Should Therapists Be
Natalia J. Garland
Therapists who should be in therapy are more obvious in instances
of recovering professionals. Or are they? What if a recovering
professional relapses on alcohol or drugs, and the relapse becomes
known among colleagues? What should be done? For guidance, let's
use the N.A.S.W. (National Association of Social Workers) Code of
Ethics. Keep in mind that only N.A.S.W. members are bound by its
Code of Ethics. Both members and non-members, however, are bound
by the code of ethics of the state(s) in which they are licensed.
The following two
paragraphs are taken from the N.A.S.W. Code of Ethics:
Section 2.09 Impairment of Colleagues.
workers who have direct knowledge of a social work colleague's
impairment that is due to personal problems, psychosocial
distress, substance abuse, or mental health difficulties and
that interferes with practice effectiveness should consult
with that colleague when feasible and assist the colleague in
taking remedial action.
workers who believe that a social work colleague's impairment
interferes with practice effectiveness and that the colleague
has not taken adequate steps to address the impairment should
take action through appropriate channels established by
employers, agencies, N.A.S.W., licensing and regulatory
bodies, and other professional
[End of quote.]
This certainly is
not a harsh injunction. Section 2.09(a) seems to allow for some
peer-to-peer expression of concern and an offer of assistance.
Section 2.09(b) then sets limits on impaired employees who
fail to get help or to get better, with the responsibility for
reporting them falling upon their colleagues. In agency
workplaces, the likely response would be to go the supervisor.
What kind of
action should an employer take? In the case of a professional who
has relapsed on alcohol or drugs, mandatory treatment at an
inpatient rehabilitation facility might seem the logical choice.
However, if we give any credence to the A.A. and N.A. fellowships,
it must be considered that the relapsed professional could return
to effectiveness through self-help alone. Again, addressing the
question of whether therapists should be in therapy, the answer
might be something like: probably, maybe, but not necessarily.
What if therapists
themselves feel a need to be in therapy? What if a therapist has
sufficient self-awareness to recognize that they are in personal
distress and need help? Let's turn again to the N.A.S.W. Code of
Ethics. The following two paragraphs are taken from
Section 4.05 Impairment.
workers should not allow their own personal problems,
psychosocial distress, legal problems, substance abuse, or
mental health difficulties to interfere with their
professional judgment and performance or to jeopardize the
best interests of people for whom they have a professional
workers whose personal problems, psychosocial distress, legal
problems, substance abuse, or mental health difficulties
interfere with their professional judgment and performance
should immediately seek consultation and take appropriate
remedial action by seeking professional help, making
adjustments in workload, terminating practice, or taking any
other steps necessary to protect clients and
[End of quote.]
We probably all
know therapists who fit the descriptions given in Section 4.05(a).
We all have personal problems. Most of us have probably worked
with a colleague who was going through a divorce, coping with the
death of a parent, having major surgery, or experiencing some
mild depression. The question is whether these personal
problems interfere with workplace responsibilities. If therapists
can manage their personal problems and still provide services to
their patients, then there is no reason for alarm.
Let's go back to the
example used in Part I of this essay. The therapist is a
female who was raped when she was 16 years old. She has kept the
rape a secret all her life. Now she has a patient who was also
raped at age 16, and the patient wants to discuss this in therapy.
At the same time, the therapist's father is undergoing cancer
treatment and her dog just died. She feels very uncomfortable
in session with the rape survivor, and she is starting to have
flashbacks and nightmares. She is having difficulty coping at
work and at home.
Since she happens to
be a dedicated worker, she decides to voluntarily enter therapy
and begin resolving her own trauma issues, as well as to obtain
support for her home problems. She confides in her supervisor
that she feels unable to treat the rape survivor at this time, and
asks that the case be removed from her caseload. She also
requests a week's vacation time. All of this seems to be in
compliance with Section 4.05(b). The therapist has taken steps to
get help and to protect her patient. Her actions are responsible
majority of therapists are probably caring individuals with good
levels of self-awareness and conscientious practice. If a few are
not of this caliber, then it falls upon the rest of us to do the
right thing. (Written 04/05/04: bibliography available.)
Until we meet