Professional Boundaries in Mental Health Care _ _________________________________________________
EMPATHY There is great power in empathy. It breaks down resistance and allows clients to feel safe and able to explore their feelings and thoughts. It is a potent and positive force for change [10]. Empathy serves our basic desire for connection and emotional joining [12]. Empathy may be defined as the action of under- standing, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another. It is a deeper kind of listening in which the counselor senses accurately the feelings and personal meanings that the client is experiencing and communicates this understanding to the client [10]. Empathy is not parroting back the client’s words or reflecting only the content of those words. It entails capturing the nuances and implications of what the client is saying, and reflecting this back to the client for their consideration using clear, simply connotative language in as few words as possible [13]. Counselors also can show empathy in nonverbal ways to their clients by, for example, looking concerned, being atten- tive, leaning forward, and maintaining eye contact [13]. Empathy is a multi-level process of relating to others. It encom- passes both an emotive experience and a cognitive one. It includes an intellectual component (namely, understanding the cognitive basis for the client’s feelings), and it implies the ability to detach oneself from the client’s feelings in order to maintain objectivity [14]. While engaged in empathic listen- ing, mental health professionals should remain responsive to feedback and alter their perspective or understanding of the client as they acquire more information [14]. Empathy may be summarized by the ability to [15]: • See the world as others see it. • Be nonjudgmental. • Understand another person’s feelings. • Communicate your understanding of that person’s feelings. Empathy should not be confused with sympathy, which may be defined as an affinity, association, or relationship between persons wherein whatever affects one similarly affects the other. Compared with empathy, sympathy is a superficial demonstra- tion of care. With sympathy, you feel sorry for the client; with empathy, you feel the client’s pain. Although a counselor can get caught up in the client’s feelings, he or she should always strive to empathically understand what the client is experienc- ing while maintaining emotional detachment. This potentially provides a broader perspective that extends beyond the cli- ent’s situational distress. Mental health professionals want to employ the best tools in order to affect change in their clients without causing harm, and empathy surpasses sympathy in terms of effectiveness. Research has validated the importance of empathy, unconditional positive regard, and congruence for achieving an effective therapeutic relationship [16].
knowing that the professional accepts it unconditionally [10]. In addition to unconditional positive regard, a growth- promoting therapeutic relationship also includes congruence and empathy. CONGRUENCE Trust is built and sustained over time through consistent limits that are maintained within the sacred space of each therapeutic hour. When a counselor is observed as consistent and congruent, the client notices. Being authentic is part of being compassionate and empathic. Clients know when a counselor’s words and actions do not match. These actions can be overt, such as cutting short the therapeutic time or going over the time allotted. They also can be subtle, as when leaked out and expressed through a stressed vocal tone, facial expression, or other body language indicator (e.g., arms folded across the chest). To the highly aware client, these actions can result in a loss of trust. Nevertheless, counselors are not perfect and can err from time to time. This is why it is important for counselors to be self-aware, acknowledge when their words and actions do not match, and discuss that within the therapeutic relationship. If a client notices one of these cues of incongruence and expresses it to the counselor, it is essential that the counselor listen openly and validate the client’s experience. Any defensiveness on the part of the counselor will decrease relationship trust. Conversely, this admission of human failure can actually build a stronger bond of trust. Clients see that counselors are, like themselves, human and imperfect. This presents an opportu- nity for clients to learn and then model this type of integrity in their own relationships. “Congruence for the therapist means that he (or she) need not always appear in a good light, always understanding, wise, or strong” [10]. It means that the therapist is his or her actual self during encounters with clients. Without façade, he or she openly has the feelings and attitudes that are flowing at the moment [10]. The counselor’s being oneself and expressing oneself openly frees him or her of many encumbrances and artificialities and makes it possible for the client to come in touch with another human being as directly as possible [10]. As discussed, this involves self-observation and self-awareness on the counselor’s part. This does not mean that counselors burden clients with overt expression of all their feelings. Nor does it mean that counselors disclose their total self to clients. It means that the counselor is transparent to the client so that the client can see him or her within the context of the therapeutic relationship [11]. It also means avoiding the temptation to present a façade or hide behind a mask of professionalism, or to assume a confessional-professional attitude. It is not easy to achieve such a reality, as it involves “the difficult task of being acquainted with the flow of experiencing going on within oneself, a flow marked especially by complexity and continuous change” [10].
4
EliteLearning.com/Social-Work
Powered by FlippingBook