their own worth as a Counsellor. It can sometimes be difficult and seem hopeless, to be objective about their own Counselling process and any opportunity with a qualified Supervisor to discuss it in total confidence would be invaluable to the Client/Counsellor relationship. Relating practice to theory and vice versa is a requirement to being a good Counsellor. The Supervisor can help the Counsellor to develop their training this is just one aspect of continuous training of on-going guidance, self-development and preparation. The Supervisor would ensure most importantly that the needs of the Client are being addressed, and would be monitoring the relationship between the Counsellor and the Client in order to maximise the therapeutic efficiency of the relationship during the Counselling process BACP (2010). As a Trainee Counsellor my thoughts on Supervision is that the Supervisor has a great responsibility to the Trainee in Supervision, the relationship would have to have a great understanding, skill and have to be a structured professional meeting of needs to avoid burnout for the Trainee and normalise best practice, in order to facilitate autonomy (respect for the client’s right to be self-governing) BACP (2010), growth and protection for the Supervisee and the Client. This would help the Trainee to develop their professional identity through reflection on the work, which should be both critical and supportive. The nature of the Supervisory work should be confidential. The therapeutic core conditions in Supervision have a central place, although this does not mean Supervision equals therapy. There is a major distinction between Supervision and therapy. There is a primary focus in Supervision where the client has the freedom to speak about any of their life experiences, but in Supervision the primary focus is always the interaction between Supervisee and the client Mearns& Thorne (2005). The boundaries of the relationship between Supervisor and Supervisee must be clear from the start, both need to take responsibility for maintaining and managing these boundaries. If there have been issues of incongruence in the therapists past life, these need to be addressed and explored without entering into a therapeutic evaluation. In the course of the relationship with a client empathy develops which is a process, the ability and willingness to enter the client’s world, casting aside our own frame of reference Mearns&Thorne (2005). The Supervisor should be setting aside their own frame of reference; they should always endeavour to be open to the experiences of the Supervisee, listening intently without any evaluation. The Supervisor is best placed to support the Supervisee when they are free from feelings of judgement and responsibility, always being careful to remain within the agreed professional boundaries. It is imperative to work within an ethical framework where boundaries should never be crossed, and values, moral and principles are in integrated into the practice, as a Trainee Counsellor I feel one should be accountable not only to oneself, also the client to whom we have a duty of care most importantly to act in their best interests at all times, and the professional body. Being able to value and respect another person as a person of worth is acceptance, without there being any conditions and also not being deflected by the person’s behaviour. Sometimes in therapy unconditional positive regard makes it possible for the client to allow into awareness some experience that normally needs to be distorted or denied in order to meet conditions of worth. In order to facilitate the movement towards congruence there has to be a combination of empathy and unconditional positive regard in therapy Mearns & Thorne (2005). Earlier this month I had a problem understanding acceptance, understanding myself and others, valuing my own self-worth. This journey has been a growing experience where I started as a seedling, grew into bud and now the bud is opening up learning to accept myself and others (See Appendix 1). Being congruent is sometimes compared to having expressions of feeling, difficult because how do we know when a person is being congruent' A client who expresses feelings of pain or sadness is said to be being real or congruent. A Counsellor’s ongoing awareness of experiencing is said to be the essence of congruence, it is the interaction between the Client and Counsellor where this experiencing is taking place. It is important that in the therapeutic relationship congruence continues as a state of being, but should not stand out as somewhat different. A Supervisor who may have little understanding of congruence should support the Supervisee in becoming more self-expressive in encouraging them to take risks in the relationship and bring feelings into the relationship. She would then be focusing on expression rather than trying to bring in the awareness of what she is experiencing Mearns & Thorne (2005). Some issues that cause dilemmas in Supervision are making a decision about what is to be discussed in Supervision to be helpful in the relationship. The Supervisor needs to explore their understanding of the client, they also need to explore the feelings they hold in reaction to the client, techniques and different interventions need to be explored. One model of Supervision that can clarify some of these issues, (Hawkins & Shohet 2007) this model contains six levels of Supervision that can be in operation they are as follows; Reflecting on the issues brought into the Supervisor/Supervisee/Client session, focusing on the client and ultimately what they want from therapy. Exploring the strategies and techniques that are used by the Counsellor, the approach they are taking and the therapeutic intentions. Exploring ways in which the Counsellor interacts with the Client and whether they have a good working relationship. What the Counsellor’s feelings are towards the Client, the counter-transference responses and the personal concerns enthused by the Client' What is happening between the Counsellor and Supervisor in their relationship and how the relationship relates to the Client' How do the current interactions differentiate or are they interconnected in ways that reveal ‘parallel processes’, how would this assist the Counselling in the Supervisory relationship if this was resolved' Looking at the Supervisor’s counter-transference, their feelings in response to the Supervisee in order to capture what is not being consciously communicated by the Supervisee or Supervisor in order for them to assess the worth of this relationship McLeod (2009). The most important qualities that should be available to a Client are good moral qualities that have an ethical or moral component when providing a service as a Counsellor. All Counsellors do not possess these qualities as these qualities are deeply rooted within us and are developed from our own personal commitment. There are personal commitments which all Counsellors and therapists should aspire to according to BACP; empathy is the ability to be able to walk in the other persons shoes, to see things as if you were looking through their eyes. Sincerity is being genuine to the Client and being consistent in the relationship. Integrity is being moral with a Client, being personally straight forward and honest. Resilience is being capable of working with the clients concerns without being personally weakened. Respecting the Client showing an understanding of themselves and showing the appropriate esteem towards them. Humility is being able to recognise my own strengths and weaknesses, I recently recognised my strengths and weaknesses in a class situation where I had felt confident enough to speak in class first, my confidence has been a weakness for me for sometime but the bud has finally opened up and is beginning to blossom (See Appendix 2). Competence is being effective and capable of having the skills and knowledge required for what is needed by the Client. Fairness is to use the appropriate criteria consistently to update decisions and actions used in the therapy. Having the wisdom to control sound judgement that is essential for the practice also having the courage to act despite knowing the fears, risks and doubts that will present themselves is a Counselling session these are all sound personal moral qualities BACP (2010). There has been a lot of criticism about Supervision as the adopted format for Supervision has been based on a Counsellor describing their work to a Supervisor, or a Supervision group or peer. In this approach it has become apparent that there could be a number of serious restrictions involved. Some Supervisees can be particularly selective in the information they bring to Supervision, as some studies have shown (Ladany et al. 1996; Webb 2000), they may not disclose information that might reflect inadequately on their ability. (Grey et al.2001; Lawton 2000) says, some other research shows that Supervisors quite frequently report that their Supervision has not been productive, and sometimes feel that they have been pressured into this relationship which is a constant battle being riddled with conflicts (Nelson and Friedlander 2001) and sometimes has been offensive (Kaberry 2000). The thoughts of Gray, Ladany and Freidlander (2001) offer an important jump forward in understanding what contributes to problematic clinical Supervision. To organize firstly and extend the line of enquiry, they propose that a distinction be made between bad Supervision which is ineffective and does not harm or traumatize the Supervisee. Next they highlight the data from both studies that were found to be most striking and disturbing. Thirdly they offer recommendations for research and practice. The advocates of mandatory Supervision state that there is no research evidence to back up the claim, that a person in regular Supervision is associated by improved client outcomes or with some lower levels of ethical breach on the part of therapists. Someone whom has identified the current position of Counselling in the UK is Feltham in relation to Supervision is reflecting on ‘the dynamics of the mandatory’. His arguments are that: In the logic of regular, compulsory Supervision is that, with rising costs of required training, membership fees, accreditations, personal therapy, insurance and continuing professional development, the doors are closed to everyone but the reasonably wealthy...the dynamics of the compulsory within Supervision (also requires) the Supervisee whether they find it useful or not must have regular Supervision. If the Supervisee finds that Supervision is not useful, it can be suggested that there is something wrong with the Supervisee, Supervision is normally found to be collectively and consistently helpful (Feltham 2000:10), McLeod(2009). This has been a central concern for Feltham (2000:21) that there is a lot of expression but not a lot of evidence, about clarifying the purpose or valuing Supervision McLeod (2009). Studying as a Trainee Counsellor involves a great deal of responsibility not only to oneself, but I find I am constantly worried about my potential Clients...their emotional pain and harrowing stories. Absorbing someone else’s secrets, this essay has touches on some of the issues associated with a career in Counselling and Psychotherapy. Being able to process and possess the ability for engaging effectively in a healing relationship with troubled people fascinates me, I just need to be pointed in the right direction, and absorb all I am learning about, but still remain curious and open to new learning throughout my journey. This has had a powerful influence already in shaping my life and relationships as I dwell within. My thoughts on being a Counsellor give me great satisfaction and a meaningful interest, constantly being stimulating, as every client is different and they represent a fresh and new challenge, and always something more to learn. The person that sits in a Clients chair is their own individual version of the eternal human struggles that we face, but if I can make a difference, it will be a privilege. To work alongside people who find the courage and ingenuity at the hardest time in their lives, and have the opportunity of learning more about myself as well as the nature of our shared human race I would be humbled. REFERENCES British Association for Counselling and Psychotherapy (2010). http://www.bacp.co.uk/ethical_framework/good_standard.php [Assessed 26 January 2011]. Gray, L.A., Ladany, N., Walker, J.A. and Ancis, J.R. (2001) Psychotherapy Trainees’ experience of Counterproductive Events in Supervision, Journal of Counselling Psychology, 48, 371-83. Hawkins, P. and Shohet, R. (2007) Supervision in the Helping Professions, 3rd Ed. Buckingham. Open University Press. Kaberry, S. (2000) Abuse in Supervision. In B. Lawton and C. Feltham (eds) Taking Supervision Forward: Enquiries and Trends in Counselling and Psychotherapy. London. Sage. Ladany, N., Hill, C.E., Corbett, M.M. and Nutt, E.A. (1996) Nature, extent and importance of what psychotherapy trainees do not disclose to their Supervisors, Journal of Counselling Psychology, 43, 10-24. McLeod, J (2009) An Introduction to Counselling 4th Edition, McGraw Hill, Open University Press. Mearns, D and Thorne, B (2005) Person Centred Therapy Today, Sage Publications, London. Nelson, M.L. and Friedlander, M.L. (2001) A Close Look at Conflictual Supervisory Relationships: TheTrainee’s Perspective, Journal of Counselling Psychology, 48, 384-95. Webb, A. (2000) What makes it difficult for the Supervisor to speak' In B. Lawton and C. Feltham (eds) Taking Supervision Forward: Enquiries and Trends in Counselling and Psychotherapy. London. Sage.