Is It Safe?

Is It Safe?

Marital or couple counseling is an intimate experience that by design enables couples to disclose and address issues held secret. Those issues held secret may be from each other or from outsiders – including therapists.

Once the word is out there though, the next issue is how each person will react. Even the mere anticipation of secrets unfolding can give rise to conce
for inappropriate and even dangerous reactions.

For instance; a person learning of an affair may seek to bring harm to the paramour; a violent individual may seek to hurt their partner for disclosing of the untoward behavior; an individual may never disclose an issue with conce
for reprisal in any manner; someone who abuses drugs or alcohol may seek to attend intoxicated to mange the stress of attendance; persons severely depressed may get more distraught and may seek to harm themselves.

In order to keep people safe, the reaction to disclosure or anticipated disclosure of personal information must be anticipated. The only way to anticipate potential reactions is first by screening the individuals privately in advance. Hence, before any couple meeting, the therapist/counselor should have a brief telephone interview with at least one party and typically starting with the person who first requests service. If on the basis of that screening interview conce
arises for the other person, then a telephone screening interview with that person may also be appropriate.

The purpose of the screening interview is to not get into the substantive issues for which the person initiates the call. The purpose is strictly to determine if maladaptive behaviors that are truly contrary to a person’s well being and indeed even dangerous may be triggered by attendance at counseling where secrets will eventually become exposed.

Thus the therapist screens for drug and alcohol abuse, severe mental illness, power imbalances and intimate partner violence.

The strategies of screening are important. The screening interview should not put inappropriate ideas into the mind of the interviewee. The person screening must be sensitive yet probing and the process must be introduced in such a manner so as not to set off alarm bells for the individual or suggest that the interviewer either suspects or blames the person being interviewed of anything. The screening interview is just a normal process of determining the appropriateness of the referral.

If conce
arises with respect to drug or alcohol abuse, power imbalances, a severe mental disorder or violence, it may be necessary to put safeguards in place to maintain the well being of the persons attending counseling and even others beyond the persons attending counseling, as well as to maintain the integrity of the counseling process itself.

People should be asked to attend sober and if there are conce
s for violence to anyone, a safety plan must be established in advance of the meeting.

To put the relevance of screening into perspective, on the matter of domestic violence alone, statistically about 60% of heterosexual couples attending therapy will have experienced some form of violence in their relationship, whether episodic or ongoing. That means more than half the people seen by counselors are at an elevated risk of harm. Thus screening and client safety becomes a serious responsibility of the therapist.

If you are going to counseling and your therapist doesn’t seek to determine if attendance at therapy is safe before you arrive, it may speak to the expertise of the therapist. You may want to consider choosing another therapist. Safety first, therapy second.

Gary Direnfeld, MSW, RSW (905) 628-4847
gary@yoursocialworker.com
http://www.yoursocialworker.com