Unstable in RL becoming a T?

Daeva, does this mean in all those 5 years you will not come into contact with any clients?

In my country we do an entry year, then year 1 of therapy training, and in year 2 i think you start getting clients, although you are very much supervised. And then there's a further year where you're out on placement i believe.

As I stated, I began this thread after talking to my department chair about a troubled student in my class who is getting her MSW to become a T (and will graduate in June). I know about this student's hospitalization because I excused her from an exam due to the hospitalization and, since returning to school, she has tried to talk to me as though I'm a counselor (which I'm not). Since I've had my own negative experience with a T (and I've read much worse stories on the forum), it simply frightens me to think of this student working with clients. Personally, I do not think many Univerisities and professional programs do sufficient screening. Some do, some don't. My question for PC was whether I'm justified to feel this way (after all, this student won't affect me personally; she'll no longer be my student at the end of the semester)-- however, I feel fear and empathy for any future clients she may have. Even as an intern, she already meets 1:1 with clients and all her supervisor knows is what she tells them. The clients don't talk to the supervisor.

My ex-partner, who I dated for 6 years, is also an MSW and she was unstable and, while I know now I made a huge mistake, at the time, I covered for her and did a lot of her work for her program so that she was able to graduate. No one at her school ever questioned or approached her about her absences or figured out that she was not the one who did half of her work (or why her handwriting changed). I'm fully aware of the horrible mistake I made, but I was only 21 and thought I was "helping" the woman I loved. Only after growing up a little did I realize that what I did was wrong. Now, she has the degree and practices and, from what I hear, she's still unstable (though I have not seen her). Perhaps I even feel guilty, and that's another thing motivating this question. I had not thought about my ex when posting initially, but I did afterwards.

ScorpioSis, i think it is imperative that people question another person's capability for a profession, in fact i think it is our civic duty to do so. Often we get to see aspects of another person that officials don't get to see, ie how they act in public or when not around the people who decide whether a person practices or not. If there are alarm bells ringing then that should be listened to, and flagged up. And there should be a place for that in college programmes. Far too much damage is being done in the therapy industry and it needs to be addressed.

I can see my T getting more withdrawn as in her life things are getting difficult. It makes me want to sugar coat my issues and look after her.

There seem to be 2 trains of thought here: one is what constitutes impairment, and whether that impairment is of short duration or a chronic condition; and the other seems to be a belief that any such impairment, as long as it isn't indicative of "instability," is ok, and maybe even an asset to practice (and I freely admit I completely disagree with the latter idea.)

I think flagrant acting out is usually noticed somewhere along the way. It doesn't mean that damage isn't done, but there is an awareness in the field about this. But the more subtle distortions are largely only visible to some clients and close friends. And great damage is done.

Nobody escapes this life without experiencing pain, and I find it absurd to think that pain must be diagnosed and treated to qualify someone as able to have empathy. And a mentally healthy T who experiences an acute life experience, like a loss, does what is necessary to self-care--such reactions are not pathological. A fundamentally healthy T, should such a reaction become pathological, will address the situation. I don't have the same confidence about a chronically impaired T, whether or not that T appears to be "stable." There is no mandate for on-going supervision after licensure. The very Ts who are most in need of such supervision may very well be the least likely to seek it. Personally, I don't want to take the risk.

When I'm paying $150 for 50 minutes of a T's time, and exposing my weaknesses and vulnerability to them, lowering my emotional defenses, talking about extremely private and sensitive issues, I just hope to God that they know what they're doing!

For that much money and that situation, I want someone who can focus on me for the entire time, and set aside whatever issues they're dealing with themselves. Also who is stable and balanced enough to respond to me appropriately and in a healthy way without their own issues getting tangled up with mine.

Past traumas, issues, etc are fine with me - nobody's perfect. But they need to be as perfect as possible during MY 50 minutes.

[quote=Asiablue;3441214]ScorpioSis, i think it is imperative that people question another person's capability for a profession, in fact i think it is our civic duty to do so. quote]

I think this comment is right on the money, but I'd take it further than just applying it to therapists. We are all consumers and it is our responsibility to keep our eyes open and our questions free flowing. I think that this concern for a person's stability and capability to perform their job well and with "no harm" can be applied to many professional, paraprofessional and jobs positions!

Who wants their child to have a teacher who has significant issues understanding social/emotional/physical boundaries or who has a severe low grade depression that prevents him/her to properly provide your child with the right academic preparation for the year? Or one who I worked with who spent his lunch hour searching the web looking at porn? For the record, I had no problem with him being interested in porn, but come on, why the heck did he feel the need to view it at school, in his classroom, on the classroom computers?! Definitely NOT in the right profession. Who wants their lawyer to show up at court disheveled and incoherent due to emotional issues that have overwhelmed him/her or dealing with substance abuse issues? Who wants their beloved grandmother to be in a nursing home, cared for by a nurses' aide or orderly who has severe anger management problems and this is the night your beloved grandmother "sundowns" and keeps wandering off the unit and refuses to take her prescribed treatment at the prescribed time, angering the aide who is rushing to get his work done? Who wants the fry cook with impulsivity and anger issues (enraged by his co-workers or boss) preparing your hamburger by spitting on it or wiping waste on the bun?

When we keep quiet and fail to speak up when we see a person who is acting inappropriately or unable to perform their job in the way it needs to be done, we need to speak up and keep speaking up . . .and that includes people we care about, like family, relatives, lovers, partners and friends! I get pretty passionate on this topic but I guess it's because I'm old and I'm tired of people not wanting to make waves. And for the record, I'm not talking about a witch hunt (beating the bushes for anyone who has ever had a problem or issue). I've had mental health issues in my lifetime and it meant taking time away from my job to get well. . . and if I hadn't done it when I needed to, I hope that someone who cared about me would have spoken up and let me know it was time to take a mental health break!

I’m glad that many training therapists go through therapy of their own. I think that’s really important. My own therapist chose to have years of therapy, despite it not being a requirement when she was trained, I believe. I also think supervision is important. Though I’ve also worked for an organisation that provided peer-led services and they had a preference for hiring people with an experience of mental illness for all positions in the company. I do think there is a place for those types of services as well.

Emotional stability, I think, is very important in certain jobs. Even with careful screening, it’s never going to be perfect. They certainly try with particular lines of work, like the police force (not that I think all their methods of testing are particularly valid or helpful). I expect that there are certain clients that a therapist could help, without having to set a good example. Perhaps a smoking CBT therapist can help a client to quit smoking, despite no desire to do that in their own lives. With emotionally complex cases, I think the therapist needs to set a good example. I think they need to be able to provide a secure base, and despite whatever clients are throwing their way, they need to know how to stay healthy and take care of themselves. It’s not like emotional stability is the one and only quality that is important for therapists to have and I expect there are plenty of stable therapists lacking other important qualities. Like, I also think that liking and enjoying people and relationships in general and having a certain level of natural compassion towards other people is important.

My opinion on this isn’t really directed at anyone in particular. It’s about me more than anything because I have an interest in clinical psychology. I guess for me, being able to set a good example is really, really important. If there is even the teeniest tiniest chance that I do on to become a therapist, I want it to be because I am healthy, because it’s possible to have a bad start in life and still turn things around and go on to live a healthy life. Without even knowing how self-disclosing I’d ever be, I’d still rather that I’d be able set the example of not ever acting on self-destructive thoughts, for example. Even unconsciously, I don’t want there to be a hint of “it’s okay to harm yourself when you feel really bad”. Now, I definitely still think it’s possible to turn things around and get to a place like that, despite how destructive and chronic particular behaviours have become (someone pointed out Marsha Linehan as an example). But for me, it’s always going to be really important that a therapist is relatively healthy and able to set a good example.

I think the problem with expecting a T to take time off when they are emotionally drained, experiencing a mental health concern, or otherwise unable to be in the right frame of mind for their clients is that taking time off means taking time off from having an income. At least for Ts in private practice in the US, if they are not working then they are not making any money. That may not be a financially feasible option for many Ts. They may weigh the effect of continuing to work on themselves/their patients... against the effect of not having an income on themselves/their family/their kids. Similarly, for Ts who work for an agency, if they take a leave of absence from their job... there may be no job to come back to once they have recovered. That would probably be scary for a lot of Ts who really need that job in order to support themselves and their family.

It's also often the case that when one is most emotionally affected, that's when one is the least rational and capable of good judgment. While it's very commendable that many Ts and Ts in training (like Asia) have the awareness to know when they need to take time to focus on their own health and well-being... a lot of others don't have that insight. Often, when one's mental illness flares up or when one is emotionally triggered, one's judgment can lapse. One may think "I'm fine" when they're really not. When there is pressure to continue working (financial, family, colleague, and self-pressure), there is an even greater tendency to say "I'm fine"... even if you aren't.

In my own profession, I know there have been times when I really could have benefited from a little time off to take care of myself but that just wasn't an option. Granted, I'm stable and my issues are pretty "run of the mill": I had a sucky childhood that I'm still processing and I'm try to learn how to better manage my stress. While those kinds of issues certainly don't disqualify someone from doing their job, even those issues might warrant some time off once in a while-- if that were an option. However, many jobs don't allow us to take time off when we need it. For instance, my grandmother died recently and I had to go straight from the funeral, onto the airplane, into the car, and straight to work to teach a class. I really could have used a few days off (or at least THAT day off!) but it wasn't an option. Luckily, I was able to "turn off" my emotions for 3 hours, teach my class, do a satisfactory job, and do no harm to my students or their education. I can't imagine having to be a T in that situation, though. If I were a T, I think I'd need to take some time off to deal with something like a death in the family or a divorce. But most people can't financially afford not to work for awhile, and most Ts don't have a second career that they can take up when they need time off from being a T.

I read a book by a therapist who talked about what he did when his wife died. He took off a week and then went back to work. According to him, focussing on work was what he wanted. When he was completely focussed on a client, he was able to get out of his loss for a bit.

It depends HOW unstable.

I think people how have psychiatric problems are more drawn to the profession. If they can handle it, its probably fine. That's probably why its a bad idea to have a dual relationship. All that really matters is the time spent in the room with the T.

That's a big "If." The time spent in the room isn't hermetically sealed from the rest of a T's life, and definitely isn't separate from a T's internal, mental life. The nature of the work, at least for anyone practicing any depth modality, depends upon the T's mental acuity and attunement as the instrument. Any impairment in that instrument will affect the therapy to some degree.

Everyone has someone to be held accountable. If truly 'unstable', their employer, will catch on, and there's consequences. If private practice,and too 'unstable', to function, they'll lose clients and possibly face lawsuits, again, consequences.

Some people can function quite highly, in the workplace. Just because, homelife/school life, isn't ideal, doesn't stop people from functioning professionally.

I think I'd voted, stable, forget, at moment, the poll. That to me, means, having worked through their own stuff, to bring logic, rational thinking, to the job.
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Ever hear the phrase that most mental health professionals get into the field first to figure themselves out? This thread made me think of that.

Yes, but I have never seen any actual evidence in that direction. I know many students of counseling and in my experience they are motivated by a desire to function helpfully and professionally in the field.

This is exactly what one wants to want to avoid: Actual clients being harmed. It would be much better for schools to screen students in the application or classroom stages.

I am actually of two minds about this. Of course, it all hinges on how unstable... BUT I do not think, necessarily, that it is the school's job to implement screening, nor is it the job of a professor to go to a chair about a student. This is someone's career here. Who's to say that the student won't resolve their issues?

Without an evaluation, by a qualified individual, I'm having trouble with the whole shouldn't be a therapist thing.

We are all crazy. The question, I think, is how well our crazy works together.

In addition to the safety of the clients, the school's reputation is at stake: it will be hard to place students in internships if there are questions about the stability and effectiveness of the students being placed.

I hear you, Bill, I really do. That's why I'm of two minds on this.

I think there's a difference between a prof alerting her dept chair about difficulties with a student in her class (which is totally appropriate), and the same prof trying to alert that student's dept (which would be overstepping and potentially damaging given that the prof isn't qualified to be making a diagnosis.) When I think of supervision and screening, I'm thinking of those actions within the department training the student. I know such screening by the supervisor is routine during internships at APA accredited programs/facilities because my T served in that capacity. But those are also the most competitive internships, and I wonder about those who are interns in less competitive situations.

I don't think we have reliable enough understanding or screening tools to know who we should or shouldn't allow into therapy school. All we can know is if they are able to do the work assigned in class, and even that isn't a great predictor of how good a therapist they will be.

I don't think we have reliable enough understanding to know how a particular student will utilize their learnings. Nor if all of those in "therapy" school go on to a clinical practice.

I had a T who was unethical, poorly trained, and I was enormously hurt by it. and yet, I can see that there are many people she has helped, including me until she didn't anymore.

I think in a perfect world, only stable, kind, intuitive people should be therapists. I don't know anyone who is always stable, kind and intuitive. In a perfect world, we could accurately assess who will do harm, and who will do good? The RL track record for that isn't very good. (who would have predicted that Schindler's would have been so good? That a priesthood would cover up pedophiles?) Heck, Major League sports teams, depsite all the money they put behind scouting, don't have a very reliable track record in predicting who will be the next superstar. In RL, people are just very very complicated.

WRiting this makes me very uncomfortable. As someone who has been very very hurt by a psychotherapist with her own issues, and not adequately trained (as best I can determine), and someone who has also met several other counselors/psychologists who clearly "have issues" I want a better system for making the system work. I just haven't figured it out.

I think you have a very good point. After all who is drawn to therapy? People who have experience with it of course. I talked to my pdoc about my concerns about being in treatment and also entering the field. He said "we all have issues, that's why we're in the field. You just have to have your s**t together before you start practicing". I thought that summed it up well!

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I actually ran across a situation like this not too long ago, only it wasn't with a therapist, but another professional.

It's a no win situation for all parties involved.

With reflection it's clear to me that it SHOULD be hard to derail someone's career. Just remember, not to long ago, women were thought unfit to serve in leadership positions because of our emotionality and innate hysteria.

I think we all have a knee jerk reaction to a potentially unstable therapist being allowed to go free range. After all, almost all of us have been in therapy and know the trust, vulnerability, and confidence that we must have and share with them.

However, this can't just be about that reaction. Just floating the idea of instability, justified or not, can target a career. Most of us aren't qualified to even float it.

Again, I just don't see any easy answers here.

I saw the same look in Jacoby Ellsbury's eyes and Eli Manning's as they went for their first big wins. I coulda been a contender!

I absolutely agree with you that it should be difficult to derail a career, and that some idea about instability doesn't meet the burden of proof that is necessary. But I disagree with those who believe there's no way to determine fitness. I think supervisors during internship are in a position to make an evidence-based decision about this (which should always be subject to a committee approval with ample right of defense). And I think the requirement for personal therapy--which is separate from supervision and not conducted by the same person--needs to be more consistent and widespread. No system will be 100%, but it would certainly improve the odds.

I am amazed at the amount of people who seem to want to protect the student-therapist's right to practice. Are we all so scared to be seen to be unfair or to make unpopular decisions for the greater good? One person's rights shouldn't overrule the rights and the safety of the collective. But maybe that's because i come from a socialist based country.
As far as i'm concerned, if you aren't emotionally stable, have serious underlying personality disorders or unprocessed baggage that could seep into your work and affect a future client then you absolutely do not have the right to undertake therapist training. Moreover, if you are aware that you have these issues then you have a personal moral obligation to hold off on your training until you've sorted your own ***** out!

I have been at the receiving end of a therapist who had her own baggage and it did not end well for me, in fact it nearly killed me. The stakes are high here, you are dealing with very vulnerable people with histories of abuse and neglect. Their own stuff is so bewildering and confusing without adding f*cked up dynamics created by an unhealthy therapist into the mix. A therapist can literally stand between a choice of life or death for some clients, it's a serious job and most of them charge serious cash for their service so the least we can expect when we hire a therapist is that they are safe to practice.

There is no point in saying it is ok for anyone to enrol in therapist school regardless of mental stability just so long as they've got their ***** together by the time they graduate because part of their course is to actually go out on placement and be a therapist under supervision. If it was all just theory then fair enough, i'd say yeah go for it. But the conditions of passing the course is how they do on placement. And if it isn't picked up then, (because let's face it all students will be on absolute best behaviour and playing by the rules,) then it won't show up till they are in their own practice where it is much harder to prove fitness to work. And what student is going to graduate and then say " no, i'm not going to practice even tho i've just graduated and have a ton of debt, because i know i should really sort out my own baggage first." ? Not very many i'd imagine.