This is one of the new sections in the Ethical Framework which has been developed in response to issues that clients have raised and also issues which have touched on practitioners lives as well. So what we’ve tried to think through is how do the concerns around breaks and endings arise. We’ve realised that they arise in a number of different ways and in each case we have tried to give some basic guidance on how to avoid difficulties.
So in terms of planned endings like holidays, limits to the number of sessions a client might be offered, these are the sorts of things that could be dealt with at the beginning of the relationship in terms of the contracting or be raised during the relationship, so clients are informed in advance.
But of course not all situations arise in a planned way, so there are some situations which arise because there is something about what the client is presenting that’s problematic for the practitioner and maybe they feel out of their area of competence to deal with it and that requires discussion in supervision and some sort of planned way, either for referring the client elsewhere or possibly continuing to provide a service but with additional support, so that the client is adequately supported and the issues addressed.
The other situation which has arisen and there have been some really sad experiences of this, where clients and sometimes colleagues have found themselves in difficulty, is where someone becomes suddenly and unexpected seriously ill or even dies, and there have been situations where clients have turned up for an appointment and either had no response or just found a notice saying services closed due to the death of the practitioner, and some clients have been informed by a relative, who may themselves be very distressed and the clients almost feeling a responsibility to address the distress of someone whose been affected. So we try to think through what would be an appropriate ways of managing these situations and for that one we have some very specific guidance.
Q1: Why include a section on breaks and endings?
Well very simply it’s because it’s something which causes real concern for clients. It’s hard for a client to experience a break or ending simply as just that, and it’s easy as a practitioner to lose sight of what sort of meanings and fantasies clients might have, sometimes clients experience it as a major loss in their lives, that the counselling or psychotherapy or other services have brought a structure to their lives which, and a way of dealing with some difficult areas in their lives that’s suddenly disappearing. Sometimes it draws up for clients other breaks, memories of other breaks and endings so it’s not just what is happening with the practitioner but it’s other things in their lives which might be touched by it. So it’s a big issue and it’s one we need to take seriously and think through how we manage them.
Q2: What commonly goes wrong for clients when their practitioner becomes seriously ill or dies? How will the new points help with these issues?
Well we’ve had some very sad instances where some clients have not been told that a practitioner has died and they have just turned up for an appointment and either not had a service, or simply found a note on the door, or have been told by a distressed relative. And the client themselves is then thrust into a bereavement process particularly if they have been working in-depth with a practitioner or come to rely on them for some aspect of the service. So it’s not an easy one to avoid, to plan for, in the sense that inevitably these are often situations which arise unexpectedly and clearly if the practitioner is seriously ill or dead, then they are not present to deal with the consequences of this or able to do anything to mitigate it.
So this is a situation which is going to depend on other people, and fortunately we could find some examples which are where a difficult situation has been made better, where practitioners have made provision in advance, or where people have stepped in recognising the difficulties that a sudden death might pose for a client, and so the provisions in the Ethical Framework are based on these things which have worked better. So either the supervisor or someone appointed as the trustee taking the initiative in communicating with clients what’s happened and supporting clients in finding alternative services seems to be the best that we can do to ease, what is inevitably, a very difficult and rather sad situation for everybody concerned.