Working with Risk in Counselling and Psychotherapy

Synopsis

The wide-ranging contexts in which counselling and psychotherapy is now practiced means clients present with a range of risks that therapists have to respond to. Risk is an ever-present issue for counsellors and psychotherapists and, in an increasingly litigious culture, the need for trainees to develop a sound understanding of how the right tools and the right knowledge can support their practice has never been greater. In this book Andrew Reeves takes trainees, newly qualified practitioners, and more experienced practitioners step-by-step through what is meant by risk, offering practical hints and tips and links to policy and research to inform good ethical practice along the way.

This book tackles:

 The definition of risk and how risk is linked to social, psychological and relational factors

 Working with those who are at risk of suicide, self-injury, self-harm and/or are an endangerment to others

 How therapists should respond to the risk in situations involving child protection, mental health crises, and in the therapeutic process itself

 The positive side of risk-taking

 How counsellors and psychotherapists can work with risk proactively and positively, informed by research.

Filled with case studies, ethical dilemmas, reflective questions, discussion questions and further reading, this book offers counsellors and psychotherapists guidance on how they can work with risk proactively and positively. It is an essential resource for all services, organisations and individual practitioners.

Summary

Chapter 1: Understanding Risk in Counselling and Psychotherapy

* Definition of risk as a potential threat to a client's well-being
* Risk factors and protective factors in counseling situations
* Ethical principles for managing risk
* Real example: Assessing risk for a client with a history of suicidal ideation

Chapter 2: Screening for Risk

* Importance of regular risk assessments
* Structured and unstructured risk screening tools
* Cultural considerations in risk assessment
* Real example: Using a suicide risk assessment tool with a client

Chapter 3: Assessing Risk in Specific Situations

* Assessing risk in crisis situations, such as suicide or self-harm
* Assessing risk for clients with mental health disorders
* Assessing risk for clients with substance abuse issues
* Real example: Assessing risk for a client experiencing an acute panic attack

Chapter 4: Managing Risk in the Counseling Process

* Safety planning and crisis management strategies
* Establishing clear boundaries and limits
* Consulting with other professionals
* Real example: Developing a safety plan with a client with cutting behaviors

Chapter 5: Confidentiality and Risk Management

* Ethical and legal obligations to maintain client confidentiality
* Exceptions to confidentiality in cases of risk
* Balancing confidentiality with the duty to protect
* Real example: Managing confidentiality concerns when a client discloses harmful behavior towards others

Chapter 6: Documentation and Record Keeping

* Importance of accurate and comprehensive documentation
* Content of risk-related documentation
* Use of structured risk assessment tools
* Real example: Documenting a client's suicidal ideation and safety plan

Chapter 7: Supervision and Risk Management

* Role of supervision in supporting practitioners in risk management
* Supervisor's ethical and legal responsibilities
* Peer support and consultation networks
* Real example: A therapist seeking consultation from a supervisor about a client's elevated risk of harm to self

Chapter 8: Cultural Considerations in Risk Assessment and Management

* Impact of cultural factors on risk perception and help-seeking behavior
* Modifications to risk assessment tools to account for cultural differences
* Creating culturally sensitive interventions and support systems
* Real example: Adapting a risk assessment tool for a client from a non-Western culture

Chapter 9: Training and Continuing Education

* Importance of ongoing training and education in risk management
* Core competencies for practitioners working with risk
* Ethical and legal implications of not maintaining competency
* Real example: A therapist attending a workshop on suicide prevention