Today's Topic



Should Therapists Be
in Therapy?
Part II

Part I
Part III

Natalia J. Garland

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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.

(a) Social 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.

(b) Social 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 organizations.
[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.

(a) Social 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 responsibility.

(b) Social 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 others.
[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 and ethical.

The 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 again..............stay sane.

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Copyright 2004 Natalia J. Garland