Tag Archives: Voice of Experience

Voice of Experience: Facing the wind

By Gregory K. Moffatt January 22, 2019

Sofia’s clothes were stylish and neatly pressed, and her jet-black hair was immaculate. Cropped short, not a strand was out of place. Subtle makeup highlighted her athletic features and youthful appearance, making her look much younger than she actually was.

Only by looking closely could I see a hint of red in her eyes. She had cried on the way to our appointment. Not surprising. Her life as she had known it was over.

Just two months before, Sofia (not her real name) had been a typical wife of a dozen or so years and the mother of two grade-school children. Aside from her stunning beauty, she could have been any one of a hundred other mothers in a car-rider pickup line or wandering the aisles of the grocery store. The life she shared with her husband consisted of packing school lunches, shuttling children and their playmates to soccer practice, managing their suburban home and running a small real estate business.

But all of that changed in a heartbeat. One careless decision led to a fleeting affair, which Sofia confessed to her husband, and their marriage was over. He couldn’t bring himself to forgive her, so she agreed to move out. Sofia was living in a small garage apartment belonging to a friend and saw her children for only a few hours on Saturdays.

Sofia was consumed with grief and, although you couldn’t tell by looking at her, every day she could scarcely get out of bed. The burden of her sadness was so heavy that, as I got better acquainted with Sofia, I could almost see her regrets weighing on her shoulders.

This isn’t a novel tale. Any of you reading this could undoubtedly identify many faces from your own client files, male or female, that would easily slip into the general details I’ve just laid out. After all, one of the main reasons people come to see us is because they’re facing the pains of life.

But one thing set Sofia apart from all of my other clients over the years. She taught me a lesson that has not only made me a better therapist, but has also helped me to manage my own depression as it has waxed and waned through the decades.

As much pain as she carried, Sofia forced herself daily to get out of bed and face the day, regardless of the tempest that was her life in the moment. Please don’t mistake my details of her appearance as misogynistic. My intent is simply to be descriptive of how much energy she spent preparing for the business of the day.

Anyone who has worked with grieving clients, clients experiencing major depressive disorder or similar diagnoses knows that failure to attend to personal hygiene is common. I have had clients come to sessions without showering, with their hair not having seen a comb or a brush in days, and still wearing a food-stained sweatshirt-and-sweatpants combo that doubled as their pajamas.

Not Sofia. Yet her appearance wasn’t an expression of vanity. It was one of professionalism and determination. She took full responsibility for her role in the dissolution of her marriage, but she refused to wallow in regret. In the most healthy way, she said to me more than once, “It is my fault, I am devastated, and I’m so sorry, but I will rebuild my life.” And she did.

Sofia’s appearance was an apt metaphor for a philosophy that said, “I will not be defeated.” And it worked for her.

In those early days of her new life, Sofia awoke each morning to face a strong headwind, but she plodded forward. Over the course of her recovery, the gale weakened into occasional gusts and, eventually, manageable breezes. All the while, the hole in her heart also began to heal.

As I’ve helped other clients work through life’s difficulties, I’ve recounted Sofia’s story numerous times. Even when she didn’t feel like it — even when it seemed her life was over — she got up, faced the day and conducted the business of life. What a powerful example.

Our final appointment was very brief. The cost of therapy was part of Sofia’s decision to terminate, but not the biggest reason. She explained that her days were getting easier and, just 15 minutes into the session, she thanked me and said, “I think I will be OK.” I couldn’t argue with her. As the door closed behind her, I knew she possessed the skills she needed to continue her recovery.

I was a very new therapist in those days, and I sometimes wonder which of us got the better deal. I doubt Sofia remembers me, but because of the lesson of courage she demonstrated, I’ll never forget her.

 

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: Avoiding boundary violations

By Gregory K. Moffatt December 17, 2018

Boundary violations happen in two general ways — a momentary bad decision or a long series of bad decisions that leads to a huge error. Here are examples of each.

A clinician friend attended a client’s graduation party. She had worked with this client for months as he dealt with the ending of his marriage, the loss of his 20-year career and the decision to go back to college to begin a new life.

The graduation party was a celebration of the long road they had traveled together as clinician and client. But the decision to attend was a mistake. It was a small party made up almost exclusively of relatives. Even though my friend stayed only a short time, the client introduced her as someone who had helped him through hard times. Subsequently, she was met with questions about her relationship with the client, whether they were dating and other awkward speculations.

Because of the way he introduced her, my friend could not clarify her relationship with the client. Her decision to attend the party was made with the best of intentions but clearly violated the client-counselor boundary. It is a mistake that she won’t make again.

The second type of boundary violation happens over time. Consider this scenario: “Bob” was a marriage and family therapist in his 40s who had been divorced for a little more than a year. His client, “Mary,” was a 40-something woman working through her own divorce.

Bob tried to ignore his subtle attraction to Mary, dismissing it as nothing that would lead to unethical behavior. She was his last client of the day and, eventually, he began allowing their sessions to run 10 or 15 minutes over the allotted time. Bob rationalized that he didn’t have to be in a hurry. After all, no other clients were waiting, and he had no place to be.

Bob also allowed the dialogue at the end of sessions to wander into questionable areas — his hobbies, movies that Mary liked, favorite restaurants. In the process, Bob discovered that he and Mary shared the same favorite restaurant.

After their first session, Bob allowed Mary to give him a “shoulder hug” at the conclusion of therapy — a behavior that became routine. Again, he rationalized this action as harmless. Mary initiated it, and he didn’t intend anything further to happen. He told himself that he had been in practice for many years and had never had an attraction to a client that he had acted on.

Then came the gross boundary violation. At the conclusion of a session, Bob and Mary lingered in the office for nearly 30 minutes, chatting like friends rather than therapist and client. Mary mentioned she was hungry and suggested that they go to their favorite restaurant and continue their conversation over dinner. Bob agreed.

At dinner, long gazes and awkward pauses made it evident that there were feelings between the two. Immediately following dinner, Bob called me, asking how to pull the reins back on their relationship.

Bob didn’t make one mistake. He made many mistakes that led to the most obvious one. Fortunately, he and Mary didn’t end up in a sexual relationship, but the boundaries of their clinical relationship had become so blurred that he chose to refer Mary to another therapist. This was a devastating setback to her. She had again been rejected by a man she cared about, even though Bob never intended that to happen.

Bob failed to recognized how his physical contact might be interpreted by his client. He ignored, rationalized and routinely failed to maintain clear time boundaries that help to clarify the therapist-client relationship. In addition, he failed to manage his attraction to Mary.

In Mary’s eyes, Bob was her friend, not her therapist, and over time, that gave her the green light to ask him to dinner. Accepting the invitation was just the last of Bob’s long series of errors.

My internship supervisor was an exceptional model of boundaries. She cared about me and wanted me to succeed, but there is no way I would ever have supposed that her concern for me was anything more than clinical. She was warm, friendly and gracious, but I laugh at the idea that I would have ever asked her to dinner. No way. She made our roles clear.

So, whether you have windows or no widows in your office door, whether you touch your clients or do not touch them, or whether you attend or refuse to attend a function such as a client’s graduation isn’t the issue. The issue is the clarity of boundaries and ethical behavior.

Our best insurance is integrity. I have worked very hard over my career to build a professional reputation that is so solid that any accusation would be met with, “You’ve got to be kidding!”

If Bob had done that, Mary would never have asked him to dinner.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: Know everything

By Gregory K. Moffatt November 19, 2018

If you want to be a good counselor, know everything. Did I get your attention? I don’t really expect counselors to know everything, but I use this simple phrase to make a point.

Remember how exciting it was when you finished your graduate work? No more tests, no more papers and no more assignments. When I finished my Ph.D., I reveled in the liberation of being able to read something because it interested me as opposed to plodding through some article or book chapter and wondering what my professor was going to ask about on a test.

I see that excitement in my students as they approach graduation. Some of them even tell me how they will never be a student again. In other words, they’re done with formal education.

I loved graduate school, but I understand those who don’t enjoy the academic regimen. Nothing shameful there. However, there is something ethically problematic if a clinician thinks that learning ends with the awarding of the sheepskin at commencement or even receipt of a license to practice professionally.

I often hear a troubling tone from colleagues regarding their continuing education requirements. In Georgia where I practice, we are required a minimum of 35 hours every two years. Sometimes people speak of these hours as if they are boxes to check off as opposed to a process that helps us improve our skills.

Continuing education isn’t something that you have to do for your license. It is something you must do to remain competent.

Your required hours for license renewal are what your state has determined is a minimum. I don’t want to be minimal. In my previous license renewal cycle, I had almost 60 CEU hours — nearly double the required minimum. One of my colleagues had even more. She was audited a few years ago and had more than 200 hours of continuing education over her two-year cycle.

Learning must continue for multiple reasons. Our ethical responsibility and professionalism are just two.

My continuing education isn’t limited to CEU hours. I have a passion for reading. For many years, I have made it a practice to read at least 25 books per year. Along with books in the counseling field, I also read at least one biography, one history book, one book on mathematics or physics, one book on chemistry or medicine, and one or two just for entertainment (I’m a Stephen King fan, if you’re curious).

A few different times, I have committed to and succeeded at reading a book a week for the whole year. I also read all of the journals from my professional organizations, plus kept up on the news each day.

I have an amazing luxury as a college professor. I am surrounded by scholars — among the best in their academic fields. Our university offers dozens of majors, and I regularly go to my friends in other disciplines and ask, “What should I be reading in your area?” Whether it is literature, history, business, psychology, social work or some other area, I am never disappointed at their suggestions. In fact, I’m disappointed only if they don’t have any.

Reading helps me relate to varied fields of study, professions and pop culture. This reading habit probably sounds boring to some of you. Again, it is OK if you don’t like to read, but at a minimum, you must stay abreast of your field in some way.

But learning brings more than that. With every news story I follow, every volunteer experience I have, every foreign country I visit and, yes, every book I read, I become a better counselor. I even use social events to learn. Instead of talking about myself, I ask about others. What is your career? What is most exciting or interesting in your life experience? I’m always thinking, “What can you teach me?”

Knowing something about everything helps us understand our clients. Even our jobs can teach us. I’ve had so many jobs in my past that I can’t name them all, but to list a few, I’ve been a truck driver, a coal miner, a painter, a carpenter, an electrician, a telephone operator, a teacher, a radio host, a restaurant worker, a bulldozer driver, a landscaper, and the list goes on. These experiences help me to understand the worlds in which my clients live.

So, I encourage you to be a learner. Know everything, even if you don’t pursue it the way I do. You will be a better counselor for it.

 

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If you are interested in some of my favorite books, you can find a reading list organized by category on my website (click on “Resources”) at gregmoffatt.com.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: Losing a client

By Gregory K. Moffatt October 22, 2018

My colleague sat across from me, teary-eyed, in the conference room where we had met so many times before while she was under my supervision. Now, only a few months into her new life as a fully licensed clinician, she had lost a client to suicide. She was understandably distraught.

The client was high risk from the beginning, but my colleague hadn’t missed anything. She had covered every base she could. She had developed a thorough safety contract with the client that included an emergency plan, coping skills for the client to use and an emergency contact person for the client. The last time my colleague had seen her client, he had appeared slightly improved. He had assured her that he would attend to the safety contract and would be back the following week for his appointment. Sadly, he took his own life two days later. Perhaps his perceived improvement was simply resolve to follow through with a suicide. We will never know.

I have never lost a client under my care to suicide, but I suppose that even now, in the twilight of my career, such a loss would be devastating to my heart and my esteem. My young colleague was just beginning to gain some confidence in her clinical skills. Approval from the licensing board had helped nudge her professional esteem into a reasonably healthy place — only to have this happen.

The tragic loss of a human being and the lifetime of pain such an act brings to family members is our primary concern, of course. But we counselors have to manage such tragedies too.

What did I miss? If only I’d hospitalized! Maybe more frequent sessions would have been better. These are among the obsessive thoughts that plagued my friend and brought her to tears that day in my conference room.

But the fact is, we cannot control the private lives of any of our clients. Some will be success stories, and others will not. All we can do as counselors is to guide them. A client’s life is their own.

When I began my career, I had a client who was having an affair but wanted to get his marriage back in order. Obviously, to reach that goal, the affair needed to end. But he chose to continue the affair, no matter how many times he acknowledged the damage it was doing to his family. The outcome was inevitable. Predictably, he and his wife eventually divorced.

Perhaps a better therapist could have helped him succeed in achieving his stated goal, but even in hindsight, I think not. He was determined to do what he wanted to do, and there was little I could do to stop him.

In a similar manner, I helped my colleague to see that even her client’s wife — someone who was with him most of every day, someone who slept in the same bed with him — couldn’t stop him from harming himself. He had been determined.

Saying “the client chooses” doesn’t remove responsibility from us as counselors. Therefore, she and I reviewed her procedures with the client to ensure that she hadn’t missed something. She had not. I suspect that even hospitalization wouldn’t have kept her client from eventually taking action.

Our clients will make their own choices. Sometimes they will relapse into addictions, return to abusive relationships and, yes, if you are in the field long enough and work with high-risk clients, some will even take their own lives.

Although we must have compassion for our clients, we must also develop something I call “disinterestedness.” This simply means that we must remain apart from the choices our clients make. We are “disinterested” in the sense that we won’t thrust our ideals upon them. Being compassionate usually comes naturally for counselors. That is why most of us pursue this career. Practicing disinterestedness, on the other hand, is difficult, but it is equally important.

Coping with this loss won’t be easy, but my friend is putting it behind her. So to you, my colleagues, I encourage you to remember disinterestedness in your practice, especially when your clients move in a hazardous direction. You cannot control them, and even if you could, that would overstep our ethical boundaries.

Yes, it is necessary for us to review such cases. If errors were made, put systems in place so that you won’t make the same errors again. But then move forward and do your job. Your clients’ decisions aren’t about you.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: One quiet hour

By Gregory K. Moffatt September 24, 2018

Seven-year-old “Adam” (not his real name) concentrates on the project in front of him. He is coloring on a piece of paper on the floor in my therapy room, and I am sitting close beside him. Crayons litter the floor, and I can see him thinking carefully as he selects each color. He leans back against my arm like a baby bird snuggling beneath its mother’s wing. This simple behavior says, “I trust you,” and it is a very good sign.

As he bends forward to color, he exposes his neck beneath the curls of his hair. I can see the fading remnants of bruises in the shape of fingers. Similar bruises are visible on the exposed skin of his arms. I know there are still more bruises in places I can’t see. I also know that he would never lean back against his stepfather like he is doing with me. It wouldn’t be safe for him. The touches he has received at home have not been gentle ones.

Adam’s world is very small. He lives in a small trailer and attends a small elementary school. He doesn’t play sports, take piano lessons or engage in any other activities outside of his home. He has never had a party or been to a sleepover at a friend’s house. Chances are good that he never will.

Adam’s world is small, but it is also very crowded. Siblings, stepsiblings, mother, father, stepparents, teachers, social workers, counselors, doctors, lawyers, judges — these are the people who inhabit Adam’s world.

Adam looks forward to coming to see me each week. When his world and mine overlap, it is just the two of us. We play in the sandbox, draw pictures or play with puppets. I learn a lot about his world from the way he plays, his choices of toys and the emotion he puts into the activities of our sessions together. Sometimes he talks of yelling and hitting. Other times he tells stories of policemen and social services workers. Still other times, he just plays quietly.

There is little I can do to make Adam’s home life easier. The law has done little to protect him and, as well-intentioned as they have been, social agencies have in many ways made his life harder. He is a powerless child at the mercy of a world of adults who like to think they care. But in reality, they care more about their own interests and personal agendas than they do about children like Adam.

To most of the people in his life, Adam is just the troubled kid whom nobody would miss if he disappeared. He is a child who makes teaching harder. He is the disruptive child whom parents don’t want their kids playing with. They can’t understand him, and many of them don’t even try. Even his caseworker is too busy and too jaded to connect emotionally with Adam. I can only help him develop skills to cope in his crowded and noisy world. It breaks my heart, but I’ve seen it many times.

In some ways, Adam is an enigma to me. He giggles as he tells me about something funny his sister did at home. How does he find happiness in this life he lives?

It always surprises me how the things of the world that otherwise would be important to me seem to fade in their significance when I am working with a child such as Adam. No matter what is happening in my life, when I close my office door and I have this quiet hour with a client, I don’t think about politics, war, terrorism, money or even my family. I concentrate fully on Adam. I am his for one hour. He knows he is safe with me and that I will always honor and respect him, his thoughts and his dreams. He knows I will not betray his secrets or laugh at his fears.

When our time is up, Adam rises to leave. He doesn’t look back as he exits my office. One way he copes is by living from moment to moment, investing only in that moment — no future and no past.

People often wonder how I work with children such as Adam. “How can you sleep at night?” they ask, shaking their heads.

I can sleep because I know that even if it is only for one hour, I can make a child’s world a little more tolerable. I know I am helping create a better world for children like Adam because for one hour, they can know they are safe and secure and that I really do care about them. I have no hidden agenda.

I can sleep because working with children like Adam helps me to put life in perspective. It makes me a better father and a better human being. This is my calling, and I wouldn’t have it any other way. This is why I became a counselor.

 

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.