Counselor and Client Safety
The topic of this paper is client and counselor safety in the crisis intervention field. It is important to always assess for this when working in a crisis situation, regardless of the type of situation that is faced. Being able to accurately assess risk is a critical component in crisis work that will be explored in this paper.
Research on Counselor Safety
Counselor safety has previously been seen as an afterthought, but is now becoming a troubling issue. There are many situations where a counselor will work with violent clients, and it is important that they take as many precautions as possible. It is important to set and maintain proper boundaries with clients, and monitor self-disclosure so that they do not have too much personal information about the counselor (Despenser, 2007). It is human nature to become too trusting when we are getting to know a client and that is usually when boundaries start to slip. Regardless of what setting and environment that we work in, we have to beware of threats to our safety. The likelihood of dealing with potentially lethal clients in our field is very high. Sommer (2008) acknowledges that we are all susceptible to work with violent clients at some point in our professional careers (Sommer, 2008). We must remain cognizant to protect ourselves, especially in situations where we are alone at the office or it is later in the workday. We also need to only work with clients that we are trained to work with. Otherwise, we place the client and potentially our safety at risk. Seeking supervision and accurately assessing the client for lethality and violent behaviors can help us figure out how to protect the client and ourselves. The learner plans to maintain proper boundaries with clients, and take precautions to watch out for her physical safety. She will try to leave with other colleagues at the end of the workday or a security officer if that is possible. Another thing she will try to do is to maintain supervision about potentially lethal clients and to see how the individual situation should be handled without compromising safety issues.
Research on Client Safety
There will be many crisis situations where we have to assess whether the client is safe and/or needs medical attention. We could end up working with domestic violence survivors, a client exhibiting suicidal symptoms, etc. Kress, Protivanak, & Sadlak (2008) states that it is our responsibility to ensure the client’s physical safety in domestic violence situations” (Kress, Protivnak, & Sadlak, 2008). Legally, we have to make sure that they are safe, and if children are involved, then we might have to notify CPS. In this situation, we would need to collaborate with the client to make a valid and reasonable safety plan (Kress et al., 2008).
A controversial intervention that is used to ensure client safety is no-harm contracts. Hyldahl & Richardson (2011) says, “Contracts can be helpful to a client by including specific steps the client promises to undertake before resorting to self-harm”(Hyldahl & Richardson, 2011, p. 122). In some cases, it gives clients a sense of empowerment in that they make a commitment to their therapist, and see that positive change is possible. When the learner works with future clients, she plans to have a discussion about duty to warn, and other issues that can affect confidentiality. She feels that it is important to be honest with the client during the first session so that they can make informed decisions about receiving services. The learner also wants to establish a collaborative approach with the client so that they would feel like they have a voice and can feel cared for. The learner will be challenged to keep up with statutes that can affect duty to warn or client safety.
Key elements of risk
There is a valid risk of client safety being compromised when their life is threatened or is in a continuous cycle of domestic violence. A specific crisis situation would be a domestic violence survivor with their children, who needs temporary shelter and medical attention. Client safety might also be impaired if they are abusing drugs or partaking in risky behaviors. If they are using when services are provided, a plan should be in place to physically protect both the counselor and the client. The crisis worker needs to be calm and able to problem solve to make sure that the client’s safety is in place. The counselor needs to be prepared to deal with a client that may be immobile and may need to be brought back into a state of equilibrium. It is also risky if law enforcement or the legal system refuses to follow up on a domestic violence situation and refuses to help protect the client by not issuing or enforcing a restraining order. Physical safety should always be assessed immediately and if the intervention is occurring near the perpetrator special precautions should be taken.
Counselor safety can be very risky when working with a potentially violent client. Another possibility is when working with a client that is displaying psychotic symptoms. Despenser (2007) describes 4 sources of risk as, “Isolation setting, being alone with the perpetrator, being employed in a negative environment, and the counselor ignoring warning signs”(Despenser, 2007). It is crucial that a thorough assessment is done, and every necessary precaution is taken to protect both parties. It might be necessary to have the client hospitalized involuntarily if lethality is really extreme, and the counselor needs to be prepared to do so and be able to summon help if necessary. Another risk with counselor safety is when they work with clients who are abusing drugs. If they are currently intoxicated during the session, that can put the client and the counselor at risk. Proper boundaries should be set where the counselor refuses to counsel a client while they are intoxicated, and that protects the counselor and the client. Some people with substance abuse issues tend to behave in ways that are not normal behaviors and that can affect them when they are dealing with troubling issues in counseling.
One way to manage risks is to use safety plans when they are appropriate. Kness (2008) defines a safety plan as, “A detailed plan that highlights the woman’s role in making the safest decisions possible while in a violent relationship” (Kress et al., 2008, p. 207). Assessing potential harm for clients in an abusive relationship can be a tricky endeavor. James & Gilliland (2013) recommends the Battered Woman Scale because it helps measure traits that can be difficult to measure (James & Gilliland, 2013). Having appropriate safety measures in place can help maintain risk management. For example, keeping the parking lots lit at night, and always having 2 people close to the facility can help lessen the likelihood of an attack. Safety is in numbers is a famous saying that the learner has heard.
In conclusion, this assignment was very helpful for the learner to reflect on client and counselor safety. This is a topic that is very commonly overlooked, and it caused the learner to stop and reflect on the importance of safety. We cannot help clients if we do not protect them and us from harm. It is also important that we stay cognizant of state statutes regarding duty to warn, and keep clients aware of situations where we might have a duty to report. For example, if we see a client and they start to admit to child abuse in their home, then we must warn them that we are mandated reporters in our state. This week, the learner learned a lot and really appreciates the opportunity to tie in crisis and trauma work with mental health counseling. She hopes to take the knowledge she gleaned from this assignment and be able to apply it in the future…
Hyldahl, R., & Richardson, B. (2011). Key considerations for using no-harm contracts with clients who self-injure. Journal of Counseling & Development. Retrieved from Capella Library
Kress, V., Protivnak, J., & Sadlak, L. (2008). Counseling clients involved with violent intimate partners: The mental health counselors’ role in promoting client safety. Journal of Mental Health Counseling. Retrieved from Capella Library