As the textbook notes, “There are often two types of counselors in the addictions field: Those who have never been addicted and those who are currently in recovery” (p.  53). What is an ethical implication that can arise for a counselor who is also in recovery?

 

An ethical implication that could arise in a therapy session is: when a therapist feels a circumstance has arisen which could cause a complication in the manner in which they treat their client. If a therapist is in recovery and they meet a client that has a past similar to their own, then the complication that could arise is that the therapist could relapse, and join the addict in their addiction. The sessions could be where drug exchanges could take place and even become a place where drug-use occurs instead of recovery and treatment.

 

“If a provider fully relapses while treating patients, the path is clear: They should no longer practice, at least until they have firmly reestablished their recovery, Warren said. The hiatus is necessary not just for the safety of patients, but also to enable the clinician to focus on his or her own needs.” (Huffington Post, 2013)

 

While it is good for a therapist to have some experience in their field, there are issues in which at times the therapist is not able to help because of emotional and mental wounds that have not yet fully healed. This is why a therapist must understand their limits, what circumstances they can handle, and what triggers their wounds so that they know how to prevent their relapse. It is also good for a client to know who they can help and what they can help with, and stay away from the circumstances, people, scenarios, or age group that they feel are their triggersto relapse. In this case, if they do that then they will be able to help their clients fully and completely; this is better than if they were only partially able to care, and risking their license and the life of their client by only treating them half-way.

 

Pearson, Catherine. (April 25, 2014) Professionals in Recovery: When your therpaist has a eating disorder too. Huffington Post. Retrieved from:http://www.huffingtonpost.com/2013/06/19/professionals-in-recovery_n_3326103.html.

Transitioning to Closure

There are several tasks that will need to be accomplished with a member that will be terminating membership of an open group. First, members of the group should fully understand how to give notice and what steps need to be taken in order to appropriately terminate themselves from the group. Second, the member that is leaving will need adequate time to prepare emotionally for their departure. Next, other members of the group should have the opportunity to say goodbye. Different cultures view endings differently, and this should be taken into consideration. Lastly, a final individual session or follow-up call should be discussed and potentially scheduled. The group leader will need to get consent for this final session or phone call. Specifically, the group leader will want to review what the member learned during group counseling and how he will implement those things into his life moving forward. Referrals will be made when appropriate (Corey, Corey, & Corey, 2010).

Third and Fourth Sessions

Checking in with the members of the group kicks off the third session. During the check-in, one of the members, Jesse stated: “I am not feeling very good about myself today.”

Group Leader: “Do you want to tell us why you are not feeling good about yourself today?”

Jesse: “Not really.”

Group Leader: “Jesse we are here for you and we want to support you. We can only support you if you are open and honest with us. Tell us what is going on?”

Jesse: “I used meth over the weekend. I put myself in a vulnerable situation and I relapsed.”

Group Leader: “Ok, do you want to share with us what happened?”

Jesse: “I went out on Saturday night with a few of my friends. We ended up at a party and before I knew it, I was high!”

Group Leader: “Does anyone have anything to say to Jesse?”

Jackie: “Jesse what were you thinking? You should have called me. I told you that I would be here for you if you were ever in a vulnerable situation!”

Jesse: “I know Jackie, I think that deep down I knew that I was going to come across meth if I went out with my friends.”

Jackie: “Why do you think that you put yourself in that situation?”

The group leader’s responsibility was to dig deeper and find out what was bothering Jesse. After further questioning, Jesse opened up and shared to the group that he had relapsed. The members of the group must be willing to share and be open with the group in order to have meaningful interactions with other members (Corey, Corey, & Corey, 2010). Jesse getting honest with the group continues to build group cohesion. Jackie stepping in and offering support shows that group cohesion is getting stronger.

Also during the check-in, another member, Michelle stated, “I was sexually abused as a child.”

Group Leader: “Do you want to share with us what happened?”

Michelle: “When I was 13 years old, my uncle Tom sexually abused me. He used to take care of me when my parents were out of town. He would get drunk and sexually abuse me.”

Group Leader: “I am really sorry to hear that Michelle. How are you feeling right now?”

Michelle: “I’m angry!”

Jackie: “I was also sexually abused as a child, so I can relate. I too was angry. I did not trust men until I finally was able to work through the trauma.”

Michelle: “How were you able to work through the trauma?”

There are many fears that the group members could potentially have including the fear of being vulnerable, the fear of rejection, the fear of self-disclosure, or the fear of being judged (Corey, Corey, & Corey, 2010). Michelle opening up and sharing such a thing shows that she is feeling trusting and comfortable with the group. It is the group leader’s job to make Michelle feel safe, to fully recognize what happened to her, and to assist her in working through the event (Corey, Corey, & Corey, 2010). Depending on how severely Michelle is affected, it might be best to refer her to individual therapy to work through this traumatic event.

The third session closes with homework being given, to complete a Relapse Prevention Plan, which will be due in one week.

During the fourth session check-in, Mike states, “I got wasted at the game on Sunday. Not only did I get wasted, but I also drove home.”

Group Leader: “Wow Mike! That came out of the blue. Do you want to share with the group what happened?”

Mike: “I went to the game with a bunch of guys from work, and they were all drinking. I didn’t want to tell them that I didn’t drink. Therefore, I thought it would be okay to have a couple of beers. Next thing you know, I was wasted. I drove home after the game because I did not want to have to call my wife to come and pick me up.”

Group Leader: “So how are you feeling about yourself right now?”

Mike: “I feel like a loser. I let myself down, I let my wife down, and I let you guys down.”

Group Leader: “Mike we are here to support you and love you. Does anyone else want to say anything to Mike?”

Jesse: “Mike, I am here to support you in anyway that I can. I wish that you would have called me prior to taking that first drink.”

Jackie: “You could have called me Mike. I would have given you a ride home.”

Michelle: “How were you feeling prior to the game? What was going on that you were in a vulnerable place?”

The group leader’s job is to provide a balance between confrontation and support. It is the group leader’s job to support Mike in taking a risk and opening up to the group. Getting him to reflect on his behavior will promote a deeper level of self-exploration (Corey, Corey, & Corey, 2010). The members of the group want to love an support Mike as well. The group leader does a good job getting the members of the group to speak up.

Second Session

Because the group will composed of recently clean and sober adults, it is going to take more than one full session for the level of trust and comfort to be at a place where productive group work will take place (Jacobs, Masson, Harvill, & Schimmel, 2011). During the first part of the second session, the beginning stage will come to an end as the trust and foundation of the group are still being formed. An activity designed for the members to get to know each other individually will be next. The group will break up into dyads, and select a new partner every 10 minutes. Questions asked of each member will include:

  • Why do you want to be clean and sober?
  • What do you expect to get out of the group counseling experience?
  • What is your biggest fear about the group counseling process?
  • What is your level of trust in the group? What is contributing to your trust or mistrust?

During this session, one of the members, John stated: “I am uncomfortable being with groups and I really do not want to be here.”

In response to this statement, this writer herein described as Group Leader stated: “John, tell me more about why you are uncomfortable being with a group?”

John: “I do not know the other members of this group. Why would I want to open up and share with complete strangers?”

Group Leader: “If you got to know the other members of the group, would you feel comfortable being in this group and would you want to be here?”

John: “I guess so.”

Group Leader: “Does anyone else have anything to say to John?”

Jackie: “You and I have had several conversations and I feel comfortable opening up to you. I have learned from you and I think that you are an important member of this group.”

Michelle: “I think that you are an important member of this group and I too am glad that you are here.”

Group Leader: “What do you think about that John?”

John: “Wow, I had no clue. Knowing that other members of the group like me makes me feel more comfortable already.”

It is important here to get John to open up and express how he is feeling and what he is thinking. This will promote group cohesion and trust will start to be established if the facilitator can get him to share (Corey, Corey, & Corey, 2010). Getting other members of the group involved in the discussion helps John see that he is an important part of the group and it makes him feel more comfortable.

Checking in with all of the group members closes the session.