There were only six of us for this session which made for a surprisingly intimate group. We started off talking about the diploma, the heavier workload and the need for a work placement. There is some confusion over this as our tutor talked about finding one as soon as possible but the course handbook for the diploma says wait until you’ve been validated as being safe enough to be let loose on real people. A nice question for the interview. The assignments however are only slightly longer rather than double in length which is what I had understood so going up from 2,500 words to 3,500. There is a research project for the second year with no great details. The interview is booked for next month. All three of us who have applied for the person-centred diploma have interviews and on the same day so that will be a comfort. There is a group element to the interview. Last time it was have a group discussion and then write it up which I think was more to test whether you could write unaided, with just pen and paper and whether you could reflect upon a conversation while under pressure. The individual interview will no doubt discuss the course workload, whether we’ve considered it and how will we deal with the added pressure. That part does not worry me as I think I’ve thought about it sufficiently. I will miss those of us who are choosing the other pathway or who are not continuing. It will be interesting to see if we do keep in contact to any great extent after the course finishes. We have only three more sessions and are continuing to wind down and to feel as if that is what we are doing.
We then changed the tone completely and start talking about risk assessment and what to do when your client talks seriously about harm and self-harm. In light of the fact that we are to be let loose on real clients next year this is very appropriate.
We discussed the need for the agency for whom we work to have suitable risk policies and plans in place and that we should be suitably informed about them before starting work so that we make sure we are following the appropriate guidelines. There is a certain dry and practical element to this discussion.
There is however a conflict, or can be, between the legal duty and your own moral imperative which needs greater research.
We start off a session talking about breaking confidentiality with a phrase that now glides off the tongue saying something to the effect of “if I think you are at risk of harm to yourself or others I may have to talk to someone else for additional support. If that is the case I will try and discuss it with you first”. But what does that actually mean in practice?
Firstly, it means if a client talk about harm, to stop all other talk and focus on that. Is it “just” talk or is there a plan, a means, a vision. If it is meant then you need to take it further, talk to a colleague, get someone to phone whoever is appropriate. This may be the police or the GP depending on who the client is threatening to harm. You may need to call for an ambulance. This should all be done under the agency’s policy rather than you as a counsellor having to make your own decision, especially if it’s a work placement.
It’s not that easy though. Being able to work out whether a client means a threat depends on how well you know them, how long you’ve known them. You have to balance breaking confidentiality with saving someone from harm. What is your legal responsibility? I’m not quite sure. Professional responsibility suggests you should consider your own limitations. “There is no general duty to rescue in British law.” The Ethical Framework is unclear. Ultimately there was talk of note taking and making sure to refer it onwards/upwards to protect yourself. What happens if a relative of a client sues you for not stopping their suicide? Can you show that you took reasonable precautions.
I of course brought up assisted suicide. What happens if your client is making a well thought out decision to take their own life rather than go through a period of terminal medical decline. Do you have to take action? There were no clear answers to any of this, other than the need to be able to square your conscience with the law. Uncomfortable.