The key issues in communicating respect to our clients involve their privacy and their dignity, and how the Ethical Framework provides guidance on how to deliver this. One of the major issues, which has evolved over time, is how we respond to the diversity of clients that we see, and also what their rights are, and clearly issues around ethnicity, culture, sexual orientation, gender identification are all issues that we need to have thought through before we start seeing clients and to find acceptable ways of working respectfully with them. The standards that the Ethical Framework sets are higher than the legal minimum and are very much informed by feedback from people who as clients have experienced situations in which they have been treated very respectfully or sometimes felt less well respected.
Another area which relates to how we communicate our respect to clients is how we relate to our clients through their informed consent, particularly if they’re children or young people, or vulnerable adults, and again the Ethical Framework gives some guidance on that and sets out some of the basic elements that might be involved with that. So if we take children and young people as an example, their capacity to understand and to give consent is particularly important and how we relate the knowledge of how young people develop against the person who’s sitting in front of us as a young person. The law is slightly different in relation to young people and similarly their human rights may be different, so it’s important that we’re aware of that. And then of course young people and children, in particular, are very influenced by the support that they get from parents or people with parental responsibility and the customs that might apply in relation to parenting. So these are all aspects that a practitioner might need to take into consideration in working respectfully with children and young people.
Q1: I can see how respecting privacy and dignity apply to medical examinations and treatments but how do they apply to talking therapies?
Well, in a medical examination clearly you are exposing parts of the body or something, so privacy and dignity are important. In the context of talking therapies it still applies but it is different, so it maybe about being overheard in terms of privacy, in terms of dignity, it maybe about how a person arrives and leaves a session quite often. So one of the things to consider is, if someone has become very distressed in the session, how do you both help them to recover their sense of control before the session ends, but also what protection or time you might need to give them before they feel ready to go out into say, a public space, like a reception area or if they are going straight out into a public place, do they need a few moments to wash their face, change their tissues or whatever it is. That all communicates respect to the person.
Q2: How can I develop my practice to be more open to the diversity of clients and their experiences?
I think, particularly if you are on a training course, listen carefully to other people who may have different backgrounds from your own and identify themselves in different ways from the way you identify yourself. Listening carefully to the experience of others in any aspect of our life, is one of the most mind expanding and personally expanding things we can do and gives us more information about the human diversity that is around us, and we may previously have passed us unnoticed or may be unfamiliar to us.
And clearly with the person in front of us, we’ve not got to assume that they are the same as people within that group, within any particular social categories will be people who identify with it strongly, people who resist it, people who position themselves in a more complex, more sophisticated ways than a simple identification, because we are all managing tensions and contradictions in our lives. So in the end it comes down to what we as counsellors are particularly good at, which is listening to what somebody says, and engaging with that imaginatively, so we have a sense of what matters to them, and if need be checking that out with our clients.
Q3: What is ethically special about children and young people? Aren’t they just adults in development?
They’re more than adults in development because they live in a more complex relationship with adults and we as therapists very often will be the adults in their lives and we are sitting alongside other adults who are influential in their lives, their parental figures, their other extended family members, teachers and other people who are significant in their lives. And so their attitude may be one of greater dependence or greater resistance.
They also, we need to bear in mind, that as we now know neurologically that as we develop we have different capacities and different susceptibilities, so adolescence is neurologically a fascinating period in people’s lives, in which they may see the world very differently from when they were a child, or when they were an adult, and that may involve us in having to present information in a different way.
We also need to think about the influence of the environment that they live in in relation to their peers, which maybe very important and may provide experiences which are very different from those that one has in the adult environment, so as a therapist one working with children and young people we’ve got knowledge, that we need to use about their development and so on and we need to be open to possibilities that their experience of life could be very different from where we are in our experience of life.