This week we looked at the role of counsellor in an agency in relation to key-workers and support workers for clients that work within the same organisation.
Before I go any further, I think it’s important to highlight exactly who these organisations are supporting. Here are some examples of vulnerable groups.
• homeless people
• individuals with mental health issues (particularly severe manifestations such as suicide ideation, self-harming, or substance abuse/reliance)
• people with learning and/or cognitive difficulties
• children from poor backgrounds, unstable home environments or in foster care
• people that have issues around addiction
• the elderly
• people with chronic illnesses or debilitating conditions
Support workers, as the job title suggests, support people that are unable to properly learn or maintain life skills. In a social welfare setting, a helping organisation, a supportive charity or a healthcare agency, a support worker basically helps a vulnerable person live a happy and independent life. The vulnerable people are sometimes referred to as “clients”.
Their duties and responsibilities could include, but would not be restricted to: helping clients with day-to-day direction, either in their own homes or at a support centre, accompanying them to appointments, such as the doctors or the dentist, or taking their clients out shopping or on day-trips. It could be said that support workers do the “dirty work”, and are dealing with the nitty-gritty real life of a vulnerable person, as it involves a lot of trust on a personal level. Some vulnerable people may require more intimate care than others, such as helping with bathing and looking after their personal hygiene, or meal preparation, or money management. Overall, support workers empower people to live the best life they can.
Support workers can also help support other staff in their organisation, by performing such tasks as as tidying up and cleaning, or doing administrative work.
Key-workers in one of these organisations generally look at the bigger picture in relation to vulnerable people’s circumstances and life-plans. They are more like case managers in that they consider the long-term plans for a client’s wellbeing, and there is more focus on how to ease a person’s burden than helping them manage it. They devise and continually review a support plan, keep all the records up to date, and maintain any official paperwork. Strong boundaries are important here as key-workers do need to keep a distance from the clients, so they remain impartial and keep their best interests in mind.
Note: There is a small amount of overlap between support worker and key-worker, as they can have different duties or job roles in different organisations.
Counsellors in these organisations quite often have to stand alone. There is a need for a written contract between counsellor and client, which is used to enforce the boundaries of their relationship. Time needs to be structured, as no doubt the counsellor will see a lot of clients over the course of a day.
Continued Personal Development (commonly referred to as CPD), is mandatory for all counsellors, as it is important to keep up to date with the latest research and findings, as well as developing your own knowledge and skillset. Also mandatory for counsellors is ongoing professional supervision. This is when a counsellor goes to see a more qualified or more senior counsellor to review the way they work with their clients. CPD and Supervision ensures all counsellors are keeping their skills up to date, and are working in a safe and ethical manner.
Communication between the three roles is important. For example, a counsellor and key-worker could discuss whether a client would be better suited to another organisation, without breaking the confidentiality between the counsellor and client. Confidentiality should only be broken if there is a safeguarding issue that needs to be reported to the appropriate authorities.
We also explored the limitations of counselling in relation to the expectations of clients in a variety of settings. Within some agencies or organisations, a counsellor may be asked to do things that would be expected of other people with different job roles in that organisation. Counsellors are bound by a strict code of ethics and cannot perform these duties or do these “little favours”.
For example, if you were a counsellor in a GP surgery, a client could expect you to give her medicine, or put a good word in to the Doctor to get her medicine a bit quicker. A patient could ask if you could make their headache go away, or ask for a sick note so they didn’t have to go to work. A person could ask for blood test results, or a repeat prescription. They could ask for your reassurance that something is wrong, or that they have a clear bill of health. They could ask you to lie to their GP so they can get access to the drugs or services they want.
If you were a counsellor in a rehabilitation centre, then a person that came to see you may expect you to magically take away their desire for addictive substances – they may expect you to fix them without having to do any of the work themselves. They may expect you to tell their family and friends what their problems are, so they don’t have to. It’s not just “things” that clients may expect of you: they could have an expectation of allowing themselves to become dependent on you. This would be a major problem, and while this could happen in regular counselling, it is a lot more likely in this situation due to the nature of addiction and dependency. They may not co-operate if they are required to attend counselling and they don’t really want to be there, and feel a lot of resentment towards you. Similarly, they may not open up to you if they think that you have no first-hand experience with drugs.
If you were a counsellor in a drop-in-centre, then someone coming in could expect you become their personal assistant: provide them with tea and toast, or get them some dry clothes. This goes back to dependency again. A person could just see the drop-in centre as a place to meet their mates and hang around, and talking to you as something they have to begrudgingly do to gain access to this place. They may not feel the importance of talking to you, and just turn up when they feel like it, or not feel like there are any consequences if they just don’t turn up for weeks on end. This would be bad for a counsellor, and the organisation as a whole, as they would have those slots booked specifically for that person – slots that could go to other people that need them.
This is similar to if you were a counsellor in a young person’s advisory centre, but the young person, having a less developed sense of responsibility, didn’t want to be there. If this young client was booked in for a course of 12 sessions over 12 weeks, but after the second week they didn’t turn up, how long would it be with no communication from them before the entire 12 week course is officially cancelled and those slots given to someone else? Another example here is that a young person may expect the counsellor to mother them, look after them, or generally take over care of them. A young person could also expect a counsellor to tell them what to do with their lives. While there is a degree of signposting in counselling, it is for general guidance, as a counsellor is not there to explicitly tell a person what to do or how to live their life.
In all these instances the role of counsellor is not fully understood in the client’s eyes. This is why boundaries, and the clear definition of those boundaries, are of critical importance in any organisation.
