Maintaining Boundaries
One of the ethical issues I encountered during the practicum is lack of boundaries between a professional and a client. On meeting some of the patients at the site, I unknowingly formed a relationship that went beyond the professional lines which proved to be a challenge when attending to them. The supervisor addressed the issue by reminding me of the importance of maintaining a professional distance. For instance, it ensures that the focus remains on helping the patient get better. I learned that sometimes it can be hard to guarantee that one is not developing a close relationship with a patient (Brashear & Thomas, 2022). At times, it is the latter that blurs lines or attempts to do so due to how the relationship develops. For instance, someone might establish a strong bond with their counsellor who seems to be more than a professional. It is essential for the expert to maintain as well as re-establish boundaries as required.
Confidentiality
All counsellors or therapists are obligated to maintain the confidentiality of their clients. This implies that they are responsible for keeping every personal data hidden from any other party including client notes, intake forms, and contact information. These have to be stored in a manner they cannot be accessed by a third party (Brashear & Thomas, 2022). The professional lacks permission to disclose any information with another person who is not the patient. Sensitive information may include the identity of the individuals seeking help, their residence, issues they are experiencing, or an occurrence during a session. I had an issue whereby I shared a piece of information without permission concerning a client to their spouse and after finding out, they were not happy and claimed that I had broken their trust. The supervisor helped by assuring the affected individual that the case would not be repeated.
According to the supervisor, ethics is important in the field of therapy since issues such as failure to establish boundaries and maintaining confidentiality might result in worse mental condition of the patient. He decided to remind everyone of the importance of professionalism and trust (Brashear & Thomas, 2022). According to ACA Code of Ethics, a counsellor should realize that being able to be trusted is a core part of the counseling job. A therapist should aspire to get the trust from clients by establishing a continuing partnership, upholding proper boundaries as well as maintaining confidentiality.
Human Growth and Development
I worked with adults victims of domestic violence and sexual assault, among other issues. It is estimated that one in four grown females and one in seven males report to have experienced severe physical violence from a spouse in their lifetime (Brashear & Thomas, 2022). Additionally, sixteen percent of women and seven percent of men have faced sexual assault from an intimate partner as well (Brashear & Thomas, 2022). Counsellors who recognize patterns of self-esteem issues, maladaptive behavior or poor decision-making by a client may automatically desire to dive into goal-setting and other methods to bring change.
Nevertheless, engaging in change-oriented work when a patient is experiencing intimate partner violence may prove to be harmful. The tried-and-true approach of talking through different scenarios while challenging a client with questions that seek to know what they could have done differently, can be hurtful. This is due to the counsellor inadvertently placing the responsibility on the victim rather than the abuser. I have learned that one is required to select language used carefully to prevent making the patient feel that they are supposed to be blamed for the incident. It is essential for one to be cautious concerning how they phrase different issues. This is as well apparent in the real world whereby individuals who have undergone a traumatic event do not appreciate being blamed for what happened to them.
Counseling Theories
Cognitive behavioral therapy (CBT) is one of the approaches used in my site. It is a talking therapy that can aid in managing problems by altering the manner in which one thinks and behaves (Carpenter et al., 2018). CBT is commonly utilized with the intentions of treating depression and anxiety but has been observed to be useful in cases of other physical and mental wellness problems. Experts use it in an attempt to assist a patient in dealing with overwhelming issues in a positive manner by breaking them into smaller components (Carpenter et al., 2018). Patients are shown how to alter the negative patterns to better how they feel. Unlike other treatments, it deals with one’s current problems instead of focusing on those from the past. The approach aims to look for practical tactics to improve their state of mind.
From observing this approach, I have learned that CBT is an effective method of treating numerous mental wellness issues. Additionally, the approach can be used to aid individuals with post-traumatic stress disorder and those with long-term medical conditions, for example, irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Even though it cannot cure the physical indicators of the conditions, it can assist patients manage their situation better.
I have gathered as well that CBT’s effectiveness matches that of medicines in terms of improving the state of someone undergoing psychological health issues. However, it is important to note that it may fail to suit everyone (Carpenter et al., 2018). Some advantages of the approach include helping in the event medicine solely failed to work, ability to be done within a short time in contrast to other techniques and teaching practical and useful strategies.
Counseling Skills
I observed various basic skills utilized in counseling sessions, for example, immediacy, attentive silence, therapy, reflection of content, paraphrasing, active listening, empathy, open-ended questions, and being non-judgmental. Apart from immediacy, attentive silence, and reflections, it was easy for me to identify all of them (Macnamara et al., 2019). I learned that during the counseling procedure, when one has difficulty in a certain skill, they can get better at it by seeking advice from peers. For instance, it is possible to improve my ability in attentive silence by counting until ten. Regarding immediacy and reflection of content, I can rehearse phrases to use during a session (Macnamara et al., 2019). I observed that not much homework was given to clients. Only some had a tangent activity to work with as it depended on the need.
Reflection of Action Plan
I was satisfied with my MID term evaluations since I proved to be great at more skills and only a few challenged me. I want to work on improving immediacy, reflection of content and feeling, attentive silence and confrontation.
- Goal 1 Clinical Skills: Immediacy:
- Action Item A: Use plural pronouns such as them or them.
- Target Date: 15 May 2022
- Outcome: Establish great therapeutic relationship with clients.
- Action Item B: Use informal manner to address clients.
- Target Date: 15 May 2022
- Outcome: Increase my clients’ awareness.
- Action Item C: Rehearse phrases.
- Target Date: 15 May 2022
- Outcome: Address maladaptive association patterns between me and my clients.
- Goal 2 Theoretical Development: Reflection of Content and Feeling:
- Action Item A: Practice phrases or words to use during a session.
- Target Date: 25 May 2022
- Outcome: Establish rapport as well as create a relationship with clients.
- Action Item B: Practicing audibility to be heard by clients.
- Target Date: 25 May 2022
- Outcome: Make clients know that they are understood and encourage them to reveal more.
- Action Item C: Practice confidence.
- Target Date: 25 May 2022
- Outcome: Help clients be aware of their feelings and emotions.
- Goal 3 Professional Development (Attentive Silence and Confrontation):
- Action Item A: Practice counting until ten.
- Target Date: 05 June 2022
- Outcome: Facilitate expression of emotions and feelings by the clients.
- Action Item B: Practice providing feedback to the clients.
- Target Date: 05 June 2022
- Outcome: Encourage responsibility.
- Action Item C: Practice appropriate responses to clients.
- Target Date: 05 June 2022
- Outcome: Show empathy.
Biblical Worldview
I feel faith is important in the healing process of an individual undergoing counseling. However, I understand that not everyone shares same values as me and thus, in case they use them as part of their system, then they will be implemented in the therapeutic plan. My agency does not offer Christian-based services but it is up to clients to incorporate them. Religion and spirituality are rooted in attempting to comprehend the meaning of life and in some instances, how an association with a higher power may impact that definition (Evans et al., 2021). The former, on the one hand, offers individuals something in which they can believe and gives a sense of structure and a way of connecting between people with same beliefs.
On the other hand, spirituality refers to a sense of people connecting to something bigger than them. It aids them in looking within which can be helpful for a patient attempting to recover from a traumatic event. It focuses on a person’s connection to what they trust in and their individual growth (Evans et al., 2021). It as well prompts a patient to express how they feel in the form of art, myth, poetry, or religious practice. Lastly, it is important to note that religion initiates social connections with different people which can be useful in a situation whereby they share a similar past such as being victims of gender violence.
References
Brashear, C. A., & Thomas, N. (2022). Core competencies for combatting crisis: Fusing ethics, cultural competence, and cognitive flexibility in counseling. Counseling Psychology Quarterly, 35(1), 215-229.
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety, 35(6), 502-514.
Evans, C., Brown, D., & Davis, J. (2021). Professional counseling from a Christian worldview. Journal of Spirituality in Mental Health, 1-18.
Macnamara, E. F., Schoch, K., Kelley, E. G., Fieg, E., Brokamp, E., Undiagnosed Diseases Network,… & Palmer, C. G. (2019). Cases from the Undiagnosed Diseases Network: The continued value of counseling skills in a new genomic era. Journal of genetic counseling, 28(2), 194-201.