Tag: Ethics

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Why are some Couple Counsellors not Qualified?

The Doctor is In
'The Doctor is In' © A Kuchling

After 4 years of hard work, sweat, tears, time-out, falling on my ass and getting up again, I worked my way through to being awarded my first Diploma in Counselling (Individual (Psychodynamic) / Accredited by the British Association for Counselling & Psychotherapy) in July of 2003. Obtaining a qualification in therapy is essential for any practitioner – not least because it’s a major factor in protecting the public from dangers such as the counsellor’s incompetence.  [button style=’float:right’ link=”2599″ color=”orange”] Learn Dean’s approach to Couple Counselling…[/button]

But what the public generally do not know is:-

  1. A majority of ‘counselling’ qualifications focus upon individual clinical work (i.e. one adult client and one counsellor).
  2. Such qualifications do not cover working with couples: couple counselling is a significantly-different approach for the counsellor.
  3. British Law (as of 2014) has no requirements for anyone to have any qualifications in counselling in order to set ones-self up in a counselling business.

Basically: ‘Aunty Joan’s Tea and Sympathy Service’ could be lovely counselling service (Aunty Joan may be a very good listener, you see, and she may have lots of things to tell you based on her life’s experience). But, with her having no formal training, no recognised qualifications, no supervision, no indemnity insurance, no membership of a recognised national professional body… Aunty Joan is offering a significantly dangerous service.

Practising Beyond a Counsellor’s Original Qualification.

Matters begin to border on the unethical when a counsellor who has an initial qualification in one particular model of therapy, begins to branch out into areas of therapy that is not covered by their original qualification. Again, in British law, there is no legal requirement for that counsellor to seek additional qualifications (although the ethics for the majority of qualified counsellors would compel them to seek appropriate training) – but still a small proportion of therapists continue to practice with no formal qualifications. In 2008 I decided I would like to practice counselling with couples – something my original qualifications did not cover – so it was necessary for me to obtain further training.

Individual-Therapy Qualified Counsellors… Practising with Couples.

After qualifying with my post-graduate diploma in Couple Counselling (Psychodynamic/Systemic) 2009, I attended a workshop for couple counsellors. In addition to the majority of attendees who had qualifications in couple counselling, were a handful of counsellors who had no such qualifications. Whilst they had full qualifications as individual counsellors, they had begun working with couples and were struggling with some of major difficulties. Again, legally, there’s nothing to stop these counsellors from working couples, and I would hope that each therapist might have been appropriately supervised by someone who was supporting their couple work, but… ethically… because these counsellors:

  • didn’t have an understanding of the basic concepts of couple counselling,
  • didn’t have theoretical frameworks for couples,
  • didn’t have appropriate counselling model for couples,

…they were getting stuck with their couples. Applying individual-counselling techniques were not helpful. There were better approaches for couples: concepts found in training for couple counselling. So, in my marketing I regularly make reference to

Not All Couple Counsellors are Qualified…

…because from the experience above, there’s practically nothing to stop people from practising counselling in ways not covered by their qualifications (should they have any to begin with).

Check your Counsellor’s Qualifications.

For anyone seeking counselling, I would recommend that you check out the following:-

  • Does the person’s website, business card, or literature, clearly state what qualifications they have (eg letters after their name, or a statement of their qualifications)?
  • If not, when you meet the counsellor: ask what qualifies him/her/them to be practising.  They should not be offended, and should not skirt around your question; if they do then maybe this isn’t the counsellor you want to be working with.
  • You might make a note of the training /awarding body or the professional body (eg ‘Chichester Counselling Services’ or ‘The British Association for Counselling and Psychotherapy’) and make contact them them asking if the body recognises the counsellor and/or they are properly registered.

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Counselling Ethics FAQ

Will my Counselling be Confidential?

"Naughty Secrets" © stevendepolo

I abide by and adhere to the British Association of Counsellors and Psychotherapy’s Ethical Framework.

As part of that framework, I practice confidentiality with all of my clinical work.  This means that you can speak with me knowing that your friends, your family, your work colleagues and so on will not get to learn what you have said in a counselling session – and neither will my friends, family, work colleagues and so on.

But … what confidentiality also means is that I will discuss your case with a strictly limited number of other professionals for sound ethical reasons.  All clients and patients of therapists should be made aware of this (as you will be during our initial meeting), but unfortunately this is not the case with some other professional therapists.  I make it a particular point to discuss what confidentiality means – and what are its boundaries – with all of my clients at the start of counselling.  During our initial meeting I will also give you a printed copy of our counselling agreement.  After all, there’s a lot to remember during our first sessions.

Because confidentiality is not just about not talking about our therapy work, our written agreement explains what confidentiality means.

For example, in addition to the ‘not discussing what we say in the room’ part of confidentiality, I will have made you aware that:

  • I meet with my choice of clinical supervisor one a month to discuss my cases and my work.
  • During my yearly quota of continued professional development (eg training courses), I may refer to certain casework in order to review of reflect upon the case  (you details will be anonymised, meaning I won’t use your name nor other identifying information).
  • UK law may require of me to break our confidentiality if I learn of something that is unlawful.

The rest of this article expands upon these matters.

Confidentiality & Supervision.

As a private practising therapist who is a member of – and accredited by – the British Association for Counselling & Psychotherapy, I meet with a qualified supervising counsellor once a month for a minimum of 90 minutes. This is to discuss my practice and my case load and to check that I’m working to my best, keeping with ethical principals, and dealing with dilemmas that come up in most every case.

I will, from time to time discuss your case and our work together with my supervisor – but I will have first made sure that my supervisor does not know you, or is likely to come in contact with you (say, for example, though the workplace).  I will refer to you only by your first name (or another name if you prefer).  If I cannot assure your confidentiality in this manner – for example if my supervisor knows you in the work place or socially – then I will seek supervision from another supervisor for the duration of our work together.

Confidentiality & Continued Professional Development (CPD).

In seeking additional knowledge to keep me up to date with therapeutic thinking, it is sometimes useful to refer to an aspect of a case whilst attending a training course.  If, when we discuss our agreement, you request that I do not refer to you during my CPD then I will respect this.  Even so, it’s rare to-the-point-of-never-happens nowadays for me to bring up casework willy nilly, and I make sure that anything I discuss within the confines of other therapists in the context of CPD still keeps your identity anonymous and our casework vague enough to never identify you.

Confidentiality & UK Law.

Confidentiality sometimes has to be broken if I am required to do so by law (for example if you disclose to me your intent of harming yourself or others (including children) or if you disclose intent of committing a serious criminal offence or terrorism).  This may also apply if I learn of someone else who may be being harmed or in danger, or is planning to harm others.

This does not mean that I will go running to the police the moment that I hear about something illegal, but it is part of my ethical commitments to you to inform you that the law may not protect your confidentiality.

I will intend to discuss with you of my (admittedly very rare) intent to break confidentiality of our work before I do so, but you need to be aware that the law may require that I take action first and without your consent or knowledge.

Declining your request to break confidentiality.

I have been discussing where confidentiality is maintained but expanded in the form of supervision and CPD, and have discussed UK Law where I may not be able to keep knowledge confidential.

There is another aspect: your request to reveal information about our counselling work.

Confidentiality is very important – even to ensure it is not broken in situations where you request it (for example, giving your permission to a solicitor to request that I give a report about our case work).

If we are still working together it is best for us to have a sufficiently detailed discussion of the consequences of such events before I decide how I will respond – and I will not automatically respond with a ‘yes’.  What has been, up until this moment, vital to protect needs a serious conversation about why this need has now changed.

Should our counselling work have been completed, and we are no longer in contact, if I receive a request to reveal the contents of our counselling work with a third party… even having received your permission (eg written) to do so … I may decline [if I am unable to discuss the request and its consequences with you directly].

Confidentiality – In conclusion.

Counselling is not to be taken lightly – neither by therapist nor clients.  Clinical work such as counselling and psychotherapy requires ethics, respect and the highest form of protecting both the therapist and the client’s right to feel safe during the work.

I take a particularly thoughtful approach to protecting confidentiality – and this may surprise a number of clients who may assume that (a) nothing is ever revealed about the case to anyone … or conversely (b) I will summarise our casework to anyone when the client wants me to.

Confidentiality is vital.

Categories
B2B Ethics

Did your client read that Tweet?

Over on Facebook, the Business & Marketing Skills for Therapist Group (here) are helpfully discussing how they can get their message about their practices (etc) out into a wider world.  Some members of the group are professional marketeers, some members are professional therapists.  Something happened to me today that made me notice something that’s essential to therapists as we learn to market our services using public social networks. 

Let me share with you a story…

Tweeting? Twittering? Tweeping?

Over the past month or so I’ve been posting information about counselling on Twitter. I have only 90-or-so followers (compare this with Stephen Fry who has nearly 4 million followers). It’s good fun, it strengthens my reflective practice, it gets me known a little more and brings some new folk to my website.

One might think that 90 people – some of whom are porn stars, one of whom I’m sure is not really a hedgehog, and some of whom seem to hope I’ll be buying their obscure products any moment now – are all who are reading my posts. Maybe not even 10% of the 90 are really reading what I haven’t say.  So little feedback, you see.  So, what might it matter if I might casually slip in a small case example to demonstrate a point in a Tweet?  What harm could 140 characters cause?  It’s only 9-ish people that’ll ever read what I tweeted.

The issue, though, isn’t how few people are reading me (or you, dear fellow therapist, once you hit that Tipping Point).  The issue is that once my post goes into the world, anyone can get at it. 

Any.

One.

Do you know who reads your tweets?

Today, I was surprised (though delighted) to find that some of my Tweets have begun appearing in online newspapers recently. Surprised because these are online resources that I do not follow, they don’t follow me, and I haven’t sent them any of my tweets.  But they’ve still gotten hold of them (“public”, remember!). 

By some mathem-agical power of the InterWeb, my little tweets have somehow spread out into the big, scary world and, by chance more than design, have gotten included in publications that I’ve never heard of.  My words are circulating around (at least for 24 hours until the next publications go out tomorrow, at least).

How thrilling!!

But, can we return back to that little case example I might have Tweeted about?

I put to you – dear ethical reader – the query…

…what if one of the readers of these online papers happened to be the client that I referred to in my Tweet?

What if he recognised himself?

What damage would I have done by, perhaps imagining that non of my followers had anything to do with my client; that they were the only ones who would have read my misplaced comment* ?

Ethics & Marketing.

In the Facebook group earlier discussed, therapists and skilled marketers are passing around valuable information on how a therapist might get their message out there into the world.  I would suggest to you that sometimes it happens – and when it happens BOY does it get far and wide out there.

Marketing experts will teach us therapists these things… but the ethics in what we, as therapists, put out there are entirely our responsibility … and ours alone. 

Anonymising a case is not the same as protecting its confidentiality.

And anything you write on the Internet is not private :p

I’ll leave you with that thought.

Comments are welcome, below, but preferably back on the Facebook group if this is where you found this post.

Just to clarify – I don’t discuss online/in public forums any current case work at all.  When demonstrating a point, I tend to make references to generalised examples or to casework that is already in public circulation (eg a case discussed by Patrick Casement in one of his books) .

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FAQ

Can I send someone to see a counsellor?

Sometimes, people see counselling as a last resort.  Something that is to be tried after everything else has been tried (and failed) … to fix someone else.

It is not unusual to find that people can think of counselling as something that they want to send someone to:

I want to make an appointment for my husband.

I think my friend needs counselling, will you see her?

Can we send our sister and her boyfriend?

My husband and I want to send our son for counselling.

My mother is upsetting the family, will you see her for counselling?

Counselling is a form of therapy that is private & confidential.  It can help people address personal problems (and problems within relationships):

  • It can help address ways of thinking (such as a cognitive-behavioural approach (CBA)) so that the person can be less restrained by their thoughts.
  • It can help address issues from the past (such as a psychodynamic approach) so that the person can be free of past bad experiences.
  • It can help address relationships (such as a systemic approach) so that a couple are less restricted by the same patterns of relating over and over again.

But… counselling is a personal resource, a form of assistance, a help. You are an equal-participant in counselling; counselling is not something that is done to you.

Counselling is not done to someone.

– and counselling does not “fix” someone for someone else’s benefit.

  • Counselling is a collaboration that you (and your partner if couples counselling) willingly take part in along with the counsellor;  it is a therapeutic and professional relationship.
  • Counselling cannot be something you send someone to (even if all else has failed) with the hope that the someone will be cured/fixed/made-acceptable-to-you once the counsellor has “dealt” with them.
  • A person – or both partners in a couple-relationship – has/have decide for himself/herself/themselves if he/she/they want to participate in the counselling process for himself/herself/themselves.  

… and sometimes a person does not want to change, no matter how unacceptable someone else may consider this.  Being sent to counselling won’t do any good if the person has no interest in changing something.

Counselling and Couple Relationships.

Sometimes a couple comes into counselling and one (or both) partners spend a lot of time and emotion telling me how the other partner is the problem.  They will point out all the problems with what their partner does and says.  They will imply – or even say quite clearly – that I (as the counsellor) should be fixing the partner (implication: so that the complaining partner is no longer upset).

The couple counsellor focuses on the relationship – not he individuals.  As they say, “it takes Two to Tango”, so it also takes two to make a problem.  Although the complaining partner may feel as though they are not part of the problem(s), a systemic point of view would be to consider that both partners are contributing to the problem(s) existing.  The couple counsellor will help the couple to discover how their relationship is contributing to – and keeping alive – the problems, and will help the couple … both partners … to perturb their relating behaviour enough to invite changes to happen … checking that this is what the couple wants.

In this example – you may notice that the idea of one partner sending the other partner to be ‘fixed’ may not be a very good solution to a relationship problem.

(For more information on couple counselling, use the Counselling Menu at the top of the page…)

Hoping to send someone to counselling.

So, when someone contacts me asking:

“…can we send so-and-so because they need counselling…?”

my response will be of the form:

“The person [or couple] is very welcome to make contact with me themselves and we can discuss matters”.

Clearly, there may sometimes be circumstances when a person cannot contact me on their own (phobia against using the telephone or email etc.), and we can be creative in this respect.  Perhaps using a third party for communication where appropriate.  However, the same guidelines apply: if a person or couple have not decided to come to counselling themselves, there is nothing I can do to see someone on behalf of another person’s needs.

Alternatively, maybe you might like to come and meet with me on your own to discuss with me how you might find some support in your struggles to manage with someone else’s problem.

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Articles

How to Find & Vet a Counsellor

How to Check if a Counsellor is Legitimate.

Counselling, Therapy & British Law.

A current problem (2011 when I wrote this article, and still current in 2014) in British Law is that counselling, psychotherapy, hypnotherapy, spiritual/religious counselling, alternative therapies (and so on) are not regulated by law. 

Anyone can set themselves up as a “therapist” or use the word “counsellor” without (legally) requiring any formal therapeutic qualifications to prove their ability to practice as a counsellor.

This situation leads to counsellors not being required have to have any insurance.  They don’t have to be answerable to a professional body to oversee their practice.  These therapists can advertise themselves as a “counsellor” without actually having any training, qualifications, nor any actual experience as a professional intended to help you therapeutically.

Some organisations use ‘counsellor’ in forms such as “Travel Counsellor” or a “Debt Counsellor” – and by the true definition of the word counsellor they’re not intending to mislead the public into thinking they’re offering a therapeutic approach to your mental well-being.

Unfortunately, by the lack of British law, that the responsibility lays on the client who is seeking counselling/therapy to find someone who is appropriate for their treatment.

Going through a GP may not be enough (limited to offering only NHS IAPT treatment … often with a waiting list) to gain access to suitable counsellor. 

All of this can leave a person at risk when trying to find a counsellor who is not an unqualified fake.

Help in Finding a “safe” counsellor.

There is good news, though.

Finding a qualified, experienced, professionally accredited and insured counsellor can be straightforward if you know some helpful things to look out for. This article describes how to find a suitable counsellor – and offers some topics to check out with your potential therapist.

At your first meeting with your counsellor, most – if not all – counsellors should not be phased by you asking about any of these topics (in later sessions, however, certain therapists may not answer questions about themselves, but be interested with you in the purpose of your question – keeping the focus upon you.  This is a legitimate approach to some forms of counsellor (i.e. psychodynamic / psychoanalytical) but I mention it here for your knowledge).

Search Counsellors’ Professional Bodies’ Online Directory.

An easy way to find a suitable therapist is to use a professional counsellors’ body that offers a “find a counsellor” type of service. The counsellors listed may have had to pay for an entry, but would also have had their qualifications checked before being allowed to pay for an entry in the list.

… however, if you wish to find your own counsellor – or you would like some advice on what to check out about your potential counsellor – then click the next page for…

“The iCounsellor’s Guide to Finding a Counsellor“.

Categories
Ethics

My Counselling Ethical Framework

BACP Ethical Framework.

Dean Richardson is a BACP Accredited Counsellor / Psychotherapist (explanation of qualifications).  I am a member of the British Association for Counselling and Psychotherapy (BACP). The accreditation means that the BACP have authenticated my substantial level of training and experience to be working as a counsellor / psychotherapist. Appropriately, my counselling work adheres to the BACP’s Ethical Framework (click to read BACP’s statement on Ethics for Counselling and Psychotherapy).

The BACP can suspend, deregister or remove accreditation from member counsellors/psychotherapists who fail to perform their work to the highest professional standards and/or who contravene the BACP’s Ethical Framework.

If you have a complaint or dissatisfaction about the therapeutic service I am providing for you, it may be helpful for you to you raise your concerns initially with me.  We will try and address the matters together.  If we cannot resolve the matter together then the BACP can provide help and assistance to you if you wish to take the complaint further (read more…).

BACP Address.

British Association for Counselling & Psychotherapy,
BACP House,
15 St John’s Business Park,
Lutterworth,
LE17 4HB.

Tel: 01455 883300,
Fax: 01455 550243,
Minicom: 01455 550307,
Text: 01455 560606

http://www.bacp.co.uk/

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FAQ

I need Paperwork Completing by my Counsellor

Confidentiality is vital to the counselling work and to our professional therapeutic relationship.  Even when a client believes that breaking that confidentiality might assist them in some way, I will still have a say on whether or not I will comply with the client giving their permission. 

Ideally, the client(s) and I will discuss such matters before the client(s) take such action.  Where no such discussion takes place, the client may wish to be aware that operate with certain boundaries in these matters:

  • Solicitors letter – If I receive a letter from a solicitor asking to give information on our case, I will – for reasons of protecting confidentiality – decline to comment on our case.  This will be so even if you give your authority for me to discuss our clinical work with a third party. Due to the paramount of the confidential nature of our therapeutic relationship I will not reveal any contents of our work, nor will I confirm nor deny if you have been in counselling with me.  It is important that a client is aware of my position in these matters as to assume that giving your permission to your solicitor for him/her to contact me may surprise you by my response if you are unaware of my position. If I am required to write a response to your solicitor I will make a charge for doing so – even when it is to decline to respond to the request for information about your therapy with me.
  • Attendance forms for a Student-of-Counselling‘s Therapy Hours – I will co-sign a form that you have prepared/completed that shows the number of sessions that you have attended.  I will not reveal any information about our counselling work.  Attendance forms that I am required to complete on your behalf (e.g. noting dates of your attendance)  I may agree to complete this with you after first discussing it with you, however  I will make a charge for completing the form and I will not reveal any information about the content of our work.
  • Sponsorship/application forms – if I am asked to co-sign a form on your behalf (e.g. housing application form) I will decline.
  • Summary of Sessions (eg Insurance) – Some insurance companies that fund counselling on your behalf may request that I summarise our work for them (eg a treatment plan, measurements & a written summary of each session – or an overview of the counselling work).  It is important that you are aware that I will decline to do this.
  • Receipt – if you require a receipt for your payment for counselling I will provide one that only shows your name, the amount the session cost, that the receipt is for counselling, and my name.
  • Most other letters and/of forms that you (or a third party on your behalf) ask of me will require a discussion between you and I before I make my decision, but I will still not break our agreement with respect to confidentiality.  Should I not invited to discuss this with you, my position will be to decline to give a response to any such requests.  My position is that I will not choose to break the confidentiality of our work.

Charges for completing forms.

Should we have discussed, and I have agreed, to complete forms as discussed within the boundaries above, my charge will be my standard hourly rate for the type of therapy offered to you – rounded up to the nearest hour.

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FAQ

What is an “Assessment” for counselling?

Counselling contract

An assessment for counselling is where you (plus your partner, if couples counselling) meet with the therapist a session (sometimes more as required) and discuss what you need from counselling and what the therapist can offer.  The therapist will ask you some questions to help understand a little more about your needs for counselling.  This will also helps both the therapist and the client to judge if both are able to work with the therapist’s style of therapy.

The therapist will offer you a number of tentative thoughts about what he learns from you.  He may offer an interpretation or two based on how he may understand how some matters may link together. T his is all part of seeing if a psychodyamic approach to therapy is suitable for you.

This is a mutual assessment – the therapist is not just assessing you for counselling.  You are assessing the therapist and the form of therapy on offer.  Both client and therapist are seeing if they can work together.  If client or therapist have any concerns of each other they can discuss these openly with each other.

At the end of the assessment, the therapist and client should have a clear idea about what the therapy is to offer, and what the client needs from the therapy. Alternatively, discussing a referral to another therapist might be more appropriate.

See also:-

Categories
FAQ

How do I Find & Verify a Therapist?

Searching for a Therapist.

It’s an unfortunate truth with UK law that, presently, anyone can set themselves up and describe themselves as a “therapist” or a “counsellor”. They are not legally required to have to have any formal training, any qualifications, any experience, any insurance, nor do they need to be a member of a professional body that oversees & regulates their therapy practice.

People like these exist – some look quite legitimate – and they can make finding a properly-suitable therapist quite dangerous for the layman.

However, when you know what to look out for, professionally qualified therapists can be easily recognised.

Even if you are still unsure that a therapist/counsellor you’ve found is legitimate or not, the following questions put to the therapist will help you decide.  Do not be afraid to ask your potential therapist to proove their legitimacy!

Vetting Questions to ask a Potential Therapist.

Any of these questions would be appropriate to put to a therapist (private, NHS, charitable, spiritual, religious etc) during the first interview.

  • What are your formal qualifications to practice as a therapist – or are you still in training?
  • Who awarded you your qualification? (Check that the awarding body is also a suitable member of a recognised professional body) -or- who is overseeing your practice whilst in training?
  • If you have no formal qualifications, and are not in training, what is your rationale for offering me therapy?
  • What professional bodies are you a member of … and what is your membership number?
  • If you are not a member of a professional body, what are the circumstances around this?  Was it your decision not to be a member?
  • Does your professional have different levels of membership (e.g. member, accredited member, senior accredited member) – and, if so, what level of membership have you attained?  Are you aware of the next level, and are you working towards it?  If you are not working to the next level, what is your rationale?
  • How do you regularly ensure that are practising to your best (e.g. do you attend regular supervision, or are a member of a group supervision group)?
  • When was your last training course or self-directed learning (continued professional development/CPD)? (Check that the therapist stays up to date with current learning).
  • Do you have indemnity insurance – and who is it with? How does your insurance protect me as a potential client of yours?
  • (If appropriate…) … having learned of my/our needs for therapy, what will be your treatment plan for me/us?
  • Is your treatment suitable for my needs?
  • Have you offered this treatment before?

Trust your Instincts with the Answers.

How do you feel with the therapist’s responses to your questions?  Were the answers given freely?  Some therapists – later on in the therapy – will not immediately answer questions, preferring to investigate the nature of the question first (psychodynamic/psychoanalytic is a legitimate model of therapy, albeit different from other models), so it might be best to bare the therapist’s response with this in mind.

How does the therapist appear to you?  Does the therapist’s website and marketing material give the appearance of professionalism?  For example, does the website look healthily maintained, or is it a bit out-of-date/bedraggled?  Do the marketing materials look professionally produced, or kind of written on craps of paper in crayon?

Services such as VistaPrint can give a professional appearance to anyone in return for some money – but these services also produce rubber-stamp images (i.e. the choices of branding can be used by anyone, over and over again).  Looking professional is a good indicator of the professionalism of the therapist, but on its own it’s not an indication of the therapist’s qualifications, practice or experience.

In addition with the above questions information, if you meet with the therapist consider the following:-

  • Do you have a feeling that the therapist is someone you want to work with?  If not, don’t … and find someone else.
  • Does the therapist at least attempt to answer the questions helpfully, or evasively?
  • Do you know of anyone who has previously seen this therapist for treatment?

Bear in mind that there is no legal requirement for any of the above considerations to be set in place, so you are responsible to protecting your own well-being.

[button type=”small” color=”orange” permalink=”3989″ br=”yes”] Click for a more detailed article on this subject…[/button]

Other sites of interest: Counselling via Skype, Online Zoom Counselling, Havant Counselling & Counselling for LGBT Couples