Failure of psychotherapy/counseling
One of the questions frequently asked of the psychotherapist by a family member is, “What in the world were you doing in therapy with my loved one? They are getting worse and not better.” Even more troubling is when the questions is directed at the therapist following the death of the loved one via suicide, drug overdose or accident fueled by alcohol or some other drug. One may have heard rumors or “intuitively knew” the client was withholding information or lying because he or she felt unable to deal with the consequence of revealing the truth. The truth might result in one committing someone to the psychiatric unit of the hospital, initiating the removal of a minor child from the home or some other action with profound long-term results.
The goal of the psychotherapist is to make it as safe as possible for the client or patient to be open with the truth so that he or she might receive some help. Yet, the client or patient knows there are times when the treating therapist must supersede the needs of the client to protect the life of the client, a child or another person. Occasionally the action one must take is very clear. If one has credible reason to believe that a child is being abused, might be abused or if one has a credible reason to think another person is about to be harmed one is legally required to report these facts to the responsible parties. This may result in a child being removed from the home or a client being ordered to stay away from his partner and children or the state assuming custody of the child. Once custody is turned over to the state it could take months or even years for the parent or parents to regain custody. The child might be placed in a home which is loving and safe or there are times when the child is placed in a home where the primary objective is to collect the relatively small amount of state money to care for the child. The child might be placed in a home where he and she is treated well and where the temporary parent, if possible, ensures the biological parent or parents have an opportunity to regularly spend time with the children.
The most typical case I, as a psychotherapist, encounter is one in which the safety of the child is questionable. One may know that the parent or parents love the child unconditionally and, yet, one also strongly suspects that the parent or parents may not be well enough to keep the child from danger.
If the child is removed from the home the parent may use more drugs or commit suicide. The care of the child they love may be the last thread to which the parent is holding on to. When that is gone the reason for living in gone. The parent from whom the child is removed may “go over the edge” and may become violent.
Although there are clear rules and laws, one often needs to enlist the collective wisdom of colleagues to come to the best possible decision; one which is likely to result in the least possible harm.
The easiest way to make a decision is to very dispassionately follow the letter of the law as one understands it. The situation is then very cut and dry. I would maintain that may result in a decision which is unethical or immoral. It is my contention that one’s duties to one’s fellow human being is to consider the intent of the law rather than the letter of the law. If the intent is to protect the long terms needs of all affected than one must consider what is the kindest, most loving and safest action possible to all involved. One cannot or should not make these decisions alone. One must consult with trusted colleagues, family members (if there healthy ones who are willing to be involved) and perhaps others who are close to the situation and genuinely care about all the parties.
My experience in life in general and not just in my professional role is that life and life decisions are often very messy. There are no simple or easy answers when dealing with human beings. If one is not struggling/agonizing a lot of the time, as a friend, neighbor, parent, or professional one is probably not serving oneself or the “village” as well as one could or needs to. One the other hand, if one is can only be okay if one makes the perfect or right decision one will be so stressed that one will not be a help to anyone. On must constantly attempt to balance these two.
Written September 12, 2020
Jimmy F Pickett
coachpickett.org
One of the questions frequently asked of the psychotherapist by a family member is, “What in the world were you doing in therapy with my loved one? They are getting worse and not better.” Even more troubling is when the questions is directed at the therapist following the death of the loved one via suicide, drug overdose or accident fueled by alcohol or some other drug. One may have heard rumors or “intuitively knew” the client was withholding information or lying because he or she felt unable to deal with the consequence of revealing the truth. The truth might result in one committing someone to the psychiatric unit of the hospital, initiating the removal of a minor child from the home or some other action with profound long-term results.
The goal of the psychotherapist is to make it as safe as possible for the client or patient to be open with the truth so that he or she might receive some help. Yet, the client or patient knows there are times when the treating therapist must supersede the needs of the client to protect the life of the client, a child or another person. Occasionally the action one must take is very clear. If one has credible reason to believe that a child is being abused, might be abused or if one has a credible reason to think another person is about to be harmed one is legally required to report these facts to the responsible parties. This may result in a child being removed from the home or a client being ordered to stay away from his partner and children or the state assuming custody of the child. Once custody is turned over to the state it could take months or even years for the parent or parents to regain custody. The child might be placed in a home which is loving and safe or there are times when the child is placed in a home where the primary objective is to collect the relatively small amount of state money to care for the child. The child might be placed in a home where he and she is treated well and where the temporary parent, if possible, ensures the biological parent or parents have an opportunity to regularly spend time with the children.
The most typical case I, as a psychotherapist, encounter is one in which the safety of the child is questionable. One may know that the parent or parents love the child unconditionally and, yet, one also strongly suspects that the parent or parents may not be well enough to keep the child from danger.
If the child is removed from the home the parent may use more drugs or commit suicide. The care of the child they love may be the last thread to which the parent is holding on to. When that is gone the reason for living in gone. The parent from whom the child is removed may “go over the edge” and may become violent.
Although there are clear rules and laws, one often needs to enlist the collective wisdom of colleagues to come to the best possible decision; one which is likely to result in the least possible harm.
The easiest way to make a decision is to very dispassionately follow the letter of the law as one understands it. The situation is then very cut and dry. I would maintain that may result in a decision which is unethical or immoral. It is my contention that one’s duties to one’s fellow human being is to consider the intent of the law rather than the letter of the law. If the intent is to protect the long terms needs of all affected than one must consider what is the kindest, most loving and safest action possible to all involved. One cannot or should not make these decisions alone. One must consult with trusted colleagues, family members (if there healthy ones who are willing to be involved) and perhaps others who are close to the situation and genuinely care about all the parties.
My experience in life in general and not just in my professional role is that life and life decisions are often very messy. There are no simple or easy answers when dealing with human beings. If one is not struggling/agonizing a lot of the time, as a friend, neighbor, parent, or professional one is probably not serving oneself or the “village” as well as one could or needs to. One the other hand, if one is can only be okay if one makes the perfect or right decision one will be so stressed that one will not be a help to anyone. On must constantly attempt to balance these two.
Written September 12, 2020
Jimmy F Pickett
coachpickett.org
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