Professionalism in Counseling
I often share that my practicum professor hosted our classes in his condo. He also wore a butterfly pin and, I’m pretty sure, the same denim shirt and jeans every time. He occasionally used profanity and spoke openly about experiences he had that related to our own. Like all the classes before, we adored him. He embodied everything I wanted to be as a humanistic counselor: genuineness, authenticity, kindness, and unconditional positive regard. Unfortunately, I can’t be that therapist because it just isn’t worth the risk due to the nebulous professionalism clauses in codes for NBCC, CCE, and state consumer protection boards. I can’t meet with a client who is having a hard time and offer her a brownie in my living room the way my first therapist did. It’s just not worth the risk.
What Sparked This?
Aside from a 10 year plus career of being surrounded by people who are way too uptight, I saw a post in a Facebook counselor group where someone at least claiming to be a therapist excoriated other therapists here in Colorado for being too casual. They ranted about therapists wearing leggings, self-disclosure, political affiliation, religious affiliation, taking calls from a walk in the park or from the car. They even complained about dogs in the background! And, yes, of course they complained about therapists using spicy language.
Group members reacted by piling on this post and one even accused the poster of using it as “rage bait.” Multiple members called this post out as a colonial model of the counseling relationship and encouraged the poster to educate themselves on a deconolnized model of counseling.
In short: ALL the buzzwords came out to play.
My first feelings were anger, shame, and sadness. I spend so much of my time and energy on other people, and if I can’t be myself while doing it, that’s not sustainable. My dogs make frequent cameos in my sessions. My clients know about my hobbies. I wear leggings. (Most of the time, I don’t wear a bra). For context: I only do telehealth. Do I have concerns about walk and talk sessions? Absolutely. Those same concerns extend to a counselor holding a session in a park. However, it isn’t because I think it’s wrong to do those things. I think the antagonistic relationship our board fosters between providers and consumers makes this kind of flexibility too risky for most of us to reasonably consider it. In a profession known for being overwhelming and isolating, this doesn’t mean good things for the mental health of practitioners.
A Dysfunctional Complaint Process
Unlike most states, in Colorado, if a consumer files a complaint against a therapist, the complaints do not go through any type of screening regardless of how frivolous they are. (Yay! Your tax dollars at work). The Board takes lack of response as either an admission of culpability or not caring about your license. They also only listen to attorneys even if you say the exact same thing your attorney does. Most attorneys traumatize counselors by belittling them, playing up the risks, and frightening them because they want to get the case and make money. It feels like a scam to me. The board claims that they don’t assume culpability on the part of the counselor when they receive a complaint, but their behavior indicates otherwise.
When I filed a complaint with the board of banking and insurance, I received multiple messages from the board asking, “Are you sure you really did everything you could to get this resolved with them?” This was after I tried to get them to bill an in-network provider as in-network instead of out-of-network, then, the biller at the practice tried and they kept doing it. Finally, the insurance company agreed to charge me nothing for those appointments, but they never accepted responsibility. Totally different experience with boards when the people being regulated have money.
Supervision & Training
I don’t give a flying pickle about professionalism. I have a long history of saying that an idiot in a suit is still an idiot. I don’t care how anyone dresses or the vocabulary they use. I don’t care where a therapist calls from. I don’t care if cameras are off or on. What matters to me when I evaluate a counseling relationship is attunement and compassion. If whatever the therapist is doing works for that client, that’s what matters. It’s also what ought to matter. The quality of the relationship heals. Bras don’t heal. Dress pants don’t heal. A fancy office with a view doesn’t heal either.
However, do I coach new counselors on professionalism in emails, dress, and other interactions: Yes. I still think it’s stupid, but I do it because I know they don’t get feedback on that in graduate school (see butterfly guy) and it’s important because those vague statements about professionalism in the Mental Health Practice Act for Colorado and CCE and NBCCs’ ethics codes are where they “get” us.
Does this mean I’m dictating what supervisees wear or whether or not they do walk and talks? Nope. I do insist on sharing the pros and cons and let them know that every time they wear something casual, use a swear word, share something about themselves, hold a session outside where other people can hear, or send a spicy email that they are making a decision that could come back to haunt them. Always ask yourself: Is it worth it?
Particularly when it comes to the spicy emails and clients, I can relate. People send us stuff that is clearly meant to be condescending or mean and it’s often a family member or friend butting into someone else’s treatment, so it isn’t even the client. However, anyone can file a complaint and an email is documentation. DORA loves emails. It’s gross. While some people view emails as a method of communication involving a lot of thought and consideration, most of us know better. We’re usually checking during random spots of time and doing our best to just provide a response before the dinosaurs return.
DORA seems to believe that counselors are simultaneously Mary Poppins and completely incompetent space cases that need monitoring.
Meeting clients where they’re at sometimes means literally driving to places to meet them. Sometimes it means giving them the tough feedback that nobody else in their life is giving them. Sometimes we need to tell a nosey relative to butt out.
Do you want to be right or do you want to be happy?
My other favorite version of this is, “Fine. Let it be stupid.” When it comes to awkward emails and questions of dress, etc. weigh what matters most to you. If parting with your leggings hurts you in your soul, don’t do it. If self-disclosure leads to breakthroughs, keep doing it. Do what is right for you in all things. Just know that whatever you choose, it carries a risk. For certain clients, you know the ones, if you didn’t screen them out on the first call, ask yourself if that person is worth spending six months going back and forth with an attorney and crossing your fingers that the board grows a brain.
