learning journal 10

Safeguarding

So I thought this was going to be quite a boring one, safeguarding. How wrong I was. My previous experience of safeguarding training has been mixed with some great stuff by Devon and Torbay councils but not always the case with other providers. I guess the beauty of our training is that we get to discuss our opinions and feeling around issues and what this raises. However, this can also raise other issues to reflect on.

Today I became quite angry inside over an issue when the group was feeding back around how they would/wouldn’t have acted upon a case study example. For me it was quite black and white. The issue itself was over a suggested example of a 15 year old girl whom we could or could intervene in order to protect given what we are aware of, in this case a paedophile uncle actively attempting to re-engage with her. The discussion became quite heated when as I felt some members of the group had gone 100% person centred at the expense of the safety of an individual, and would not have acted in any way beyond supporting the person in the session to try to find her own best strategy.

While that is a laudable example of the purist person centred approach and one I would agree with on the whole, the age of the client, 15 and the potential harmful consequences immediately removed any shadow of doubt that I would have broken confidentiality with the person knowledge as her safety and well-being were my responsibility now as an aware citizen. That there can be any confusion in the case of a minor is worrying for me. Yes there is a process of evaluation so as not to act in haste, but we had had that as the counsellors to be had had a lengthy discussion about it. What followed was an alarming justification not to act as the client’s confidentiality took precedence. I saw quite a clear case to act given a school girl rape victim was currently threatened by the perpetrator and was in immediate and current risk of distress if not worse.

Looking within at how I felt around this was more interesting. I felt angry. It was a feeling borne of frustration I think. I know I was on a short fuse and have been for sometime with moving house stresses and getting ill so often lately which I think is due to lack of sleep. But, why am I frustrated with others in such an unproductive way. Frequently I don’t understand things the first time. This is happening a lot to me at work also over the last few days. I have been getting frustrated with people at work for not pulling their weight or doing things in what I feel is a wrong way, and this is not at all helpful to one of the biggest things you need in a workplace environment, to get along.

What I’ve noticed is that I am highly critical, of everyone, including myself, which is a character trait I could do without, quite frankly. Also this seems to be accompanied by an urge to be right, in discussions with co-workers. Its over-riding sometimes and takes over what I know to be better for me in the long run when for example I speak in a team meeting. Its not whether or not I am right that matters in the long run. People always come round to the better option but like in counselling, the better outcome I guess is for them to need to feel its their decision and I cant make it for them.

This is a factor in all my interactions particularly when I’m tired or under siege from feeling overwhelmed by tasks. Right now I feel this very much and wonder if doing the course was the right move this year. If I take this feeling of being overwhelmed in to my work place with clients then I will become less tolerant of them, irritable. I would lose the person centered approach and not be with them in their experience. Further in my role on Saturdays as a counsellor in training I would struggle to be present in the moment if I start to apply a judgementalness to my listening skills. This would totally detract from the experience of being there in their shoes for everything that they are saying. I recognise this in myself. So far I am confident I do keep it out of my one to one work with clients, but I have started to see it leak out in group work in my job role with particularly difficult boundary pushing behaviour working with addicts in the community.

An example would be yesterday in stage 1 drugs group, which is a group I co-run with another person. We had devised a group looking at self-awareness and denial, but during it clients began to get food out and roll cigarettes. When I asked them to stop doing this I noticed my reactions were short and irritated. In that moment my impatience and judgementalism came through and I could see it in the responses I got from some of the clients. The fact that I was less tolerant than usual over the boundary pushing and that it was apparent clearly could have a negative impact on my client work.

I recognise that stress is playing an important role in my ability to humanistic with clients, my ability to not be cynical and my overall feelings towards my client group on the whole of late. I am recognising after the event a lot of times yesterday that I was not tolerant of clients in their boundary pushing, which is only part of who they are in this process perhaps. I am quite shocked by even how a rise in stress levels has had abeit a small change in my reactions to clients. Partly I think that it is a rise in congruence when boundaries are being pushed which is no bad thing, and I feel that by and large that is the impact is has had on clients but also the emotional responses of anger behind my intolerance has been what I have been left contemplating. Clients will have noticed that shift. In one to one sessions client will notice that shift should it come about and then the impact would be really poor to the therapeutic alliance. All this leaves me feeling this week that I have been more emotional and I recognise the need for self-care. I look forward to therapy when it comes. I look forward to the house move being over in December also as this is probably the stressor that’s proving too much for me at the moment.

Gong back to my placement now I saw two clients this week in Truro. One was a man who presented with no issues at all. Quite an interesting session we had exploring positivity and moving forward. S was at first quite a tricky client in so much as he was seemingly quite reluctant. However I embraced this in a light-hearted way and worked more on building a connection between us so that he would feel comfortable in sharing. Sure enough this then brought out a lot of exploration in the past and present that I feel was an hour well spent.

The second person was completely the opposite, as they really wanted to unload. J presented overwhelming grief for recent losses of both parents and the upheaval that losing home, job and health in the past 18 months had made on her life. It crossed my mind that a counsellor in training may not be best suited to such an intense amount of emotion. However, I just stayed with the client, used all the basic listening and focussing skills and had no agenda to fix at all. I feel we accomplished a huge amount. It was emotional for the client and it was quite a draining experience being with such emotion for so long and I felt exhausted afterwards.

With both clients I clarified the level of confidentiality. I am really getting to grips with this as a fundamental aspect of introducing what it is we are able to do. It clearly sets the boundaries and truly informs the person what they can expect. I stated that what they discuss is confidential, although if they let me know that they will harm themselves or another or I believe them to be at risk of harm, I am duty bound to break that confidentiality. However, I will do this with their knowledge if at all possible. Also I was very clear about me keeping brief notes and relaying concerns to the team which I am part of. The other factor given that this is part of a service within a rehabilitation service for alcohol and drugs clients in recovery, is that I obviously make them aware of the provision to break confidentiality if they reveal that they plan to or have used mind altering substances. This is due to the risk they may pose themselves or the dangers that this could have on other vulnerable members of the houses. Some of this I read from a contract, but I always make it part of a wider discussion if the person intimates that they want further clarification. I feel that I am very comfortable with expanding on this and know the value of dealing with these issues right at the start of the relationship, as it makes that person feel boundaried and safe I feel, knowing what are the confidentiality limits.

I did speak to the engagement worker immediately after and only them, as it was necessary to hand over some of the essence of what had gone on, with a view to managing risk. The clients are bringing up very emotional things for them and leaving themselves vulnerable. This particular client group can use mind altering substances as a coping strategy for difficult emotions and so to let others in the team know that this has happened is really important.

I handed over to Sheeana the engagement worker for about ten minutes after the sessions. This was a very important part of sharing the process that the clients had been through so that we could ensure their care and safety, but also part of integrating the team as a wider and unified cohesive unit. It is really important for us all to feel that we are all aware of what is going on for the client group and that we are all aware of what is going on. This enables us to be more alert to risk, managing risk but also to build our working relationships to enable a strong bond between us as a team.

In line with the basic principles of the Data Protection Act 1998 (http://www.legislation.gov.uk/ukpga/1998/29/contents), the information I have is only to be used fairly and for limited specific purposes so that Sheeana and I share for a specific reason, the protection and support of our clients. We shared information in a specific and relevant way and in a safe and secure manner. In order for this to happen we shared client information behind a closed door in the team office so that clients could not hear us. Had there been any alarming risks or need to alert others, there is duty on call worker to bring in and we are very aware of how to do this should there be any need to involve them. This could be for very immediate risk of clients breaking rules in the house or for example clients’ fighting as happened on Monday just gone. At all times the mood in the house and the relationships between clients has to be monitored, after all these are people regaining emotions and living on top of each other in quite life changing circumstances. Had I felt that there were any such risks I would have called the on-call worker in addition to liaising with the engagement team. Further to all of this I wrote an anonymysed email to the team leader afterwards detailing who attended, any concerns or otherwise. This is a soft copy of my anonymous notes, which are very brief after each session and go in a folder, which is then locked away in the team leaders cabinet in a locked team office. This enables the team leader to check who is making use of the service and gaining from it, which in turn highlights risky attitudes possibly if they are not. Also it makes very clear any concerns or risks I feel that there are for the team leader to be aware of over the coming week, as he will be privy to their visits and general calendar events. Should these create any further raised levels we are sharing as a team to best prepare for the client to be supported.