292 – Working with Self-Harm in Therapy

292 – Working with Self-Harm in Therapy

Ethical Framework in Supervision – Do’s and Don’ts of Logging Client Hours

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In Episode 292 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly are back with this week’s three topics:

  • Firstly in ‘Ethical, Sustainable Practice’, we look at the ethical framework in supervision.
  • Then in ‘Practice Matters’ Rory speaks with Kate Day about working with clients who self-harm in therapy.
  • And lastly in ‘Student Services’, we look at the dos and don’ts of logging your client hours.

Ethical Framework in Supervision [starts at 02:48 mins]

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When in supervision, the ethical framework is something that should come up regularly in relation to your topics of discussion. In this section, Rory and Ken highlight some of the reasons this can be so important:

  • Revisiting your ethical framework will help make sure you understand your obligations.
  • It can offer guidance in complex situations.
  • It might not always be about a client, you can consult your ethical framework in relation to a professional challenge in an organisation.
  • You might speak about protecting a client’s data.
  • It can allow you to make defensible decisions.
  • Protects your practice.
  • Fosters trust in the profession through ethical and successful counselling.
  • Supports client welfare.
  • Might help prevent potential instances before they come because you're aware of the ethical framework.
  • Helps with your own professional development.
  • If your supervisor doesn’t bring it in, you can.
  • Consider how does what you're bringing to supervision link to, or impact on, the ethical framework?
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Working with Self-Harm in Therapy [starts at 22:46 mins]

In this week’s ‘Practice Matters’, Rory speaks with Kate Day about working with clients who self-harm.

The key points of this discussion include:

  • There can be many reasons why people might self-harm: self-punishment in response to self-loathing or anger, to gain a sense of control or self-regulation, to express their distress, dissociate or relieve unbearable tension.
  • Those who are neurodivergent are particularly vulnerable.
  • The experience and meaning of self-harm can differ greatly from person to person.
  • When working with self-harm in therapy, think about what is going on underneath the behaviour – what is driving the harm?
  • There are many different ways to self-harm, and it’s not always physical.
  • Psychological-based self-harm - repeating harmful behaviours and patterns as a form of self-sabotage.
  • Allow the client space and time to openly talk about their self-harm with a skilled and empathic practitioner.
  • Remain non-judgemental.
  • Facilitate change by working with and supporting the client, not by trying to ‘fix’ them.
  • Practice coping strategies, see what works for them as an individual.
  • When working with self-harm in therapy, find the underlying feelings.
  • Listen to the client, pick up on non-verbal cues.
  • Offer reassurance that their thoughts and anxieties are going to be taken seriously.
  • If you feel there is a need to break confidentiality, be open and honest with the client, try to get their consent and help them to understand.
  • The wound somebody may or may not have, doesn’t necessarily show the severity of how distressed a person is feeling inside.

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Do’s and Don’ts of Logging Client Hours [start at 44:57 mins]

When in placement to become a qualified counsellor, don’t let logging your hours incorrectly hold you back. In this section, Rory and Ken take us through some of the dos and don’ts of logging your client hours:

  • Make sure you are logging your hours on the correct form, in the correct format.
  • Find out how many hours you need.
  • Make sure you are doing full counselling hours, not 20 or 30 minute sessions.
  • Every hour has to be supervised – this also needs to be logged on your form.
  • Look at your ethical body and your course requirements. What exactly do they need from you?
  • Make sure your log is clear.
  • Check requirements regarding if you have to have the same supervisor all the way through.
  • Clarify anything you are unsure of – ask questions, look at guidelines, etc.
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Discussing Ethical Frameworks in Clinical Supervision

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