A Time for Renewal

A new year brings new opportunities to help others.  As we know, helping others adds more stress, along with being drained physically, emotionally and mentally.  So how do you plan to handle the stress?

Paul, in 2 Corinthians 1 wrote about our God, the Father of compassion and comfort, gives us comfort in all of our troubles so we can comfort others.  We see that happen in our personal life, then in our counseling office with the people He sends to us.

Receiving comfort, strength and wisdom from our heavenly Father becomes a daily necessity for us in light of imparting the same to others.  How is your seeking and being filled going for you this new year?

Consider a popular acronym used to set goals and objectives to meet those goals as one strategy to replenish your self this year.

S – specific statements

M – measurable expectations

A - achievable

R – results oriented

T – time driven

For some, goals work better than for others.  Whatever healthy strategies works for you, be sure to include them in your daily lifestyle when imparting what God has graciously given to you.

Would you take a moment to post how you are planning to replenish yourself this year?

Is it time for a getaway?   Consider a retreat, one designed for counselors at:  Marble Retreat in Colorado.

 

 

2012 Calling

What is God calling you to be and do in 2012?  This is a common question for most Christians this time of year.

Personally, I (Gary Reed) would like to share my calling with you as a brother in Christ and fellow counselor.

First, to reflect Jesus to the hurting, the confused, the conflicted and the searching soul.

Second, to be an extension of the local and global church of Jesus Christ.

Third, to promote Christian mental, emotional and spiritual health both locally and globally.

Fourth, to train student counselors and provide opportunities for Christian counselors to share their skills.

Being a little (maybe more of a lot) hyperactive causes me to be scattered, though when disciplined I am promoting opportunities of God’s work within the soul and in various communities.  I love partnering opportunities, just like this network of counselors.  Connect with me to further our partnership or to develop a new one at:  scctnet@gmail.com.

By the way, comment on your 2012 calling?  Post your comment below.

Peaceful Rhythms

Blessed are the peacemakers for they will be called “sons of God”.  Matthew 5:9

Helping others is draining, at times exhausting yet fulfilling all at the same time.  As people sit down in our office, feeling on edge or out of control emotionally, God enables us to help them find peace.  What an opportunity we have as counselors to watch God do His work in people.

Feeling fulfilled as God’s workman is a marvelous thing.  Yet the emotional and mental energy required to help others interrupts our normal body rhythm.  Sleep can be interrupted or become excessive. Our appetite may increase due to stress or decrease due to being over focused on work.  Normal workout routines may be inconsistent and relaxing weekends turn into working weekends.

Sound familiar?  Dr Michael Lyles, a Christian psychiatrist recommends several strategies for maintain your health as a counselor.

1.  Be aware of your illnesses and patterns of interruption.

2.  Maintain sleep hygiene, following your body sleep rhythms.  Go to:  sleepfoundation.org.

3.  Use relaxing, fun and energizing activities.

4.  Develop balance relationships, both giving and receiving from friendships.

Are there any strategies you want to use this week to maintain your balance and rhythms while helping people?

Practitioner Relational Risks

In another recent HPSO newsletter, the writer warns counseling professionals about liability when sharing office with other practitioners.  See what you think and leave a comment below with your thoughts.

Many human development practitioners are now sharing office space and aligning themselves with other professionals to increase everyone’s ability to attract and service clients, and at the same time reduce costs. There are many positive aspects to these arrangements, yet as a counselor or human development professional you must be aware that these arrangements can increase your exposure to professional liability. Therefore, you should take steps to protect yourself with the right kind of professional liability protection.

How do you know if you are taking on more risk than you intended? If you are not in a traditional business arrangement (sole proprietorship, partnership or corporation), are you in a situation that may include one of the following scenarios: clients see more than one counselor in an office; group sessions are conducted by more than one professional in a shared office setting; you share office staff; client records are stored in a common area; fees are shared with other human development practitioners; the sign on the office door has a name that leads the public to think you are a traditional group practice?

If your practice or the practice you are affiliated with falls into any of the above scenarios, you open yourself up to a different area of legal risk than that of a traditional business arrangement. One key way to protect yourself in the event of legal difficulties is to apply for professional liability insurance as an individual. This affords you the proper protection, should you be included in a lawsuit that is a result of a practitioner with whom you share office space. You’ve worked hard to build your practice, and you want to be able to have the peace of mind knowing that your insurance carrier will provide you with representation against legal actions that you did not cause. Healthcare Providers Service Organization (HPSO), the endorsed professional liability program of the ACA Insurance Trust (ACAIT), can bring you and your practice the protection that is essential to you.

Whether you choose to participate in a sole proprietorship, partnership, corporation or remain independent but share office space, you can take steps to reduce your risk of a malpractice lawsuit.

• Check the references of new professionals joining a traditional group practice or shared office setting. It is necessary for you to know who is joining the practice and what their background is.
• Keep records separate. If you are participating in a non-traditional group practice, your records are confidential and should not be in a common file area. Unless you are consulting on a professional basis with of the other practitioners, your records should be in a location where only you can view them.
• Consider adding individual phone lines with separate numbers. Even though you are sharing office space, you are still an independent human development practitioner.
• If you engage in peer consultation, do not use client names, and consider using the term “peer consultation” rather than “peer supervision.”
• Make sure that those with whom you share office space keep their own professional liability insurance current and carry the same limits of liability as you.
• If you are part of a “loose association” or shared office situation where someone else takes care of insurance, never assume that everything is up to date. Be sure to check the records and make certain that all counselors or human development professionals have provided a current copy of their policy certificate. Also, be certain the policies are renewed at the due date.
• Remember, if you are a sole proprietorship, partnership or corporation and are doing business as such, then you should obtain coverage under a group policy. There are several benefits to using the group approach. The most important is that the business, employees and independent contractors are covered under the policy and share in the limits of liability. But, if you are not operating as a traditional business, you will need to purchase individual coverage to properly protect yourself.

Boundary Lines

In a recent article from HPSO called Clients Who Cross the Line,  Cynthia Saver writes:

Clients who cross professional boundaries present significant challenges, including how to manage the situation without putting yourself at risk for legal action related to inappropriate behavior. Before describing strategies for dealing with boundary crossing by a client, here’s a quick look at boundary crossing and how to prevent it.

Crossing boundaries can be a normal part of our own personal life and clients’ daily lives.  But when we have a professional relationship with someone, professional and ethical boundary lines have to be established.  In all helping relationships, this is quite difficult.

Cynthia Saver continues, writing …

Establish boundaries from the start of the counseling relationship. Talk to your client about items such as the purpose of the relationship, fees, and appointments, and document your discussion. Have the client sign a form that he or she has received the information. In essence, you’re obtaining informed consent.

Sit at an appropriate distance during the appointment and be cautious when touching a client because it can easily be misinterpreted. Don’t disclose too much personal information. It’s acceptable to receive small gifts of gratitude, but nothing that’s valuable or creates some kind of indebtedness to the client. You should document all gifts received.

Don’t let issues build. If the client makes an inappropriate comment, say so right away. Document your conversations objectively. For example, state the client’s exact words rather than, “Client made sexual innuendo.” 

If you’re unsure whether a boundary has been crossed, consult your association’s code of ethics and standards. You can also talk with trusted colleagues, and document the consultation to show that you sought advice. The ACA offers its members free, confidential ethical and professional standard consultations.

For a link to the whole article, go to:  http://www.hpso.com/resources/article/333.jsp

What do you do when clients cross boundary lines?  What do you recommend others to do?

Helping Resistant Clients

In the latest HPSO E-letter, Clifton Mitchell posts an article called, “Managing Resistant Clients”.  This is s very good article, one we consider when we meet resistant.  We may not agree with everything he writes, though he makes some valid points.

Managing Resistant Clients

You can’t change anyone else; you can only change yourself. Many counselors have used this common bit of wisdom to help clients overcome problems, but it’s crucial that counselors internalize that idea themselves, says Clifton Mitchell, a professor and coordinator of the community agency concentration in the counseling program at East Tennessee State University.

“We tell our clients things like, ‘You can’t change other people; you can only change yourself.’ Then we go into a session trying to change our clients. This is hypocritical,” says Mitchell, the author of Effective Techniques for Dealing With Highly Resistant Clients, which is in its second edition. “I teach, ‘You can’t change your clients. You can only change how you interact with your clients and hope that change results. That’s all you get.’”

The concept of counselors focusing exclusively on their interactions with clients and letting change happen on its own is key to the successful management of resistance and the pivotal point of effective therapy, says Mitchell. For 10 years, he has studied and presented seminars on dealing with resistance in therapy. “Although most therapists have been trained extensively in theoretical approaches, few have had extensive training in dealing with resistance,” he says.

Read full article

What are your thoughts about facing resistance?  How do you find success working with resistant clients?  Post your thoughts below.

Media on Emotional Wounds

In the last decades or so, the social media and printed materials have dramatically increased on “emotional wounds and restoration” topics.  Brokenness, woundedness and spiritual/emotional healing are fairly common phrases used by speakers, writers and lay helpers today.

What printed materials and electronic media is out there?  Take a look below and please post a comment with you favorite titles!

Wounded Healer by Henri Nouwen

Ragamuffin Gospel by Brennan Manning

The Emotionally Healthy Church by Peter Scazzero

Honourably Wounded by Marjory Foyle

Taking Out Your Emotional Trash by Georgia Shaffer

What are some of your favorite links and printed titles?

Non-Compliance or Just Difficult

Counseling is a collaborative relationship in which counselors work with clients to find solutions and achieve life goals — the client’s goals. Sometimes, though, problems aren’t getting solved, the client isn’t following the treatment plan, and the counselor is feeling frustrated. What then? Termination may be the best answer, but only if you end the relationship properly. 

 

The Code of Ethics of the American Counseling Association (ACA), prohibits “abandonment” of a client.¹ But as long as continuation of treatment is arranged, you may end a counseling relationship when: You feel you can’t be of professional assistance to the client, or you believe the client is not likely to benefit from further counseling or is even being harmed. You may also terminate a client relationship if you feel endangered, or the client is not paying agreed-upon fees. Whatever the reason, avoid making the client feel you have abandoned him or her. A client who feels abandoned may become angry, which can lead to disciplinary complaints and lawsuits.

What makes a counseling relationship go sour? Consider this scenario: You’re a counselor with a behavioral approach who assigns homework exercises to help your client overcome social anxiety or free himself of compulsive rituals. The client agrees to follow your instructions but fails to do so, citing countless reasons for his failure to perform the exercises you’ve recommended. David Kaplan, PhD, chief professional officer of the ACA, noted that though such a client is often labeled “noncompliant,” he “is simply a client who, for his own reasons, doesn’t do what you want him to do.” This client, for example, may have scheduling problems that he has been reluctant to reveal. You can avoid such a situation, Kaplan suggested, by making your approach clear to prospective clients in the informed consent brochure you give them at your first encounter. Or, if the relationship has been established, you can offer an alternative approach—as long as you are qualified by training and experience to do so.

What are your thoughts?  How do you determine the difference?

Helping Students help Students

Today, students of all ages hear from their peers about life, stressors and family issues.  How can we help students help students?

Identifying Student Issues

First help the student identify the need which may be stated directly or indirectly, strongly or modestly. Notice what the student is saying, how he or she is saying it and their body language.

Unusual Changes in Behavior and/or Mood

• Withdrawal from usual social interactions, very quiet, head down
• Decreased productivity
• Increased mistakes
• Noticeable absence from class
• Emotional outbursts and crying
• Loss of interest or apathy
• Exam time “jitters”
• Increased or decreased sleep
• Exaggerated irritability  or  hostility, anger or resentment
• Depressive symptoms
• Excessively blaming others
• Excessive Obsessions (unwanted thoughts)
• Excessive worrying or expression of fears
• Increased forgetfulness  or  Confusion
• Thought disorders (the student’s conversation does not make sense)
• Compulsive disorders (ritualistic ways of acting, such as twitches, repeated words, excessive hand washing)

Rapid Onset of Physical Illness

• Elevated blood pressure
• Chronic digestive problems/stomach pains, including ulcers
• Increased muscle tension
• Severe and frequent headaches
• Dizziness
• Elevated pulse and respiration
• Moist or sweaty palms
• Increased frequency of urination
• Respiratory problems, elevated temperature

Thoughts of Self-Harm or Harm to Others

• Statements about extreme sadness, anger, hopelessness, guilt, apathy
• Statements “It’s useless”, “I don’t want to be here”, “I hate my life”, etc.
• Statements “He’ll get it”, “When I see her she will be sorry”, “Goodbye”, etc
• Extreme mood swings, giving items away, carrying a weapon

What can you do?

1.  Give him or her your attention, be a friend.

2.  Tell them what you see and hear from them.

3.  Ask them if they are getting help?  Discuss options for getting help.

4.  Help them connect with a school counselor, student minister, pastor or professional counselor.

5.  If student is displaying concerns regarding harming them self or someone else, accompany student to a school staff member, pediatrician or call 911.

Trauma and PTSD Therapy

Helping people who suffer with “acute stress” and “post traumatic stress” can be exhausting and complicated.  With soldiers returning from Iraq and Afghanistan over the last decade, foreign studies in African tribal conflicts, various kinds of abuse and missionaries returning home due to emotional/behavioral dysfunctions.  In war, some soldiers say, “There are no atheists in foxholes” and others say, “I found God in the terror of war”.  At home, many have suffered from traumatic events and kept their physical, sexual and/or emotional abuse a secret.  Still others, have experienced catastrophes, violent crimes or death in a traumatic manner.

As Christian therapists we ask, “How can we help?”  Treatment of traumatic events, PTSD and other related disorders is quite controversial and confusing.  Various therapies have found success such as Cognitive Behavioral Therapy, EMDR and long term treatment programs, along with medication.  The purpose of this post is to stir a discussion and lead to a better understanding of helping others.  For the sake of time, let’s look at one type of therapy, a peak at what Dr Edna Foa describes as “exposure therapy”

As a contributing author in the book Prolonged Exposure Therapy for PTSD, Edna Foa believes “aversion therapy techniques” are useful in helping those who suffer with traumatic events.  Whether we agree with Dr Foa or not, she has a good point when she says,  ”It is natural to run from things we fear”, but many of us know intuitively that what really robs pathological fear of its power is confrontation. Avoiding what frightens us is exactly the wrong thing to do” (from Sunday’s Philadelphia Inquirer article).

“The trick”, Foa says, “is to activate our fears and then change how we think of them in the same way that we call up a file stored in our computers before we can revise it. You do this by exposing someone to whatever he fears in a nonthreatening way so he can see it’s not as bad as he thinks”.

This Scripture comes to mind when confronting fearful events, “There is no fear in love.  But perfect love drives out fear, because fear has to do with punishment.” 1 John 4:18

So, what do you think? Leave a comment (click on top of article and go to the end of the article to submit a comment) and let SCCT Network know how do you help those who suffer from traumatic experiences?

Written by Gary Reed

Network Director

Resources:

PTSD symptoms and treatment

Crisis & Trauma Counseling – H. N. Wright

PTSD and Clergy

Missionaries who suffer from PTSD:  New Book