Ethics, Self Care, Counseling Skills and Ongoing Supervision
Counselor Toolbox for Mental Health...

 
 
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Ethics, Counseling Skills Development, Self-Care and Ongoing Supervision
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs Counselor Education
Host: Counselor Toolbox Podcast

To access the CEU/OPD/CPD course go to https://www.allceus.com/member/cart/index/product/id/994/c/ in the US or https://australia.allceus.com/member/cart/index/product/id/994/c/ if you are in Australia

Objectives
~ Review the philosophical ethical principles
~ Explore how the following are ethical imperatives and how to fit them in
~ Counseling Skills Development
~ Ongoing Supervision
~ Self-Care

5 Ethical Principles
~ Nonmaleficence
~ Do no harm
~ Beneficence
~ Help further important interests (education, advocacy, outreach)
~ Justice
~ Giving all people what they are due
~ Fidelity
~ Faithful in keeping promises including confidentiality
~ Autonomy
~ Supporting clients right to choose
~ Recognition of the impact of one’s behavior on another

Steps in Ethical Decision Making
~ Recognize an Ethical Issue as a decision or situation be damaging to someone or to some group which involves a choice between a good and bad, two “goods” or two “bads”
~ Get the Facts
~ What are the relevant facts of the case? What facts are not known? Can I learn more about the situation? Do I know enough to make a decision?
~ What individuals and groups have an important stake in the outcome? Are some concerns more important? Why?
~ What are the options for acting? Have all the relevant persons and groups been consulted? Have I identified creative options?

Steps cont…
~ Evaluate Alternative Actions
~ Which option will produce the most good and do the least harm? (Utilitarian)
~ Which option best respects the rights of all who have a stake? (Rights)
~ Which option treats people equally or proportionately? (Justice)
~ Which option leads me to act as the sort of person I want to be? (Virtue)
~ Make a Decision
~ If I told someone I respect — or told a television audience — which option I have chosen, what would they say?
~ Act and Reflect on the Outcome
~ How can my decision be implemented with the greatest care and attention to the concerns of all stakeholders?
~ How did my decision turn out and what have I learned from this specific situation?
https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/a-framework-for-ethical-decision-making/

Counseling Skills Development
~ When you have an illness, do you want a physician who has not been trained on new techniques since she graduated medical school?
~ Our understanding of people, development, the brain and what “causes” mental health issues is in its infancy.
~ Skills development helps us
~ Avoid providing sub-par treatment (N)
~ Ensures we are providing the best possible care (B)
~ Allows us to keep our promise of providing the best possible care (fidelity)
Counseling Skills Development
~ Not all skills development comes in the form of continuing education/professional development courses.
~ How to fit it in
~ Find a mentor to work under
~ Get task-focused supervision
~ Self-supervise
~ Read
~ Journal articles
~ Clinical Guidelines SAMHSA APA ACA NICE COPE ORYGEN Social Work Policy
~ Resource Websites
~ Watch videos
~ Webinars
~ Conferences

Ongoing Supervision
~ Ongoing supervision helps us
~ Become more self-aware
~ Helps identify areas for early intervention
~ Become accountable for skill development
Ongoing Supervision
~ Fitting it in
~ Self-supervision
~ Colleague meetings
~ Peer review (using a rubric)
~ Staff meeting brown bags
~ Supervision at work from your supervisor
~ Supervision from an independent supervisor
Self-Care/Burnout Prevention
~ 11 characteristics of burnout work environments.
What can we do to protect ourselves from these things and what can be done at the organizational level to try to address them before they cause burnout?
~ From TLC to TNC. There's little boundary between work and home. Work environment driven by “time, numbers and crises” not by “tender loving care.”
~ Rapid and Unpredictable Change.
~ Destructive Communication Style.
~ Authoritarian Leadership / Staff has no say in what happens
~ Defensive Attitude.
~ Double Standard. Different policies and procedures, bias in application, for management and employees

Self-Care/Burnout Prevention
~ 11 characteristics of burnout work environments.
What can we do to protect ourselves from these things and what can be done at the organizational to try to address them?
~ Unresolved Grievances. No mechanisms or only adversarial ones – “us vs. them” – to settle grievances.
~ Emotionally Troubled Personnel / Low Morale
~ Repetitive, Boring Work. (i.e. 6 assessments in one day)
~ Deficient Training. Procedures (like double booking or bad Electronic health record systems) that don't allow people to work effectively or efficiently…and then workers are criticized for not being productive. Also, rapidly inundating people with new equipment and operational standards without sufficient transition.
~ Hazardous Setting. Exposure to secondary trauma, staffing shortages leading to overtime and exhaustion…

Advice from the Trenches
~ Eliminate, delegate, prioritize and simplify
~ Practice what you preach
~ Mindfulness
~ Work-life balance and boundaries
~ Recreation
~ Assertiveness
~ Good sleep and nutrition
~ Work Smarter
~ Progress notes of individual and group
~ Treatment plan creation and reassessment
~ Resource linkages check sheet
~ Identify repetitive data and create check sheets
~ For integrated summaries, use a template

Advice from the Trenches
~ Remember the major factor in creating change
~ Identify sources of distress and
~ Address them with your supervisor
~ Develop a plan to mitigate them
~ Work from a strengths-based, recovery-oriented perspective
~ Remember stages of readiness for change to avoid getting discouraged
~ Talk with your supervisor to balance your caseload (not all clients require the same amount of energy)
~ What would you tell your clients?

Summary
~ Clinicians have an ethical imperative to do more than no harm, but to advocate and advance the cause
~ With good self-care and burnout prevention you can have the energy and time to improve clinical skills and engage in additional supervision.