41. 咨询师培训及监督的必要性
本章知识点阐述
41 Counsellor training and the need for supervision In order to qualify as a professional counsellor, a person needs to complete an accredited course of study and training; have ongoing supervision, and meet the requirements of the relevant counselling professional body in their country of residence. In Australia there are two professional bodies. Membership of either of these can lead to national registration as a counsellor. The two bodies are the Psychotherapy and Counselling Federation of Australia (PACFA) and the Australian Counsellors Association (ACA). We believe that it is not sufficient for counsellors just to complete an academic training course. Additionally, it is desirable that training should include either personal therapy or experiential groupwork, and also attendance at professional development workshops. Both during and subsequent to training all counsellors need to undergo ongoing supervision so that they can debrief, discuss their work, improve their skills and address personal issues that might be triggered as a consequence of counselling others. When m supervision counsellors often find themselves in a position similar to that of a person seeking counselling help, as they seek to resolve their own personal issues which may have been triggered by the work they are doing, or have done, as a counsellor. Counsellors are required to maintain their current accreditation by undergoing professional development activities to demonstrate a commitment to ongoing training and development. Most importantly they are required to practise in accordance with the relevant code of ethics for counsellors in their state or country of residence. WHY IS SUPERVISION NEEDED? As counsellor’s we must value the people who seek our help so that we offer them the best possible counselling service. It is therefore not ethical for a person seeking help to be seen by a new counsellor unless that counsellor is being adequately supervised. Additionally, our belief is that all counsellors, new and experienced, should have ongoing supervision. There are several important and quite different reasons for this, including the following: • to enable the counsellor to work through their own personal issues • to enable the counsellor to upgrade their skills • to provide an external review of the counselling process • to address issues concerning dependency and professional boundaries. We will now consider each of the above.
TO ENABLE THE COUNSELLOR TO WORK THROUGH PERSONAL ISSUES You may be surprised at the suggestion that supervision is required to enable a counsellor to work through their own personal issues. You may be asking, 'If counselling is for the benefit of the person seeking help and not the counsellor, why should the counsellor use counselling supervision in order to deal with their own issues?’ The answer is simple: unless a counsellor owns and deals with their own issues, these issues are quite likely to interfere with their ability to counsel effectively. Frequently, a counsellor will feel emotional pain when a person seeking help discusses issues similar to the counsellor’s own unresolved emotional issues. Consequently, when issues are discussed that are painful for the counsellor as a result of unresolved issues, the counsellor may consciously or unconsciously avoid their own pain in a number of ways during the counselling session: • The counsellor might deflect away from the painful issue by encouraging the person to talk about something else. • The counsellor might try to comfort the person rather than help them deal with the issue. • l ire counsellor might attempt to encourage the person to pursue a course of action that in some way satisfies the counsellor's own needs, bhe counsellor may wish, for example, that they had taken a particular course of action in their own life and may encourage the person to take a similar course. • bhe counsellor may avoid facing both their own issue and the person’s by failing to recognise the issues and subconsciously suppressing them. A perceptive supervisor will spot counsellor behaviour that demonstrates avoidance of painful issues and will ask the supervisee to explore whatever was happening emotionally within them when the avoidance occurred. 1 his means that counsellors need to be prepared to own and explore their own issues on an ongoing basis, otherwise these issues are likely to diminish the effectiveness of counselling. Most people don’t look closely at their own emotional problems unless they are causing them considerable distress. It is a natural human defence to suppress uncomfortable feelings and not to delve into them without good reason. However, a counsellor must delve into uncomfortable feelings, because if they have a problem that they can t face, then it will be quite impossible for them to help a person with a similar problem. As counsellors, therefore, we need to explore and deal with all of our own painful issues as they come into our awareness, bhe spin-off for us is that our personal growth is enhanced when we do this.
Effective counsellors explore and resolve their own personal issues
TO ENABLE THE COUNSELLOR TO UPGRADE THEIR SKILLS Everi experienced counsellors find it useful and valuable to learn from other counsellors. We all have a different range of skills and use differing styles when counselling. During our counselling careers we have both discovered that our own counselling styles have continued to change. This has enabled us to integrate new skills into our work and to continue to take a fresh approach to counselling, rather than sink into a rut and become stale.
Effective counsellors never stop learning
We find that it is sometimes useful for us to receive input from counsellors who use different frameworks from ours. By doing this we usually find that we learn some new ideas for enhancing our work.
Although didactic learning can be useful for counsellors, it seems to us that the experience of personal supervision is more powerful in promoting professional development. Learning through supervision can integrate skill training with personal growth. Additionally, the counsellor is reminded in supervision of what it is like to be in the position of a person seeking help. This can be helpful in enabling a counsellor to continually meet with each person seeking help as a person of equal value. TO PROVIDE AN EXTERNAL REVIEW OF THE COUNSELLING PROCESS Often a person seeking help will not see what seems obvious to the counsellor, This is because the person is personally and deeply involved in their situation. In comparison, the counsellor, after joining with them and trying to see the world in the way they do, can stand back to take a more objective view and see more clearly. A parallel process happens when a counsellor is being supervised. The supervisor is able to view the counselling process and the case details in a different way from the counsellor. I he supervisor may recognise processes that are occurring for the person seeking help or the counsellor that have been unrecognised. Therefore, a supervisor is able to provide useful input on ways of working with particular people who are seeking help. Additionally, helpful supervisors have the benefit of experience, which can be a source of useful information for the supervisee.
TO ADDRESS ISSUES CONCERNING DEPENDENCY AND PROFESSIONAL BOUNDARIES As discussed in the previous paragraph, a supervisor may recognise processes that have not been recognised by the counsellor. Of specific importance are issues of dependency and respect for professional boundaries.
Both people seeking help and counsellors experience dependency issues
It can sometimes be hard for new Counsellors to recognise when the time for terminating a series of counselling sessions has been reached. I his may be partly due to issues of dependence that inevitably will develop in some counselling relationships (see Chapter 12). Sometimes it is hard for a counsellor to recognise whether the person seeking help really does have a need for further counselling or whether dependency is occurring on the part of the person or the counsellor themselves. People who become dependent on the counselling relationship sometimes produce new material for discussion when the counselling process is moving towards closure. This may be as a consequence of a subconscious or conscious desire to prolong the relationship. By discussing cases in supervision, a supervisor may be able to recognise when dependency is interfering with appropriate termination processes. Additionally, a supervisor may be able to help a counsellor devise suitable strategies for managing dependency issues. Some counsellors have difficulty in recognising when their own personal feelings towards a person seeking help could result in behaviours that would inappropriately transgress professional boundaries, and consequently interfere with the counselling process. Additionally, new counsellors sometimes have difficulty in knowing how to respond to direct or indirect invitations for friendship and closeness from people seeking their help. Once again, supervision can help a counsellor to recognise inappropriate processes that are occurring and to develop appropriate strategies to deal with these processes. WHAT DOES SUPERVISION INVOLVE? There are a number of ways in which supervision can occur: 1 by direct observation with the supervisor in the counselling room 2 by direct observation through a one-way mirror 3 by obseivation using a closed-circuit TV 4 by use of audio or DVD recording and analysis 5 by direct obseivation together with audio- or DVD-recording and analysis 6 by use of a verbatim report. These methods will be discussed in turn. DIRECT OBSERVATION WITH THE SUPERVISOR IN THE COUNSELLING ROOM Trainee counsellors are usually apprehensive during their first few counselling sessions. A good way to help them adjust to the counselling environment is for trainees to sit in on counselling sessions conducted by their supervisors. Naturally, the permission of the person seeking help is required. Student counsellors who are allowed to do this need to understand what their supervisor expects of them. We prefer our students to take a low profile and to sit quietly out of the line of vision of the person seeking help. This reduces the likelihood of the person feeling the need to interact with both the counsellor and the student simultaneously, leaves us free to conduct the session in the way that we choose, and enables the trainee to observe without feeling pressured to participate. As the trainee's level of comfort increases, some participation by them can occur. Adopting this approach allows them to directly observe the counselling process, and to feel at ease while being in a situation where counselling is occurring. The method allows the trainee to gradually make the transition from being a passive observer to being an active counsellor under supervision. The process just described is excellent for beginners who have had no previous counselling experience, but there can be problems connected with having both the trainee and the Supervisor in the room together. Obviously* some of the intimacy of the counselling relationship is lost, and as a consequence the person seeking help may find it difficult to deal openly with sensitive issues.
DIRECT OBSERVATION THROUGH A ONE-WAY MIRROR I he one-way mirror system as shown in Figure 41.1 provides an alternative to direct Observation^ Many counselling centres have a pair of adjacent rooms set up like this for training purposes and for family therapy. The one-way mirror allows a person in the observation room to watch what is happening in the counselling room without being seen. A microphone, an amplifier and a speaker system provide sound for the observer, so that they are able to see and hear what is happening. Ethically, it is imperative that a person seeking help who is being observed from behind a one-way mirror should be informed in advance about the presence of the observer or Observers, and that consent is obtained for the session to proceed in this way. I he one-way mirror system can initially be used to enable a trainee or trainees to watch an experienced counsellor at work. Later, the trainee can work as a counsellor while being observed by their supervisor and possibly by other trainees also. I he system has the advantage that the supervisor is not present in the counselling room and therefore does not intrude on the counselling process. However, they are available to take over from the trainee if that becomes necessary, and they can give objective feedback after the session is completed. OBSERVATION USING A CLOSED-CIRCUIT TV A similar method to the one-way mirror system is to have a camera in the counselling room connected to a TV monitor in another room. However, this method doesn’t provide as much visual detail as is obtained with the one-way mirror system. It is often difficult to see facial expressions if the camera has a wide-angle lens to enable most of the room to be in the picture.
Figure 41.1 Counselling and observation rooms PERSON SEEKING HELP COUNSELLOR INTERCOM PHONE X CEILING MICROPHONE COUNSELLING ROOM VIDEO CAMERA ONE WAY MIRROR BENCH AT DESK HEIGHT INTERCOM PHONE
AMPLIFIER SUPERVISOR . 1 SPEAKER VIDEO RECORDER OTHER TRAINEES / OBSERVATION ROOM MONITOR
USE OF AUDIO- OR DVD-RECORDING AND ANALYSIS One of the best methods of supervision is by use of DVD recordings. Audio recordings can also be used, although their usefulness is more limited because non-verbal behaviour cannot be observed. DVD recordings of counselling sessions are a rich source of information. Not only may selected segments of a session be viewed repeatedly, but it is also possible to freeze the picture so that non-verbals may be studied. The supervisor and the counsellor can then review and analyse parts of the recordings. Often it can be useful for the counsellor to review additional recordings on their own in order to recognise unsatisfactory processes and to improve their counselling techniques. Whenever an audio or DVD recording is to be made, it is essential to obtain the prior written consent of the person seeking help, and to tell them who will have access to the recording and when it is to be erased. Many agencies have standard consent forms for this purpose. It is sensible to have such forms checked for their legal and ethical validity.
DIRECT OBSERVATION TOGETHER WITH AUDIO- OR DVD- RECORDING AND ANALYSIS
A combination of a one-way mirror system together with audio- or DVD-recording is a very powerful arrangement for counsellor training. Trainees can be directly observed during practice sessions, and may later process their work in detail with their supervisors by analysing and reviewing the audio or DVD recordings.
DVD recordings can be a valuable learning tool
USE OF A VERBATIM REPORT Another method of supervision is by use of the verbatim report. A verbatim report is a written report that records, word for word, the statements made by the person seeking help and the counsellor’s responses, it may be produced from memory, or as a transcript of an audio recording. Here is an example of a verbatim report. Note that this example is invented and does not relate to a real person or counsellor. VERBATIM REPORT Name of counsellor: Fiona Smith Name of person seeking help: Simon Anonymous Date of counselling session: 19.01.11 Background information about the person: Simon is 36 years old, has been married twice and has two children: a girl 12, and a boy, 10. Both children are Living with Simon's second wife. He lives alone.
This was Simon's second visit to see me. He came a week ago feeling tense and depressed. He told me that he was worried about his inability to build lasting relationships with women, and he couldn't understand why. My feelings and attitudes prior to the session: I was feeling good and was looking forward to working with Simon again. I believed that I had built a good relationship with him during the previous session and that this would enable him to talk freely with me. l/l/hat occurred prior to the responses given below: When Simon arrived for this session he looked pale and was very subdued. During the first 15 minutes of our time together his body looked tense and he seemed reluctant to talk. After a few minutes of silence, I felt as though he had put a barrier between us and I spoke. Fl Seems like there's a barrier between us. [Said quietly] 51 Ah what... what da ya mean? [/ thought he sounded defensive] F2 Like we're separated by a barrier. [I used my hands to suggest a barrier] 52 Separated? [Said with non-verbals that suggested disbelief and questioning. I felt very shut out from Simon now] F3 Yes, I feel shut out by an invisible barrier. Sometimes you open it up a ... [Simon interrupted heatedly] 53 No, no, it's a double brick wall with a door in it. The door is usually closed and that's because it keeps me safe. F4 That brick wall's important to you! 54 It sure is! F5 It protects you. [Simon started to talk freely and easily after this] 55 Yes, it does ... [He went on to explain how vulnerable he would feel without the waif and then started to cry. I waited] ... You see, I've been hurt too much in the past, and !m scared that if !m me, if I'm really me, and open up, then I'll be rejected again. F6 The barrier protects you from the pain of rejection. [Long pause] 56 It also prevents me from getting into a relationship and I'm not sure that I like that. [Said carefully, slowly and firmly] F7 You don't sound sure about whether you want the barrier or not. 57 Well, it would be hard to tear it down. I'm so used to it now. You know, I realise that the barrier's been there for a long time now. Goodness knows what might happen if I didn't have it there. F8 It would be risky to tear it down. 58 It would. [He paused to think for what seemed a long time. I had difficulty staying silent because I wanted to tell him what he was discovering for himself] ... You know, I would get hurt for sure, and what's worse, I'd have to take responsibility for the ways I hurt the women I get close to. [He laughed] That's worse. That's worse! I can't bear it when I hurt someone I love. F9 Getting close involves lots of hurt. [He interrupted, fortunately, before I was able to take him off track by suggesting getting close could also involve pleasure. I was bursting to tell him!] S9 Yes, it seems like that to me ... [He then told me in detail about his pain at losing his wife. He couldn't understand how he hurt so much when he had left her] ... It's not over yet. How can I still be hurting after so long? F10 I get the impression that you're still grieving. S10 I should be over her by now! [Sa/d despairingly] Fll It takes time to grieve. Can you give yourself time? (From here on the process flowed naturally as he dealt with his grief ! got the strong feeling that his barrier would gradually disintegrate as he worked through his grief.) My feelings after the session felt good because Simon had moved forward to a fuller awareness of himself and his behaviour. Additionally, I realised that I had been infected by some of his sadness. What I have learnt from the session (or things I would do differently another time) I Learnt that it was helpful for Simon when I shared with him my own feelings (of separation, see Fl, F2 and F3). Because he interrupted (F9 and $©), I discovered that it was better to follow his path. If I had brought the focus onto the pleasure associated with closeness, then I would have made it more difficult for him to address the underlying issue of his grief. I learnt that my desire 'to make him feel good' could have been counterproductive.. I'm pleased he interrupted and prevented me from doing this. Structure of the verbatim report As you will see from the example of a verbatim report, the report begins with background information about the person seeking help, their problems and their emotional state. The first part of the report may also summarise the process and outcome of previous counselling sessions. 1 he next section of the report concerns the counsellor s own feelings and attitudes prior to the counselling session. This information is required because a counsellor’s behaviour and performance are often influenced by their mood, feelings generally, and feelings towards the person seeking help, and their preconceived ideas and attitudes concerning them and their behaviour. A central component of the verbatim report is the section containing statements made by the person seeking help and the counsellor responses. This section usually contains only about 10 to 20 responses from each person. It would be very laborious to write out a transcript of a substantial part of a counselling interaction and this is unnecessary. Preferably the trainee counsellor will select a portion of the session that demonstrates some important learning or highlights some difficulties. Often a new counsellor will find that a part of the interaction seems to ‘go wrong’ inexplicably. Such a segment provides ideal material for a verbatim report and subsequent discussion in supervision. Notice that responses are numbered and identified by the initial letter of the person’s name, for example, statement F7 is Fiona’s seventh in the report. After each statement other significant information is recorded, in parentheses, including non-verbal behaviour, silences and the feelings and thoughts of the counsellor. Immediately before the verbatim record of the conversation is a description of what occurred in the earlier part of the session, and immediately after the record of rhe conversation is a brief description of what occurred in the remaining part of the session. These descriptions are required so that the statements that are recorded verbatim are seen in the context of the whole session. The verbatim report concludes with sections that describe the counsellor’s feelings after the session and what they have learnt for the future. It is then signed. The value of verbatim reports Verbatim reports enable a supervisor to tap into trainee issues that might have blocked them from satisfactorily helping a person to work through their issues. Such reports also enable the supervisor to identify unsatisfactory processes and inappropriate counsellor responses, and to help the trainee discover better ones. CONFIDENTIALITY Audio recordings, DVD recordings and verbatim reports require the same level of protection as other records concerning people seeking help, in order to ensure that confidentiality is preserved (see Chapter 40). It is essential that electronic records of counselling conversations and reports are not left in places where they might fall into the hands of unauthorised persons. IN CONCLUSION By using any of the methods described in this chapter, a supervisor can help a new counsellor to improve their skills and to understand the process that occurred during a particular counselling session. This chapter has discussed ways in which you may be supervised as a new counsellor. Your initial training is just the beginning, and there is no end to the ongoing need for further training. A good counsellor never stops learning from their own experiences and from what others can teach them. In order to improve, it is essential to continue in supervision even as an experienced counsellor.
Ongoing supervision is the key to good counselling
The counselling strategies described in this book are the basic ones. Once you have mastered them, you may wish to continue to learn from experienced counsellors who have advanced skills or who are skilled in specialised counselling techniques. We believe that ongoing training can best be carried out through experiential training in workshops and seminars, together with hands-on experience under the supervision of a qualified and experienced practitioner.
Learning summary Counsellors need to complete an accredited course of study and training, have ongoing supervision and meet the requirements of the relevant counselling body in their state or country (PACFA or ACA in Australia). Counsellors are bound by a code of ethics determined by the relevant professional body. It is essential for new counsellors to have adequate supervision. A counsellor's own unresolved issues may adversely affect the counselling process. Common supervision methods involve direct observation, observation using a closed-circuit TV, audio- or DVD-recording and analysis, and use of verbatim reports. Further reading Bor. K. & Watts, M. 2010, The Trainee Handbook: A Guide for Counselling & Psychotherapy Trainees* 3rd edn, SAGE, London. Cotey, G., Corey, M.S., Corey, C. & Callman, P. 2015, and Ethics in the Helping Professions, 9th edn, C'engage Learning, Stamford, CT. McMahon, M. & Patton, W. (eds) 2002, Supervision in the Helping Professions: A Practical Approach, Pearson Education, Frenchs Forest, Australia. Walker, M. & Jacobs, M. 2004, Supervision: Questions and Ansivers for (Counsellors and Therapists, Whurr, London.