331 – Ethical Dilemmas in Supervision
Working with Life-restricting Conditions – Challenging Stereotypes in Counselling
In Episode 331 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly take us through this week’s three topics:
- Firstly, in ‘Ethical, Sustainable Practice’, we explore ethical dilemmas in supervision and discuss strategies for resolving them effectively.
- Then, in ‘Practice Matters’, Rory speaks with Dorothy Hodgkinson about working with clients who have ‘life-restricting’ conditions and how these conditions impact the therapeutic relationship.
- And lastly, in ‘Student Services’, Rory and Ken discuss the importance of challenging stereotypes in counselling training, offering insights into how counsellors can avoid stereotyping clients in their practice.
Ethical Dilemmas in Supervision [starts at 02:52 mins]
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In this section, Rory and Ken dive into ethical dilemmas in supervision, an important topic for all counsellors and psychotherapists.
Key points for this section include:
- The Ethical Framework: Ethics are at the heart of counselling practice, guiding every interaction with clients. It’s important to consistently refer back to the ethical framework, especially when faced with dilemmas.
- Supervision and Ethics: Supervisors play a critical role in helping supervisees navigate ethical issues that arise in their practice. Regular discussion around ethical frameworks ensures that therapists stay aware of their ethical obligations.
- The Ethical Problem-Solving Matrix: Professor Timothy Bond’s ethical problem-solving matrix is a tool mentioned in the BACP Code of Ethics. It helps therapists systematically analyse ethical dilemmas by posing important questions, ensuring that decisions are defensible.
- Ethical Challenges: Common ethical dilemmas include questions about harm to self or others, dual relationships, confidentiality, and the complexities of working with vulnerable clients.
Key Practice Tip: When faced with an ethical dilemma, always write down the dilemma clearly and consider whose dilemma it is—whether it belongs to the client, the counsellor, or both. By doing so, you can more effectively determine the best course of action using the ethical problem-solving matrix.
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Working with Life-restricting Conditions [starts at 23:28 mins]
In ‘Practice Matters’, Rory interviews Dorothy Hodgkinson about working with clients who have life-restricting conditions. This topic focuses on the therapeutic relationship and the impact of physical and mental health conditions that limit a client's life.
The main points of this conversation include:
- Life-Restricting Conditions and Therapy: Clients with conditions such as chronic fatigue, incontinence, and other debilitating issues often face the challenge of being overlooked in therapy due to the invisibility of their conditions.
- Client Flexibility: Therapists need to be flexible with their session formats, as clients with life-restricting conditions may have irregular energy levels and fluctuating abilities to attend regular sessions.
- Addressing the Hidden Challenges: Often, clients with life-restricting conditions feel invisible or unable to fully engage in therapy because their needs are not recognised by the therapist. Counsellors need to create a safe space where clients feel heard and understood.
Key Practice Tip: In sessions, practitioners should be willing to adjust the session structure—whether that means allowing breaks, reducing session time, or allowing alternative communication methods like writing or drawing. These adjustments ensure that clients with life-restricting conditions still receive the therapy they need.
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Challenging Stereotypes in Counselling [starts at 47:37 mins]
In ‘Student Services’, Rory and Ken discuss challenging stereotypes in counselling training. They explore how stereotypes can form and limit both the therapist’s understanding of their clients and their therapeutic practice.
The key points include:
- Stereotypes in Counselling: It's natural for humans to categorise and stereotype others based on certain characteristics (e.g. gender, culture, or profession), but these assumptions can lead to misunderstandings and hinder effective therapy.
- Challenging Our Assumptions: Rory shares a personal story about a training exercise where he and his peer were asked to challenge their initial assumptions about each other. This exercise revealed the harm stereotypes can do in relationships, both personal and professional.
- Non-Judgemental Stance: Counsellors must consciously avoid reducing clients to a set of stereotypical attributes, seeing them as multifaceted individuals instead of applying labels or assumptions.
Key Practice Tip: Therapists should recognise and challenge their own biases and stereotypes. A useful practice is to engage with clients with curiosity and openness, acknowledging that they are not defined by a single characteristic.
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Ethical Problem-Solving