I read this morning of yet another person claiming to be a therapist who had had sex with his clients. Carmine Baffa from Atlanta persuaded as many as eight people to have sex with him while claiming it was part of their treatment. He bought a Ph.D. online and claimed to be a therapist, although he is not a licensed psychologist, psychotherapist or counsellor of any sort.
He wasn’t the first, and he certainly, sadly, won’t be the last. Given that people seeking professional help are sometimes in a very vulnerable place in their lives, and given that there are a plethora of people out there willing to either work with them or exploit them, I thought it would be a good time to rehearse some of the questions that anyone seeking counselling or therapy ought to ask of the person they go to see. Having been a counsellor/therapist in private practice for a number of years, I know from personal experience that very few potential clients actually ask these questions in the early stages of our contact, if ever at all.
Qualifications
Millions of years ago you might have gone to any dentist who felt they had a gift for removing teeth, but these days you are only likely to go to someone who has had several years of professional training at university. Ask your counsellor what level of training he or she has had, and ask to see the certificates. There are hundreds of tin-pot organisations offering certificates in counselling skills, based on a relatively short period of superficial study. Personally I would be skeptical of anyone who had not had several years of study at a reputable university - and diplomas and degrees are preferable to certificates.
Professional Membership
In the UK, at the moment (there are slow moves to get it changed), any one can claim to be a therapist or counsellor. However, the reputable ones are all accredited members of respectable national bodies such as the British Association of Counselling and Psychotherapy (BACP). This means that in addition to their years of academic study, they have also had to gain several hundred hours of supervised practice demonstrating competency. Watch out for ‘accredited’ membership. As a student, for example, you can be a member of BACP, but only accredited members have demonstrated (amongst other things) both training and practical competency.
Ask your counsellor about membership of professional bodies, about the level of membership he or she has, and about the criteria for determining that level of membership. Ask to see proof of membership.
Model of Therapy
Ask what kind of counsellor he or she is, and try to do some research once you are given the answer. For example, Person Centred Counsellors are very different to Cognitive Behavioural Therapists, and Gestalt Counsellors are very different to Rational Emotive Behavioural Therapists. Each ’school’ has a different set of underlying core assumptions and will encourage practitioners to work with clients in a particular way.
More and more counsellors these days are describing themselves as ‘eclectic’ or ‘integrative’ meaning that in addition to their initial training, they have picked up ideas and skills from other counselling models and try to integrate these into their practice for the benefit of the client. Rather than sticking rigidly to one model, they tend to go with whatever suits the particular client best.
For most clients, the model used is not a big issue - the therapeutic relationship they form with the practitioner is far more important. However, for some, knowing the kind of way the counsellor is likely to work is important.
Area of Expertise
Ask about any particular area of expertise a counsellor may have. Some clients are not initially able to identify their problems and value the chance to explore with a trained professional. However, others are well aware of particular areas they want to work on and they are looking for specific and skilful help. If you and your partner are attending, you may wish to see someone who has both training in and experience of working with couples. If you are struggling with an addiction, or with obsessive compulsive disorder (OCD), for example, you may wish to assure yourself that the counsellor you are seeing has experience of working with clients in these areas.
Record Keeping
Ask your counsellor what records are kept, how they are stored, and for how long they are stored. If records are kept on a computer, ask about whether or not they are encrypted. If the answer is ‘No’ then any technician at the local computer shop is likely to be able to read your records every time the computer is taken in for a memory upgrade or to fix a hard drive failure. If they are kept in a filing cabinet, is it one which is securely locked?
Professionalism
How professional is the counsellor in terms of his or her honesty in advertising, openness about charges, willingness to offer receipts for payment, making and keeping appointments, and time keeping? Does your counsellor have professional insurance to operate? If boundaries are crossed here, they may also be crossed in therapy.
Confidentiality
If you are not told, ask about what confidentiality policy is in operation. Confidentiality is not the same as absolute secrecy. There may be occasions when any professional counsellor may need to talk to other trusted professionals about something that takes place in any session. Find out what these occasions are and assure yourself that you understand and are comfortable with them.
Code of Ethical Practice
Find out whether or not your counsellor follows a code of ethical practice which spells out his or her requirement to work in your best interests at all times, and which often advises on acceptable practice in situations which may initially appear ambiguous. Any counsellor who is also a member of a national professional body will almost certainly be required to agree to a code of professional conduct before becoming a member.
Accountability
There are two ways in which any reputable counsellor operating in private practice is accountable for his or her practice. Membership of a professional body means that clients can complain and, if the complaint is upheld, gain some form of redress. In the UK the ultimate sanction is removal from membership of the professional body. Readers of newsletters and journals produced by the professional bodies will know that this does, in fact, happen on a regular basis.
The second, more immediate, form of accountability, is through regular supervision. Reputable counsellors are required to meet regularly with experienced practitioners who will question and support ways of working with particular clients and monitor practice. For example, BACP members are required to have at least one and a half hour’s supervision a month.
When an individual is encouraged to be vulnerable on a regular basis with another human being, it is inevitable that the level of intimacy between the two increases. In order to protect herself or himself, potential clients should make more efforts to ensure that the person they are planning to see has sufficient knowledge, experience, skill, and protective structures in place to make it very, very likely that the counselling experience will be therapeutic rather than damaging.
Excellent advice. And a perfect blog to demonstate the importance of proper training which will be mentioned as vital in my next blog. This is perfect timing athinkingman, I could not have done it any better myself if I had tried.
Very good post. Your advice can be applied when evaluating practitioners in a wide array of professions.
One of my jobs used to be checking the equivalence of qualifications presented by candidates for degree courses. Given that candidates came from all over the world, this was not always easy. Fortunately, there were expert bodies I could consult but there was always the possibility that bogus qualifications could slip through. We had a list of institutions who would sell you anything from a school certificate to a medical doctorate.
Putting it more succinctly, suppose someone claiming to be a police officer shows you his warrant card: are you confident that you would infallibly accept a genuine one and reject a bogus one? Personally, I don’t know what a police warrant card looks like.
There is unfortunately no certain way to immediately detect a fraudster. False qualifications seem to turn up every year in the heart of the NHS, the owner having perhaps practised advanced medicine or surgery for years without being unmasked.
Anyone who lies about his qualifications will lie about the rest. Conmen are very plausible.
[...] will love that analogy just written). He will think himself as a screw-driver from now on. (see here for a list of what you need to ask when considering [...]
It is very good advice but I suppose people are so desperate to get help and often such a mess that it is the last thing they think of - it feels like challenging someone sometimes when you ask about their qualifications etc and if you are already feeling shaky you do not want to do that.
I think things are easier now than they once were since most people tend to do a bit of research online before they approach someone - I know I would. But I guess checking qualifications and going on the recommendations of others are still the safest approach.
But Silver Tiger is right about the plausibility of conmen. We get students from time to time who lie about their backgrounds and I recently had a member of Research Staff who had woven a complete web of deceit and was only found out after she had worked with us for about a year.
That’s sad. Taking advantage of his vulnerable, mentally ill clients for sex is a bit like being a child molester, the way I see it. Thanks for bringing up the issue, hopefully this post will be helpful to someone.
[...] why I was so pleased to see this excellent post from athinkingman which really covers everything you need to ask of a potential practitioner (in [...]
Hey, this is a great post - thanks! BTC