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My apologies – I seem to have already found myself falling behind …
Question 1:
It was ‘gut-wrenching’ to watch that video about Anna Jenning’s, learning of her suicide, and knowing that it probably could have been prevented if somebody had just taken the time to listen to her story and help her heal from that. Her symptoms were adaptations to her distress and in my opinion completely misread; had they not been she would have received the assistance she needed. Symptoms are merely indications of an illness; they are not the illness itself – in order to alleviate the symptoms, you must treat the illness or disease itself. Why does that seem like such a simple concept but yet is so difficult for some, even to this day, to understand?Question 2:
I whole-heartedly agree with the shift in behavioral health treatment from, essentially “what’s wrong with you,” to “how can I help you.” I work with many individuals who have suffered from trauma, whether it be mental, physical, sexual, during childhood and/or adulthood and I am surprised (while not surprised at the same time) to see the expressions on their faces when I ask them if they would like to share their story with me because I genuinely want to hear it. I could relate to an example given by a fellow classmate about an individual who was diagnosed with ADHD, when they were really attempting to cope with their traumas … unfortunately, I still see that so many times where people are “labeled” based upon the symptoms as opposed to their story. I am not sure if this situation is a completely accurate example for this question but just the other day I was so deeply disheartened when talking with a psychiatrist with whom I share a person. The individual who has a severe childhood sexual abuse trauma, has begun engaging in self-harm and verbalizing potential suicidal ideation. When discussing this with the psychiatrist, they express doubt, and actually stated, “well, I have been working with this person for 10 years and they ain’t done it yet.”Question 3:
I would like to think that in my private practice, I demonstrate and communicate to folks that they can feel and are safe in my office both physically and psychologically. My office and waiting room are furnished in much the same way my home living room might be, with fidget toys and stuffed animals, and other decorations to make it feel warm and inviting. I also have posters and small things around the room with empowering statements on them and I consistently find something positive to say about them each week when they visit me (two if they present as having a bad day). I refer to them by their name at all times, even on documentation, they are not a ‘client,’ they are a person with a name, and I am sure to ask their pronouns so I can address them properly. I attempt to instill in all my folks that we are partners in their recovery, that I will work just as hard as they are willing and able to.As for how I may improve in my private practice to be more trauma informed – continuing to educate myself is perhaps the biggest thing, as that will keep me informed of and remind me of best practices. I could improve upon my collaborative efforts with others, including peer support programs in the area, and it is getting near time to review my policies and procedures to ensure they continue to reflect appropriate language that is in align with trauma-informed care.
Hey everybody!
I am an LCSW in private practice in Bangor, Maine although thanks to telehealth, I provide services to clients throughout the state. I too have completed prior trainings on being trauma-informed, work with many clients with PTSD as their primary diagnosis and those who have trauma histories, and as such, want to continue learning as much as I can about trauma and staying trauma-informed. I guess my hopes for this course are to perhaps refresh and renew my knowledge and remind myself of tools and techniques (and potentially learn new ones) I should be implementing in my practice with clients.Question 1: What is it like for you to know that you have taken or might take on the duty and responsibility of vicarious liability as a clinical supervisor?
Honestly, the idea that I am accepting responsibility for the actions and inactions of others that I supervise is scary. I attempt to hold myself to a relatively high standard when it comes to ethics (thanks to an amazing supervisor I had in the past who also prided herself on ethics) and while I may advise a supervisee to take certain action, there is no guarantee at the end of the day they are going to follow said advice (i.e., inaction); that is kind of a scary thought.
Question 2: Describe 3 strategies you have already employed or have thought about employing to manage this sense of responsibility so it doesn’t impact your clinical and supervisory work negatively and/or does impact your work in a positive way?
(1) “document, document, document” – this was a mantra instilled in me during my school years! As noted above, while I may advise a supervisee to take certain action, they may decide otherwise and that is where, I feel, documentation is key in that if something should transpire as a result of their inappropriate actions or inaction, I have documentation of what I recommended. (2) “supervision of the supervision” – this was something mentioned in the lesson materials. While I perhaps do not do this as consistently as I should, I have on several occasions sought the opinions of others RE: recommendations I have made or am thinking of making. (3) I honestly cannot think of a third strategy that I employ to manage this ‘sense of responsibility’ aside from maybe ensuring I engage in appropriate self-care?
Question 3: How does your agency support/not support you to manage the legal and ethical responsibility of vicarious liability and how can you advocate for more support if it is lacking?
I am actually in private practice and currently sub-contract with an agency to provide supervision to their case managers. As a sub-contractor, there is little to no support from the agency as far as managing legal and/or ethical responsibilities of vicarious liability, which is another reason why I emphasize documentation …. as well as possessing liability insurance coverage! ????
My name is Nichole Gulowsen and I am an LCSW, CADC, CCS in private practice in Bangor, Maine, working with adults, and while I accept co-occurring clients, it seems as I have been working primarily with anxiety disorders, PTSD, and depression of late. I too would be interested in a conversation about working with adolescents as that is an area I have ‘avoided’ due to concerns about the ethical issues that may arise (divorcing / disagreeing parents, etc.). I am also interested in discussing further psychotherapy vs. sound clinical supervision and if possible, case manager development, in that I provide clinical supervision to a handful of Section 17 Case Managers.
