Discuss about the Challenges of Counseling Survivors of Abuse.
Counseling therapy is one of the most relevant mental health therapy used in the treatment of survivors of abuse. The counseling therapy helps to enhance the self-respect of the victim through the enhancement of patient’s self-esteem. It is done by the establishment of therapeutic relationship with the patient and promoting the positive thought process of the victim, while hindering the negative thoughts (Ivey et al. 2013). There are different types of abuse happening in the society, the most common forms of abuse include the domestic violence, child abuse, sexual and psychological abuse. The domestic abuse is one of the challenges in the modern society. Researchers are attempting to explore new windows for dealing with the survivors of domestic abuse (Gladding 2012). In this context, domestic abuse has been taken significant recognition as a successful intervention for dealing with the survivors of the domestic abuse and achieved significant success. There a number of studies, that explained the ways by which the counselor facilitated the recovery from domestic abuse within a secure and supportive therapeutic relationship (Dal Santo et al. 2014). The domestic abuse includes any kind of abuse that is performed within the family. Here, the focus of the discussion would be the challenges of counselor survivors of the domestic abuse and the implication of it for mental health practice.
Domestic abuse and domestic violence is one of the most significant issues in modern society, which has become a burden of the modern society. Domestic abuse is usually seen mostly in women and children (Kane et al. 2014).
Statically, it has been shown that thousands of children are abused physically, sexually or mentally by their parent or some other family members. Child abuse can be defined as the action of a carer, which can significantly harm a child’s mental or physical health. When the children are abused by their family members, it is considered as the domestic abuse. The survivor of childhood sexual or psychological abuse by a domestic member faces issues in their relationships, but there are support and help available for the victims. One of such support is individual counseling, which can assist the victims to address issues of trust and anger that might resurfaced in further life (Dal Santo et al. 2014). Another type of child abuse include witnessing abusive action upon their carers, mostly mothers, which also affect significantly in their mental, physical as well as emotional development. It is also very common form of domestic abuse; women are mostly abused physically, psychologically or sexually by their intimate partners. Survivors often experience frequent mental illness and lack of trust upon anyone.
Challenges of Working with Counseling Survivors of Domestic Abuse
Counseling is a promising approach to deal with the domestic abuse and related issues, many has shown significant benefit, which restored their normal lifestyle with the reduction of psychological issues. However, there are a number of challenges experienced by the counselor or other professionals to work with the survivors of domestic abuse during the counseling sessions. According to Egbochuku (2009) the low resource settings, where the counselor works, combined with the degree and intensity of contact, have a direct effect upon the counselors in promoting or disintegrating stress. It is very difficult to measure the intensity of the emotions experienced by a counselor in a session, but one can only imagine. Burnout due to the counter-transference is a common phenomenon, experienced by the counselors working with the victims of domestic abuse (Curtis et al. 2013). According to the viewpoint of a colleague counselor who has also and experience of working with the victim Jane, “At one point I felt like slapping her, I saw my kid sister in Jane, I longed to beat some sense into her head”. Some common challenges experienced by the counselors include the far for client’s safety, sense of helplessness and powerlessness. The counselors expressed the feelings of omnipotence, which significantly enhanced the demands and challenges of working with the domestic abuse survivors. Survivors of abuse might impose relational challenges upon the counselor (Kezelman and Stavropoulos 2012). These service users are usually mistrustful, but they often need a trustworthy relationship. Sometimes, counselor finds himself over fascinated by a victim’s abuse history or sometimes due to some of their personal reasons; they attempt to avoid the discussion of abuse.
One common challenge of working with the survivors of the domestic abuse is the limitation of professional boundaries. As the domestic abuse and neglect is based on the violation of trust, it is critical for the counselor to maintain a professional relationship with the implementation of professional boundaries and limitations properly (Francis 2014). Mostly, in the case of domestic abuse, the victims go through severe violations by the family members and they need emotional support. Here, the professionals often cross the professional boundaries. When two people undergo a counseling session for solving an issue, sometimes they forget that they are not friends; rather, they have a business relationship. Often counselors play a rescue role, which is not the job of a counselor. They have only to encourage the client to reach the finish line. Poor boundaries or losses of professional boundaries promote the therapist to feel like the client (Foster et al. 2012). It promotes compassion fatigue, the service user may feel betrayed, poorly served and abandoned. There would also have increased potential for “splitting” on teams. Poor boundaries promote the service providers to act unethically. Loose boundaries enhance the chances of dual relationships, as it promotes personal relationship with the client beyond the counseling sessions.
Another common pitfall is, if the client’s values, relationship, feelings or lifestyle issues conflict with the service provider’s values or practices. It can reduce the client’s self-esteem, if the counselor, in spite of empowering the client, point out client’s negative beliefs and perspectives. Another major challenge, which is often done by many counselors, while working with the domestic abuse patients (www.youtube.com 2016). They play the “hero” role, needing to save the client, which is not the role of the counselor. In theory, it is nice, but it is not the exact role of the counselor. It enhances the expectation of the client that every time she will be rescued by the counselor. Especially, in the case of domestic abuse victims, the reliability and expectation would be high, as the client has a chance of repetitive abuse by the family member (Gladding 2012). Thus, it hinders the recovery of the client through the positive thought process. Vicarious trauma is another challenge, which is a trauma symptoms experienced by a service provider, after hearing the client’s experiences. It is very hard for the therapist or the counselor to deal with the situation, to maintain the required level of detachment with the client, while empathizing the client. The counselor, when fails to recognize the boundary between supporting the client with his abusive experience and feeling same experience as a victim, it leads to the occurrence of vicarious trauma (Kongstvedt 2012).
One common pitfall, often shown, while working with the victims of domestic abuse, is poor teamwork. Teamwork is very important for dealing with the victim of domestic abuse. However, if the counselor thinks that, he or she is the only one who can handle the situation; it might cause miscommunication throughout the team and thereby reducing the patient’s outcomes. When the client-counselor relationship goes beyond the professional boundaries, the chance of accessing the client’s personal information enhances, which violates the ethical considerations (Weisz et al. 2012). Sometimes, too much self-disclosure shifts the focus from the client to the service provider, thereby confusing the client in terms of roles and expectations of the relationship.
There are a number of ethical dilemmas experienced by the counselors. It is often inevitable that the victim of domestic abuse is exploited as the only source of information concerning child abuse. One potential negative consequence of mandating a report might be in direct opposition to the wishes of the victim and to empowerment, objectives discussed in the therapy settings (Kaae et al. 2012). Some victims never disclose their abuse during the sessions, many do so as the client-clinician relationship strengthens and a trustworthy bond is formed. The victim, whether she discloses the domestic abuse directly in the counseling session or not, is in a highly vulnerable position. The victim is often taking potentially dangerous steps, as she needs assistance regarding the abusive and coercive relationship (Gladding 2012). Sometimes, clinician inadvertently becomes an authoritarian figure, where the he or she plays the role by directing the victim in an effort to improve the victim’s life and ensuring safety. In these kinds of situation, the victim can feel as being coercive within a non-egalitarian client-clinician relationship, which is similar to the form of abuse from which the victim wants to be free. Thus, when the domestic abuse is disclosed by a client, the clinician should adhere to mandatory reporting laws and the ethical duty for protecting, which is often opposed by the ethical issues of confidentiality and respect for consumers autonomy (www.youtube.com 2016).
From the above discussion, the key challenges experienced by the professionals working with the victims of domestic abuse included transference, which can be referred to the feelings and issues transferred by the client to the counselor through the client-clinician relationship. The other one is countertransference, which is referred to the responses and reactions of the counselor towards the client, which are directed by the background and the personal issues of the counselor (Muskett 2014). It often promotes the counselor to go beyond the objectivity of the counseling session and become overwhelmed. Secondary traumatization has also been highlighted, which is often painful for the counselors, including burnout.
Implication of Challenges on Mental Health Practice
For avoiding the above discussed challenges, while working with domestic abuse victims, the counselor should establish and maintain a treatment frame, which are required for supporting a professional relationship and they should ensure that the professional relationship should not be confused with the personal relationship. Therefore, the key suggestion for the counselor is to retain the professional boundaries and limitations as much as possible. The counselor should attempt to generate a safe and empowering atmosphere for the service user and should decrease acting out through the practice of “grounding” techniques (Ivey et al. 2013). These techniques include anchoring or grounding the client, mirroring and proper way of timeout. The counselor should avoid joining in the disruptive behavior of the client in any ways. Another implication for the mental health practitioners is ‘avoiding the role of “rescuer”’ (Kezelman and Stavropoulos 2012). The counselor in such critical situation should use his own strong viewpoints in an environment, which is entirely different from the client-counselor relationship, which can help the counselor not to confuse their own issues with the client.
Another suggestion for the professionals is to recognize their professional boundaries properly. If it has been seen that, the counselor is not compatible with a client, then with the consent of the client, another counselor should take his responsibilities (Ivey et al. 2013). In addition to the counselor, the mental health agency should also fulfill their responsibility to support the counselor. According to the Consensus Panel, the agency should provide the counselor, a sense of mission to work with the domestic abuse patients. The agency should provide trauma training to the counselor regarding the proper ways of handling trauma cases. The supporting staff members should also be aware of the professional limitations, thereby ensuring their responsibilities not leading to burnout (Francis 2014). The agency should also allow the counselors with unstructured time, when they would be able to talk to each other and transfer support.
In the discussion paper, the focus was the challenges faced by the professionals, who are working with the domestic abuse victims. The previous literatures identified different types of domestic abuse and the impact of counseling sessions on their recovery. Different significant challenges and issues were identified, which are experienced by the professionals, which are affecting them significantly. The discussion paper also included the implications for the mental health professionals as well as mental health agencies regarding the ways by which they can handle these challenges potentially.
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