Question/Answer Corner: What’s On Your Mind?
Q: A client sees you once or twice and expresses a fairly high degree of sadness about the death of a spouse or close friend/family and perhaps even expresses a history of self-harm, although you don’t feel that the client is in imminent danger of self-harm at the time. Then, the client cancels subsequent appointments. You reach out and get no response from the client. What should you do? Anything?
A: Protect yourself by sending the client a letter stating that since he/she has canceled appointments and is not responding to your phone calls/emails that you are closing the case at this time. You should also state that if the client wishes to return to see you in the future, you are fine with that, but want the client to know that at present, you are closing his/her file. You can provide some referrals to emergency crisis lines or Hospital ER departments, but don’t make it seem as though you believe the client is in danger of self-harm.
The liability with leaving a case “open” is that if the client were to hurt him/herself, the case might be made that you were still the therapist and, therefore, responsible for not making sure the client was protected by hospitalization, etc. The letter indicates that the therapeutic relationship is terminated and you should state expressly that you are no longer the client’s therapist, although if the client wishes to reinstate the therapeutic relationship, he or she may do so. That way you are handling the matter ethically from a clinical standpoint (offering referrals and the opportunity to reinstate therapy), but also making sure to protect yourself legally. Understand that if the client commits suicide, you can still be sued, but hopefully the termination letter will aid in your defense that you were no longer the therapist and not responsible for the client’s self-harm.
New Year’s Resolutions – Why and What Type are Most Likely to Endure: Does This Understanding Help Us with Other Types of Personal Growth Techniques?
My idea for writing this blog is to ask to questions about such resolutions. First, why do we make them? Second, is there a particular type or version of the age-old New Year Resolution that is more likely than other types to remain part of our consciousness past January.
Much is made of New Year’s Resolutions and most of us probably make them in one variety or another. Forbes contributor Dan Diamond writes that 40% of Americans make such resolutions.
And, research from the University of Scranton suggests that just 8% of people achieve their New Year’s goals.
So, first – why do we make these resolutions if statistically we are likely not to keep them? Most things we do that fade from our minds fairly quickly we probably don’t repeat year after year. So, why keep making the New Year’s Resolutions?
Other blog posts you might be interested in:
DORA: What’s On the Various Boards’ Radar?
I try to attend all the public Board meetings of all the Mental Health Boards: Social Work, Professional Counselors, Psychologists, Marriage & Family Therapists, Addiction Counselors, and Registered Psychotherapists. Each month, this section will address current issues that arise in various Board meetings that may seem helpful for practicing clinicians.
LPC Board Meeting:
There were 3 issues at this month’s meeting that I thought might be helpful to bring to your attention. First, one case involved allegations of fraud and the Attorney General noted that in order to find the licensee guilty, it must be proven that he or she must had the requisite intent to commit fraud. As in another case before the Social Work Board last month where fraudulent billing was alleged, due to the lack of any intent to commit fraud (that case involved merely a mistake in billing), the Board found no violation. Here in the LPC Board meeting, the matter was referred to Executive Session (the private portion) so I do not know how it turned out, but unless fraud was evident, that aspect of the case likely would be dismissed.
Second, although I have mentioned this before, the LPC Board Chair reiterated that once a file is open before the Board during the consideration of a matter that came before the Board via a Complaint, anything is available for the Board to consider. What the Chair said is this: “When files are open to us, we’re looking at all documentation even if not related to the allegations of the Complaint.” This is important to understand and why I recommend that if you receive a Complaint, you seek legal representation before responding to any requests for production of materials from the Board or one of its investigators. All of your material will be examined, including all the Boards’ favorite: the mandatory disclosure. For any of you who have not yet revised your mandatory disclosure statement to comport with the Board’s revision a couple years ago, now would be a good time to do so. Each Board lists a sample on the web site and instructs you on what needs to be contained within the disclosure form.
Finally, another issue the Attorney General noted during the LPC Board meeting was concerning a rather unusual situation where a Complainant (in this case, the ex-wife of the licensee) wanted to withdraw her Complaint. The AG noted to the Board members that even if the Complainant wishes to withdraw a Complaint, the Board still proceeds to investigate the allegations because “there may be issues that the Board needs to address.” In other words, once filed, a Complaint lives on irrespective of whether the Complainant recants. Of course, if there is nothing other than the allegations of the Complainant and no merit to those allegations, the fact that the Complainant states that he or she wishes to withdraw the Complaint indicates a lack of credibility in the allegations. But the Board will still examine all that is brought before it.
Training/Legal Consultation For Clinicians/Agencies
Deb has been providing training for high risk clinical situations and legal involvement of the therapist for groups here in Colorado. Deb consults with agencies to help therapists prepare for deposition or trial testimony, or to handle a subpoena request for clinical records.
Deb is available to meet with individual therapists who need risk prevention consultation and/or with groups of any size for any type of self-protective, clinical practice in this litigious age. Deb will be working with a staff group of around 70 in March 2017. She can custom tailor training to your particular agency or small group with questions submitted in advance by participants, if desired.
She is offering the following training in New Orleans in 2017 and would be happy to provide a similar presentation for groups in Colorado: Ethical, Clinical Practice in the Electronic Age.
What people said about my most recent seminar:
- “I always enjoy your trainings. I appreciate your flexibility in regards to discussing audience members’ concerns/experiences.”
- “My third seminar with you — you are great! Keep on teaching this class…”
- “Always great! Thank you! Wish you had more throughout the year… You are engaging and positive.”
- “Excellent! I could not think of anything to improve on this workshop. Keep doing what you’re doing.”
- “Excellent presentation. Very informative and well thought out frame work. Thanks Deb!”
- “Presenter was engaging, knowledgeable, and very thorough.”
- “Great seminar and very informative. Thank you!”
- “Very intriguing and engaging session.”
- “Nice work! Very interesting, especially when examining specific case studies.”
Deb’s Clinical Practice
(1) Referrals being accepted for women’s therapy group to begin later this fall. Good candidates include women between ages approximately 35 – 60 who are undergoing a significant life transition, such as (a) loss of job, (b) major health issue, (c) divorce or death of partner, or (d) depression/anxiety that you believe group work would help. Client would continue in individual therapy with referring therapist – group would only augment clinical work. Group will meet in the evening at Deb’s Lakewood office.
(2) Deb will be teaming up with a trauma Yoga instructor who offers Trauma Sensitive Yoga for survivors – both a teen group and a women’s group. We will be offering short-term (probably 6-week) groups starting in the New Year. These groups will be structured around providing a safe space for survivors of any type of trauma. Here is the blurb about the group:
Certified Trauma-Sensitive Yoga Instructor Rachel Stroud and Therapist Deborah M. Henson, LCSW are collaborating to offer two 6-week Trauma-Sensitive Yoga Workshops. One workshop is aimed towards teens who have survived or are enduring any type of trauma and the other is geared towards women trauma survivors. If you are a trauma survivor or know of someone who could benefit from this type of workshop, we’d love to hear from you so we can come together to find a 6-week slot that works for the majority. Please email Rachel Stroud at firstname.lastname@example.org or call at 405-640-5132 to express interest and to collaborate meeting times.
Rachel & Deb are passionate about helping trauma survivors navigate through their healing journey and offering a safe place for them to heal from the deep places where trauma is held within the body. Trauma-Sensitive Yoga provides survivors with the opportunity to heal from the source, empowering them with renewed relationships with their bodies.
- Learn how to connect with your breath, mind and body to provide calm and safety within
- Learn techniques to help release stress, tension and anxiety
- Find connection, strength and support with others in a safe setting
- Learn to process your trauma & healing through movement, optional group sharing, journaling and mindfulness.
Trauma is different for everyone. The exact same traumatic event can, and likely will, affect individuals differently. Trauma can be, but it not limited to:
- PTSD of any kind
- Childhood trauma
- Sexual trauma
- Surviving a natural disaster
- Surviving/witnessing an attack
- First responders holding trauma from their first-hand accounts on the job
- LGBTQ processing/marginalization/discrimination/questioning…etc.
- Emotional/spiritual/physical abuse or trauma
- Death of a loved one and/or close encounters with death
- Surviving an accident
- Surviving or witnessing anything horrific and/or traumatizing
(3) Deb offers family counseling to those who have a LGBTQ kid or family member of any age coming out. If sufficient referrals come forth, Deb will start a multi-family group, which is very potent for families who feel isolated as in these situations. For more info, please call or have the family member call Deb at 504.232.8884. Deb is also a new Board member for PFLAG and will be assisting with the support groups in the near future, including the family and significant other support groups.
(4) Post-Divorce Facilitation – if any of your clients are considering divorce or have recently gotten divorced, I am available to help facilitate the process between the parents with the co-parenting of their children. It takes a new headset to become successful, non-conflictual co-parents, especially when the baggage of divorce litigation is hanging heavy over their heads. If you want more information about the co-parenting facilitation, feel free to email or call me or have the interested client contact me.
(5) Deb’s therapy office in Lakewood (Green Mountain area) is available for reasonable subletting by day, half-day, or evening. A couple evenings have been taken, but some remain as do a few days or half-days. Please check out her listing on Craigslist Denver or call her for more info or to schedule a time to visit the office: 504.232.8884.
Legal Services Offered
- Legal Representation & Consultation for grievances (complaints) to licensing boards and/or malpractice lawsuits
- Training & Consultation for Clinicians and Agencies (e.g., respond ethically to subpoenas while protecting yourself and your clients; identify high-risk clients and situations to avoid client disciplinary complaints and harm to clients or third parties)
Deb Henson is an Attorney and LCSW (Tulane School of Social Work, MSW) in private practice in Denver and New Orleans, specializing in mental health licensing defense. She represents clinicians in DORA grievances (CO) and licensing board Complaints (LA) and regularly consults with clinicians in both states to help them deal with legal and clinical conundrums, such as: (1) the receipt of subpoenas for records or testimony; (2) the escalation of high-risk clinical situations; and (3) other sticky ethical wickets that arise in clinical practice. Deb helps clinicians develop self-protective, clinically sound and legally proper strategies for risk prevention.
Deb also maintains a clinical practice in Denver, with an office in the Green Mountain area of Lakewood. Through that private practice, Deb offers individual and couple therapy, and work with LGBT individuals and families. Call her for more information about clinical services or to schedule an appointment: 504.232.8884.
Deb has been presenting half- and full-day seminars on “Avoiding Ethics Complaints and Malpractice Lawsuits” or “Legal and Ethical Issues in Clinical Practice” around the country through PESI, Inc. for over 7 years and presenting for many CEU groups in Louisiana and Colorado. She also has lectured for Tulane School of Social Work Continuing Education and the University of Texas School of Social Work (Austin) Continuing Professional Development program, and for many other clinical and counseling groups. Deb started her own training biz — Beyond Ethics, LLC — in 2009. Contact Deb for group presentations to agency staff and/or private practice consultation groups.
Deb can be reached through her law and social work web site: www.deborahmhenson.com or through her training web site: www.beyond-ethics.com. Deb can also be emailed at email@example.com or firstname.lastname@example.org. And, you can use the old tried and true method of calling her at 504.232.8884.