034 – Safeguarding Computer Data – Margaret Warner and Fragile Process – Confidentiality in Counselling
In episode 34 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about how to store digital backups of notes and documents securely. ‘Theory with Rory’ looks into Margaret Warner's work on fragile process. Finally, the presenters discuss practical issues and tips regarding client confidentiality.
Safeguarding Computer Data (starts at 2.12 mins)
These days, we tend to store study notes electronically. But what happens when data gets lost, corrupted or inadvertently deleted?
Ken and Rory suggest using a cloud-based server (e.g. Google Docs or Dropbox) to store copies of documents remotely. Another option is to get a software program on your computer that backs up your documents online, for example CrashPlan.
With regard to client notes, an external hard drive that is password-protected may be a good solution for backing up data. It is important never to dispose of hard drives or any other data-storage devices without properly removing any confidential data.
Margaret Warner and Fragile Process (starts at 18.19 mins)
Rory explores the nature of fragile process, a concept developed by US psychotherapist Dr Margaret Warner, who used the person-centred approach in clients with active psychosis. It is sometimes thought that person-centred counselling is inappropriate to use with this client group, who experience different realities from other people.
Warner’s work seeks to de-categorise and de-pathologise psychotic conditions, and so highlights the contrast between the medical model (which asks: ‘What’s wrong with you?’) and the psychosocial model (which instead asks: ‘How did this happen?’). It is possible to work with psychosis using the person-centred approach, but only with lots of training and experience.
To understand a client’s fragile process, it is important to explore its cause. For example, Warner has worked with people who were sexually abused as children. Someone who has experienced sexual abuse in the first seven years of life may – through their inability to physically escape their abuser – have created a hiding place in their mind. For example, one young person might stare at the pattern on her wallpaper, and another might have an out-of-body experience, watching themselves from the ceiling, in order to cope with abuse. In this type of situation, the self-concept can ‘crack’ to form two or more personalities, leading to voice-hearing, an altered vision of reality, and odd bodily sensations.
Clients with fragile process may have difficulties in:
- holding onto their experience
- regulating the intensity of their experience
- naming what the experience is
- talking about the experience.
For therapists working with clients with fragile process, it is important to empathise with and give unconditional positive regard to both/all parts of the personality. Such clients often feel more comfortable to have control over the practical arrangements for counselling, for example to be able to choose a regular slot for therapy, for sessions always to start in the same way, and to choose and stick with the physical lay-out of furniture in the room. They may have difficulty in finding the words to describe their experiences, so therapists need to be patient and to allow time.
In time, the client may be able to integrate the disassociated parts of their personality, and become whole again: the organismic whole, as Carl Rogers called it.
Confidentiality in Counselling (starts at 23.55 mins)
Ken and Rory discuss some practical issues relating to client confidentiality, and give the following tips:
- When you contract with clients, talk about what you would do if you bumped into them when you were out and about in your everyday life – for example, you might suggest to a client that you will not acknowledge them unless they acknowledge you first.
- Explain to your partner that you will be unable to discuss your counselling work with them, so that they understand if they witness you being acknowledged by a client when you are out, and they don’t expect to be told who the person is and how you know them.
- Think about privacy in your counselling room. For example, if you open the window in warm weather, might the client’s material be overheard by people outside? If you have a regular window-cleaner, tell them not to come on days that you are in practice as a counsellor.
- Hope for the best and plan for the worst!