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Do Social Workers need counselling

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Top 25 Contributor
Female
Lins Posted: 3 Jun 2008 9:37 AM

Due to the at times very traumatic cases that Social Workers deal with on a daily basis, should they receive counselling without having to formally request it. Are Social Workers suffering from post truamatic stress syndrome wich is going unnoticed and undiagnosed. The police officers who entered the family home of the children who were found starving were given counselling due to their distress. Is the same standard of care given to Social Workers on the frontline? 

Top 10 Contributor
Male

Hi Lins,

I think that automatic counselling as you suggest would be unhelpful. We tried that after the Hillsborough disaster and as I understand it the incidence of PTSD was much higher than expected. I'm afraid I've no reference to back this up but I do remember attending a lecture on it once.

Many people will just deal with their traumas if we leave them alone to get on with it. Throwing counselling or other 'talking therapies' at people who don't need it can actually get in the way of that. People get over stuff on their own if we let them.

To give people counselling when they haven't asked for it might be repeating the same mistakes and ultimately make things worse. Having said that I do think that it ought to be available for those who want it.

FWIW

Stuart

Top 10 Contributor

 There has been some research published recently, which I mentioned in my blog, suggesting it's not always better to talk about things after a collective trauma 

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Top 75 Contributor

I know my husband did not recieve counselling after Gulf War 1/Kosovo/Bosnia/Somalia- don't know if a man thing, or personality type, but he just doesn't discuss it.  And I respect that.  However, if his feelings or thoughts would ever change, then I would like to think counselling would be available freely and quickly- same for anyone in horrific front line protection work of any kind.

“First they came for the Communists, but I was not a Communist so I did not speak out. Then they came for the Socialists and the Trade Unionists, but I was neither, so I did not speak out. Then they came for the Jews, but I was not a Jew so I did not speak out. And when they came for me, there was no one left to speak out for me.” —Martin Niemoeller
Top 75 Contributor
Female

During my time at CC I've interviewed - often face to face - a lot of social workers and social care staff working with clients who've told them about their very traumatic experiences (e.g. asylum seekers who have fled rape and torture). It's always struck me social care professionals may find it hard hearing about such things and may need support. Hopefully this is what their supervision sessions are about, a dedicated time when they can share any worries or problems with their manager.

 If they are too distressed by what their clients are telling them does it mean they don't have enough professional distance to do their job properly?

Senior writer, Community Care

Top 10 Contributor
Male

Are we not all vulnerable to such problems precisely because we are doing our jobs properly?

We must have compasssion and the ability to empathise surely. That leaves us open to being overwhelmed from time to time but it's better than not feeling isn't it?

Maybe people need to step back and 'regroup' from time to time but I don't think that's the same as not doing their job properly. It's just part of the process isn't it?

Top 500 Contributor

''Maybe people need to step back and 'regroup' from time to time''

This describes exactly what is often needed, but there is never time to do just that. Furthermore it is often seen as a weakness.

In my opinion, the more experienced one gets, the more one recognises the need to take a step back in order to come forward from a fresh objective standpoint.

Unfortunately the newly qualified/inexperienced workers are often left to drown and then blamed for mistakes they make.

 

Top 10 Contributor
Female

 Don't most local authorities and NHS Trusts have access to confidential counselling services? 

I haven't worked in many but the places I have all had as a part of general employee benefits, access to external counselling services which was provided free to staff and close family members - for any range of personal or professional issues and without the knowledge of anyone within the employing organisation.. 

Maybe that's too broad an assumption that I made but I know it's always been available to me. 

Top 25 Contributor
Female

Hi Stuart

 

I wasnt talking about throwing counselling at peopl or in this case workers. What I was attemptiung to do is open up a debate on the issue of offering this service more freely than having to be referred by managers and the stigma that goes with it including the fact that it may or may not depoending on the authority show up on your personal file. The notion to some people of going to counselling to talk about how they are coping with some very horrendous cases which they take home in the minds each night may be useful depenedant on the individaul and should not in my opinion be dismised. We work with trauma everyday to different degrees and that trauma must surely go somewhere. Over a long period of time this must effect workers or we wouldnt get some mush burn out.

However, I agree with Simone2 in the fact that it is not always helpful and in some cases it has been suggested that it has caused more harm than good. But wouldnt it be nice to have an option.  

Top 75 Contributor
Female

Stuart Sorensen:

Are we not all vulnerable to such problems precisely because we are doing our jobs properly?

We must have compasssion and the ability to empathise surely. That leaves us open to being overwhelmed from time to time but it's better than not feeling isn't it?

Maybe people need to step back and 'regroup' from time to time but I don't think that's the same as not doing their job properly. It's just part of the process isn't it?

Hello Stuart,

The key word on my sentence was "...too distressed...", meaning that of course social workers and social care staff are going to find some of what they hear from their clients distressing (they are human afterall), but when it becomes too debilitating for them to deal with is when they may have crossed a professional line??

 I know when I have interviewed for features some service users who've told me about their traumatic experiences I've found it upsetting, however I have never shown this distress to them as I didn't want to influence what they were saying. Afterwards I've just processed it and been grateful they were brave enough to share their stories with me. I am lucky that hearing this sort of thing is not part of job day in, day out, as it may be for some social workers.

Senior writer, Community Care

Top 10 Contributor
Male

Ah, OK.

I think I see the confusion. I hadn't realised that support services were only available of formally requested by the managers. So really you're talking about direct access if people want it. In that case I absolutely agree that it should be available.

I'd interpreted your original post as basically saying people should have counselling whether they want it or not. I'd assumed that access would be there upon request anyway.

Ho hum.

Cheers,

Stuart

Top 150 Contributor

The agency workers dont have access to in house support.  its best to pay someone to assist and not allow details to be noted on your medical records- maybe its me but I dont want anyone in the NHS to write anything about me- the way the GSCC are ready to stake you to the cross should there be a need to find someone to blame, they sure dont see the bigger picture in my view. I dont tell anyone in SW anything about how I am feeling, I pay a therapist who is there for me and just me- is not worrying about protecting the "Local Authority"- but willing to understand the stress and difficulty of the job in hand.Yes I have supervision, but I talk about the cases/ clients- let the manager tell me what she wants me to do- agree with what she saying, unless its illegal. If the Local Authority want me to do their bidding, then my mortgage needs to be paid. Before anyone gets on their high horse about my comments- when you have been in a challenging position ie: possibly cant pay your mortgage, your prorities change.

Top 10 Contributor
Male

I see. As a nurse working either for the NHS or for voluntary sector organisations I've always had access to staff support (including counselling) if needed.

I realise that your concerns about confidentiality with 'in-house' services would prohibit some people using the service but the notion of there being no provision for those who want it seems very odd to me.

"I'd rather you than me" as they say.

Cheers,

Stuart

Top 200 Contributor

I do think there is a need for counselling to be an option for Social Workers. Why should we have to pay for 'treatment' when our job is playing with our emotional well-being. Counselling has its own place aside from supervision. There may be some things said in supervisions that managers could consider a capabilities issue unless counselling is accessed, eg, if you were assaulted and then found it difficult to practise with violent people.

Not Ranked
GJ replied on 11 Jun 2008 11:53 AM

Some people have said that counselling can make trauma worse. It should be borne in mind that there are many types of counselling and therapy. Any form of counselling that encourages people to relive traumatic experiences when they are in an emotionally aroused state will embed the trauma and make symptoms worse. If someone is genuinely suffering from ptsd (which is not particualrly rare) it is unlikely that talking things through with a manager will help. Appropriate therapy for ptsd is necessary, not just a chat. PTSD is relatively easy to treat but re-living the experience and getting upset while doing so is most definitely not the answer.

Top 75 Contributor
Female

GJ:

Some people have said that counselling can make trauma worse. It should be borne in mind that there are many types of counselling and therapy. Any form of counselling that encourages people to relive traumatic experiences when they are in an emotionally aroused state will embed the trauma and make symptoms worse. If someone is genuinely suffering from ptsd (which is not particualrly rare) it is unlikely that talking things through with a manager will help. Appropriate therapy for ptsd is necessary, not just a chat. PTSD is relatively easy to treat but re-living the experience and getting upset while doing so is most definitely not the answer.

This is a really interesting point GJ. So what are the alternatives?

Senior writer, Community Care

Not Ranked

What are the alternatives you ask.

 

Pretty easy I would have thought. Counselling that is appropraite for trauma should be available to all social workers. Supervision will simply not provide what is needed because the vast majority of managers will not be qualified to handle these issues in supervision.
At least one correspondent said that if a worker has developed symptoms of trauma then they must have allowed themselves to work outside a professional boundary. This is patently not true. Working in highly distressing situations on a daily basis will certainly make people susceptible to developing ptsd. It is not purely the responsibility of the worker to protect him/herself from stress, it is also the legal and moral responsibility of the employer. Many workers have workloads that subject them to levels of stress which are undoubtedly dangerous to their emotional health.
One problem is that workers may not always realise when they have developed ptsd because it is not a commonly understoo condition. This emphasises the responsibility of the employer to take a lead role in staff care. This would require action far over and above that taken by many employers in social care currently. It is important that employers realise that appropriate workloads and staff care policies are completely in their own interests. Not only will such policies avoid them getting taken to court for causing health breakdowns (this will happen more and more without a change in working culture), it will also provide far more competent workers. People who are stressed and those suffering from trauma have severely impaired thinking processes. They make bad decisions. Therefore dangerous mistakes can be made in the lives of service users. This will keep cases open longer and create greater problems for workers to unravel. Taking staff care seriously is win win for all concerned.
Top 25 Contributor
Female

Anabel - I have on another thread talked a bit about the Human Givens http://www.hgi.org.uk/archive/human-givens.htm approach to counselling and therapy. This recognises that many traditional approaches to therapy (talking about the past / what happened etc over and over) simply embeds the memory and reinforces it and therefore ensures that the impact of the event is longer lasting.  By contrast the Human Givens therapist uses something called the rewind technique to deal with highly stressful memories and which does not require the patient to verbalise the memories, similar to that used in NLP.  'Treatment' should be completed in only a very few sessions.

Human Givens is not normally available via referral to in-house therapy services - mainly because therapies such as CBT have a longer record of clinical trials.  The results of the clinical trials matter less than the fact that the trials have been held.

Top 10 Contributor
Male

Allelujah!

There is more to life than Rogerian 'archeology' and 'emotional drifting'!

Not Ranked

Couln't agree more re The Human Givens. I have received HG training and it is the most useful education I have ever received. The principles. ideas and appraoches are used by me every day professionally and personally.

As to the rewind technique, like much other stuff from the HG approach, it works, pure and simple!

Top 10 Contributor

As far as I know we have not written about Human Givens in Community Care... it sounds like an interesting topic to address though. I will ask my colleagues in the features department whether it is something they are interested to write about - I'm certainly interested to find out more, given what people have said on this forum 

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Top 75 Contributor
Female

aitch:

Anabel - I have on another thread talked a bit about the Human Givens http://www.hgi.org.uk/archive/human-givens.htm approach to counselling and therapy. This recognises that many traditional approaches to therapy (talking about the past / what happened etc over and over) simply embeds the memory and reinforces it and therefore ensures that the impact of the event is longer lasting.  By contrast the Human Givens therapist uses something called the rewind technique to deal with highly stressful memories and which does not require the patient to verbalise the memories, similar to that used in NLP.  'Treatment' should be completed in only a very few sessions.

Human Givens is not normally available via referral to in-house therapy services - mainly because therapies such as CBT have a longer record of clinical trials.  The results of the clinical trials matter less than the fact that the trials have been held.

Human Givens sounds interesting Aitch, and it's something I have never heard of before.

I'm personally a bit sceptical about NLP - my limited understanding of it is that a person can 're-programme' how they feel about particular things by changing how they communicate and think about it - and I wonder how HG benefits individuals? I'm not sure how a person can deal with a stressful memory if they do not verbalise it?

Has anyone gone through HG? Either as part of their training for their job or personally? I'd be interested to hear anyone's experiences, if people want to share this information.

Senior writer, Community Care

Not Ranked
I have been trained in HG and have used it extensively.
The thing about the rewind technique is that it allows a traumatic memory to become an ordinary memory. I will try and explain. When we experience trauma there is a possibility that the event will be stored by the brain in a way that is different from ordinary memories. Most events in our lives are 'processed and broken down' by the brain so that we can fully understand them. However when we experience something traumatic there is a chance that the WHOLE EVENT will be stored by the brain in the amygdala. When this happens the 'victim' only needs to experience something vaguely connected with the original event to bring back the whole event. This is best explained by a couple of examples. One evening a knock at the door is answered. A policeman is there and announces that a very close relative has been killed in an accident. The person hearing this news goes into shock. They experience panic, numbness, palpitations, changes in body temperature, desperate sadness, disbelief all at the same time. The event is so shocking and the person so emotionally aroused that the event is stored as a whole event in the amygdala. So in future it may only take something like a knock at the door or the sight of a policeman or even a uniform to bring back all of these symptoms. And of course each time it happens it embeds the trauma, so that it is possible for more and more things to be capable of triggering off the original trauma. Another example.Someone is bitten by a large dog. In future it may be posible for the sight of a dog or just the sound of a bark to trigger the whole experience. Again each time it is triggered the experience is embedded. This also highlights why many phobias are in fact cases of ptsd. Whether or not something is stored as a traumatic event is not dependent so much on the seriousness of the event itself as the person experiencing it. Their past experiences, levels of emotional arousal and ability to stay calm will largely determine whether an event is stored as a traumatic one. Hence two people can process the same event in completely different ways.
The rewind technique allows the memory to be processed properly. It works simply. The person is taken into a deep state of relaxation and then gradually allowed to visualise a fast forward and fast rewind of the original event. This is done repeatedly. What happens is that the brain is allowed to re-experience the original event without becoming traumatised. So that in future the brain does not have to make the connections that had previously triggered the re-experiencing of the trauma. The original memory then becomes processed like an ordinarry memory. This allows a person to remember something sad and experience appropraite sadness but without becoming traumatised. An important thing to keep in mind with both ptsd and phobias is that what the person thinks they are afraid of is not what they are actually afraid of. EG the person with the dog phobia is not actually afraid of dogs. They are afraid of the impact of a memory. Once the distorted memory has been dealt with events in the here and now can be experienced normally.
Hope this helps.
GJ
Top 75 Contributor
Female

Thanks GJ, you've made the HG approach a bit easier to understand.

Senior writer, Community Care

Top 200 Contributor

Ahh we in features are way ahead of the game! Here is the link to a piece we published back in April 2004 on the human givens approach: http://www.communitycare.co.uk/Articles/2004/04/01/44296/finding-the-missing-pieces.html

Top 50 Contributor

I think one interesting barrier to social workers getting counselling is THEMSELVES. I know one social worker (child protection) who was in desperate need of counselling, but said she would too readily judge the professional capability of the counsellor...! anyone else seen this happening?

 
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