Did Not Attend (DNAs)
by Chris Molyneux (June 2009)
DNAs (Did Not Attend) have probably been my biggest struggle, learning curve and place for exploration during my placement. I entered the placement with a very nave view that I book two clients a week for a year and that's my 100 hours done, no problemo!! I don't think I could have been further from the truth...
As time went on I think it became more and more clear how difficult a step counselling can be. The potential client is faced with coming to a place and meeting a person that they have not seen before, they may often have no idea what this counselling lark is all about and also the difficulty of having to get in touch with some really deep and complex areas for exploration. Having DNAs enabled me to step into the clients' world in a different way. It enabled me to think what the process of agreeing to attend counselling and then actually beginning this journey must be like. Although I had gone through a similar process with my own counselling (another thing I think is hugely recommended for any trainee counsellor), it felt a little different as I understood the aspects of counselling a little clearer due to attending the graduate diploma.
The alien world of counselling can be quite scary for some people, especially if some of the issues that they are bringing could be related to things that present themselves in the process of attending counselling. For someone who is scared of trust, other people's views, leaving the house, working at depth etc then counselling can really be quite a daunting prospect for the client. Although I do paint a quite dark picture of my experience, I don't think that these are the only experiences that trainee counsellors will come across, however I do think it is important for these things to be in the counsellor's consideration when working with clients.
Each DNA seems to a bring a new area to explore as well, there are DNAs for initial sessions with clients (in my experience, the most common) and also DNAs during the beginning, middle and end of client relationships. For me, they all brought a new dimension to DNAs whether it be exploring not attending the first session or if it is around your facilitation of the session or the content of the work that is being explored at the time. Of course it is different with each client and this is what makes it such a rich and invaluable area to explore. Another aspect is bringing the subject of DNA/late attendance and commitment into the counselling room with the client (if appropriate) and this can provide a whole new area of work as well. Often the relationship and behaviour in the counselling work can be similar to that which is presented in the outside world and so is of great importance.
Two areas which came up for me during my placement was the issue of working with adolescents and also booking my own appointments with the clients. My fellow students on the course have had different variations on these roles but I also think these contribute massively to the attendance and experience of clients. Having to ring the client myself to book our session was something which I liked and enabled me to make the first connection with the potential client rather than being rung up by a receptionist who then passes them on to possibly be screened and then finally meet their eventual counsellor. For me, this lengthy process almost emphasises the feelings of uncertainty or discomfort for some clients and by ringing up the clients myself, explaining our meeting and making that initial connection was a very important part of the relationship between client and counsellor. However, along with this, is the responsibility of wanting to provide a welcoming connection with the client as first impressions can be crucial, even over the phone! I am sure that my desire for the client to attend and nervousness came across strongly in my initial phone calls and the DNAs raised issues such as this that I could look and change if I felt that it needed to be.
I have not had any experience of counselling other age than those that I have worked with on my placement (16-25). It is hard for me to generalise this age group or compare it with others but the feedback I have gained from a number of people is that often working around this age can provide many difficulties in terms of attendance, commitment, awareness etc. I myself fit into this age group and so do not want to generalise but in my experience I have had a lot of people who have seemed a little uncommitted to the counselling and maybe not as keen to attend as I have heard about other age ranges. It goes without saying that I have explored my own contribution to the client's commitment and attendance and have pinpointed and worked through certain areas but the age does seem to be an area that people tend to experience more DNAs than others.
I think what I would hope to advise people through reading this article is to expect DNAs. I think that they are inevitable and provide a very rich area for exploration and development in supervision and counselling courses. In my experience, it has given me a lot to think about and work on both with my own practice but also in understanding the client's perspective in relation to counselling. I think that as long as the counsellor is committed to exploring these types of issues and can separate their own contribution to the clients then it is material which is invaluable in counselling. DNAs are the types of issue that the placement is there for, to give us a taster of the counselling world and to bring issues to our attention that otherwise would not have appeared.