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Boundaries and counselling


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#1 Angelot

Posted 20 January 2013 - 08:07 AM

Question, for outside perspective:

A counsellor is seeing a client.  The counsellor's colleague wanders in during the session with a coffee for the counsellor (does not knock or anything first, just walks in).  The client is very upset, feels that her privacy and confidentiality have been seriously breached, but the colleague seems to think what she did was normal.

WDYT?  Random coffee deliveries in that setting, ok or not?

#2 Maple Leaf

Posted 20 January 2013 - 08:10 AM

I would think not ok.

Most counsellors won't accept phone calls during a session let alone a random walk in with coffee.


#3 Guest_Dinah_Harris_*

Posted 20 January 2013 - 08:11 AM

Not okay,  and breach of trust and confidentiality in my opinion.    For some,  it's incredibly difficult to open up to one person,  without someone else randomly wandering in.

#4 WithSprinkles

Posted 20 January 2013 - 08:13 AM

No. I don't think it's very professional for a coffee to be drunk during a session either (unless the client also has a coffee).

#5 CountryFeral

Posted 20 January 2013 - 08:13 AM

Definitely needed to knock first.

Absolutely.

That has happened to me - there was a knock and a muffled voice from the other side of the door, my counsellor asked "Oh do you mind if my colleague brings in a cup of tea?" I said "No." counsellor stood up went to the door took cup of tea and closed the door again.

Jeepers we don't even barge in when we are having a student chat!  (although sometimes there is crying and counselling going on there too - not deliberately though!)

#6 Pompol

Posted 20 January 2013 - 08:14 AM

All kinds of wrong.

Eta: misread the OP. what did the counsellor say/do?

Edited by Pompol, 20 January 2013 - 08:16 AM.


#7 MrsWidget

Posted 20 January 2013 - 08:21 AM

That is completely inappropriate.

#8 zrello

Posted 20 January 2013 - 08:27 AM

Not a breach of confidentiality, as colleague could have seen her in the waiting room, and I would assume they stopped talking when colleague entered. It is unprofessional, but depends if appointment was scheduled at that time.  If colleague thought counsellor was free & didn't realise they were with someone, that could explain it. But usually closed doors means you knock, counsellor goes to door, explains they are with someone & can they catch up later.
Coffee should be offered to patient, or not drunk at all.

#9 Feral Borgia

Posted 20 January 2013 - 08:28 AM

It probably wouldnt bother me....I mean the minute I heard the door open i would stop talking and presumably the counsellor would too...or would switch to something innocuous like "oh thanks for the cuppa" so I wouldn't expect anything private to be revealed in the presence of the third person.....it WOULD upset me if it were a drs room and I was...for example...being examined and had my gear off.....

#10 Cat People

Posted 20 January 2013 - 08:32 AM

I think it's very unprofessional but I'm not sure how privacy and confidentiality has been seriously breached?

#11 alwayshappy

Posted 20 January 2013 - 08:36 AM

Unprofessional, and may be a breach of privacy/confidentiality if the colleague saw the client, who had previously been unseen or wanted to keep his/her presence private.

#12 caitiri

Posted 20 January 2013 - 08:37 AM

No its not appropriate at all.

#13 Phascogale

Posted 20 January 2013 - 08:40 AM

Unprofessional but not a breach of confidentiality as I'm guessing that as soon as the door opened that both would've stopped talking.  I can see why the client was distressed about it - especially if she was crying.  I'm guessing the way she feels is linked to why she's seeing the counsellor in the first place as I'm guessing most people wouldn't feel quite as strongly about something like this.

The colleague needs to be told never to do it again.  Knocking first and waiting till the door is opened (or someone yells to come in) is what needs to happen if there's something that can't wait until the appointment is over.  It's a concern that she doesn't feel that she did something wrong.

#14 WhimsicalDragonfly

Posted 20 January 2013 - 09:07 AM

I think its unprofessional and the wrong thing for someone to open the door to deliver a coffee during a counselling session. It may break the feeling of safety, security & predictability that you had in the room, interrupt your train of thought, and communicate that there are more important things to the counsellor than listening to you. Though may depend in how well you know the counsellor and how formal or informal the setting is, and the nature of the counselling (ie how sensitive the topics discussed are).
I think coffees should preferably not be in sessions, but if they have to be for some reason (counsellor sanity?!!), they should be prepared prior to the session starting and one offered to the client.
If this wasn't possible then, the counsellor should let the client know that someone will be delivering a coffee and that person should definitely knock!

#15 vanessa71

Posted 20 January 2013 - 09:33 AM

Wouldn't concern me at all. I fail to see how drinking coffee stops a person listening to me.

I think a knock first is appropriate, but apart from that I wouldn't care and I don't think there was a breach in privacy and confidentiality.


#16 JustBeige

Posted 20 January 2013 - 10:05 AM

QUOTE (Phascogale @ 20/01/2013, 09:40 AM) <{POST_SNAPBACK}>
Unprofessional but not a breach of confidentiality as I'm guessing that as soon as the door opened that both would've stopped talking.  I can see why the client was distressed about it - especially if she was crying.  I'm guessing the way she feels is linked to why she's seeing the counsellor in the first place as I'm guessing most people wouldn't feel quite as strongly about something like this.

The colleague needs to be told never to do it again.  Knocking first and waiting till the door is opened (or someone yells to come in) is what needs to happen if there's something that can't wait until the appointment is over.  It's a concern that she doesn't feel that she did something wrong.

I agree with this.

Unprofessional of the colleague.  Knock should have happened even if they didnt think a client was in there.  Immediate apology for the interruption and an offer of a drink to the client and a hurried exit would have been the thing to do.

Client is well within her rights to feel intruded upon.  

There was no breach of confidentiality or privacy unless the agreement with the client was that no one from the practise knows that she goes.

#17 ednaboo

Posted 20 January 2013 - 10:06 AM

It's unprofessional.  It wouldn't happen in a professional therapy session, but I accept that some counsellors work in a more laid back setting.  I don't see any good reason why a colleague needs to bring coffee in at that time.  


But I don't know that it is an invasion of privacy.

#18 toosenuf

Posted 20 January 2013 - 10:15 AM

Not ok at all, if i were the client, i might have lost all faith in the councellor, especially if the councellor thought that their colleague did not do anything wrong.

#19 Coffeegirl

Posted 20 January 2013 - 10:15 AM

QUOTE (zrello @ 20/01/2013, 09:27 AM) <{POST_SNAPBACK}>
Not a breach of confidentiality, as colleague could have seen her in the waiting room, and I would assume they stopped talking when colleague entered. It is unprofessional, but depends if appointment was scheduled at that time.  If colleague thought counsellor was free & didn't realise they were with someone, that could explain it. But usually closed doors means you knock, counsellor goes to door, explains they are with someone & can they catch up later.
Coffee should be offered to patient, or not drunk at all.


The last counselling centre I attended staggered their appointments so you only saw the receptionist and your counsellor. Never another patient or counsellor (small close-knit community where everyone knew everyone else's business).   So yes I see a breach of confidentiality.  

QUOTE (WhimsicalDragonfly @ 20/01/2013, 10:07 AM) <{POST_SNAPBACK}>
I think its unprofessional and the wrong thing for someone to open the door to deliver a coffee during a counselling session. It may break the feeling of safety, security & predictability that you had in the room, interrupt your train of thought, and communicate that there are more important things to the counsellor than listening to you. Though may depend in how well you know the counsellor and how formal or informal the setting is, and the nature of the counselling (ie how sensitive the topics discussed are).
I think coffees should preferably not be in sessions, but if they have to be for some reason (counsellor sanity?!!), they should be prepared prior to the session starting and one offered to the client.
If this wasn't possible then, the counsellor should let the client know that someone will be delivering a coffee and that person should definitely knock!


^^.  It takes a lot of time for some patients to build a sense of trust in the counsellor.   What if the patient was on the brink of divulging they had been abused or finally explaining the reason for their anxiety?   The interruption could put the patient back many days before they feel ready to open up again.

#20 désir d'amour

Posted 20 January 2013 - 10:19 AM

If the door is shut, you don't come in, unless the practitioner intercoms out for something/someone.   That's my opinion on anything where patient health is required, mental or physical.

anything else is entirely unprofessional and if the patient didn't want their presence to be known, I would consider that a breach of confidentiality.

#21 Alacritous~Andy

Posted 20 January 2013 - 10:20 AM

Definitely unprofessional.  I wouldn't be happy if someone walked in unannounced to a therapy session.  But then, I wouldn't be happy if someone walked in unannounced when I was talking to my accountant, or solicitor, or during any meeting, to be honest.  

But in terms of privacy breach? I think it depends.

I can understand a patient being upset if they have been intruded upon while visibly distressed.

#22 JJ

Posted 20 January 2013 - 10:25 AM

QUOTE (Coffeegirl @ 20/01/2013, 09:15 AM) <{POST_SNAPBACK}>
The last counselling centre I attended staggered their appointments so you only saw the receptionist and your counsellor. Never another patient or counsellor (small close-knit community where everyone knew everyone else's business).   So yes I see a breach of confidentiality.


That's a great idea. It's kind of awkward when you live in a small-ish community and the person that comes out before you go in is a school mum... ph34r.gif  (not to mention all the other people that come and go while you sit in the very public and busy waiting area)

As for the OP's scenario - definitely not OK.

The coffee - well some counsellors seem to do it, some don't, it wouldn't bother me... but no knocking - wrong for all the reasons already mentioned.

From personal experience, it seems to me that some counsellors do get rather casual and blasé about this kind of thing once they've been in the job for a while.

Edited by JJ, 20 January 2013 - 10:27 AM.


#23 weepingangel

Posted 20 January 2013 - 11:55 AM

QUOTE
It takes a lot of time for some patients to build a sense of trust in the counsellor. What if the patient was on the brink of divulging they had been abused or finally explaining the reason for their anxiety? The interruption could put the patient back many days before they feel ready to open up again.


This absolutely. The only counselling i have had was grief counselling after stillbirth. There was no way it would have been OK with me if someone had interrupted my time.

I would have felt like the counsellor wasn't really there for me as such and would not have gone back. It can be incredibly emotional and very taxing doing counselling, it's not just a chit chat, casual like.

When i was having counselling, the door was shut, a sign put up on the door saying "counselling in progress", telephone off etc and this was in a major tertiary hospital.

Truly unprofessional OP, i hope you are OK?

#24 Angelot

Posted 20 January 2013 - 12:05 PM

Oh thank God.  I was wondering if I had lost all perspective on this one.

QUOTE (zrello @ 20/01/2013, 09:27 AM) <{POST_SNAPBACK}>
Not a breach of confidentiality, as colleague could have seen her in the waiting room, and I would assume they stopped talking when colleague entered. It is unprofessional, but depends if appointment was scheduled at that time.  If colleague thought counsellor was free & didn't realise they were with someone, that could explain it. But usually closed doors means you knock, counsellor goes to door, explains they are with someone & can they catch up later.
Coffee should be offered to patient, or not drunk at all.


The thing is, this colleague does not usually work in this building and basically wandered in when I had no reason to believe she was even in the building.  The door wasn't actually closed but it was completely obvious that there was a discussion in progress, and it would still have been possible to knock on the frame or call out (and yes, it was a scheduled appointment).

No, I'm not really ok about it at all.




#25 Ianthe

Posted 20 January 2013 - 12:26 PM

That is very poor form. That could be really confronting (and obviously was) for the client. Not good for rapport and having the client be relaxed.




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