Holy Small-Town Ethics, Batman! Navigating Community Spaces and Experiences as a Counsellor in a Northern, Remote, Small City

Posted by: Robyn Steinke, MC, CCC on March 25, 2019 9:06 am

I live in the interesting community of Grande Prairie, Alberta. Technically it is a small city with a population of around 65,000 and it is technically situated in an intermediate northern part of the province. I say “technically” because by way of feel and experience, Grande Prairie still holds to “small town,” we receive Northern Living Allowance and incentives to live here though not as fully as those say in the Territories, and the population fluctuates up to 125,000 on weekends because of Costco, Walmart, and the Prairie Mall. I should note that when my family moved to this community in 1995 the population was roughly 28,000. While the community has changed, the core remains the same, and when it comes to the professional counselling community, it’s a small one. Back to that small-town feel, experience, and all the conundrums of small-town ethics.

It is well-recorded that small town counsellors face unique challenges such as multiple relationships, limited resources and competence, and geographic and professional isolation (Schank, 1998). Luckily there are ethical codes and standards of practice established by the CCPA that provide guidance. Unluckily ethics are not black-and-white and one-size-fits-all. So, what have we got?

“Counsellors should discuss confidentiality with their clients and any third party payers prior to beginning counselling and discuss limits throughout the counselling process with clients, as necessary” (CCPA, 2015, p. 11).

Check.

“People are more likely to know each other in small communities and the counsellor is more likely to meet up with clients in non-professional situations. Practitioners in small communities protect private knowledge, and ensure confidentiality in the face of intricate social networks and lines of communication that lead to the availability of informally-gained knowledge” (CCPA, 2015, p. 11).

Check check.

“Counsellors, whenever possible, avoid entering into social, financial, business, or other relationships with current or former clients that are likely to place the counsellor and/or client in a conflict of interest and/or compromise the counselling relationship. This includes relationships via social media” (CCPA, 2015, p. 24).

Getting a little trickier, check.

“In rural communities, and in certain other workplace circumstances, such as in closed communities or remote, northern, and isolated areas, it may be impossible or unreasonable for counsellors to avoid social or other non-counselling contact with clients, students, supervisees, or research participants. Counsellors should manage such circumstances with care to avoid confusion on behalf of such individuals and to avoid conflicts of interest. Lack of anonymity requires rural counsellors to think carefully as they develop new social networks. Boundary management is a challenge in small communities as multiple relationships are inevitable.” (CCPA, 2015, p. 25).

Now we’re really into the weeds, especially considering people (myself included) with history in the communities they counsel in, but check.

If CCPA’s ethics codes seem straightforward and yet challenging, you are not alone. What do we do? How do we navigate the code? Professionally, one of my favourite research pieces includes a practical to-do list by Schank (1998), which can be found in full PDF version online. Of the 13-item list, I have found the particular items listed below integral, though all of Schank’s (1998) recommendations are worth knowing as a rural or remote counsellor:

  • Recognize that ethics codes and or standards are necessary, but not sufficient (Schank, 1998, p. 279).
  • Know relevant codes, regulations, and laws (Schank, 1998, p. 280).
  • Talk directly with clients about the likelihood of out-of-therapy contact (Schank, 1998, p. 280).
  • Set clear boundaries, both within yourself and with clients (Schank, 1998, p. 280).
  • Be especially aware of issues of confidentiality (Schank, 1998, p. 280).
  • Participate in ongoing consultation and discussion (Schank, 1998, p. 281).
  • Know when to stop (Schank, 1998, p. 281).

Further I would like to add some personal tips that have helped me navigate these moments when your feet are on the ground, your eyes are open, you are not in the office, and a client or former client has been seen.

  • Strive to maintain your natural facial expression upon sighting the individual. Internally I refer to this as my “poker face”, though it is not a single expression.
  • Find a comfortable distance, if possible. For example, I often spot clients or former clients at the community gym and library, my eyes are looking for a space with an amount of distance to allow the individual their freedom to engage the environment while allowing myself to do the same.
  • Use community sightings as a way to review informed consent and build the working alliance in follow-up sessions. I found a great value in discussing these sightings and interactions at the next session to review important client rights and touch in to the counselling relationship following these interactions.
  • Be polite.
  • Isolation is not the solution, exploring the community, finding comfortable spaces, and social connections are necessary components of therapist self-care that are not to be underestimated in importance.

To my fellow counsellors in your unique communities with your unique challenges, I wish you well and I hope you have found a helpful tip or two.

-Robyn

Canadian Counselling and Psychotherapy Association. Standards of Practice, 5th Edition, April 2015.
Schank, J. (1998). Ethical issues in rural counselling practice. Canadian Journal of Counselling, 32(4), 270-283.

https://files.eric.ed.gov/fulltext/EJ581163.pdf




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Technology is Expanding a Counsellor’s Toolbox

Posted by: Sherry Law on July 22, 2015 9:37 am

I recently spent some time with a colleague and the idea of video conference counselling came up. Both being technology buffs, we dove right into the idea without hesitation. As we discussed, it became clear to me that there were real ethical arguments to support the idea of integrating technology with therapy. Unfortunately, the fears around the little known realm of technology in counselling creates a demanding barrier of entry, stifling enthusiasm to attempt online therapeutic practice. Hoping to fan some burning embers of excitement, I present three ethical considerations for the use of technology in counselling:

Financial Access

Cost has always been a struggle for people who need mental health assistance. Both the direct cost per session as well as indirect costs can affect people’s budgets, adding pressures to the decline of one’s mental health. For example, taking time off work or out of the day may not always be feasible for people, especially if you have children to take care of, and during a contracting economy where every day matters in the eyes of your employer. The struggle to balance self care, and life responsibilities is very real. Online counselling could reduce the cost of office space rental, parking space rental, and utilities in the office. The savings from such a transition could help to increase access for some clients.

Physical Access

Physical access can be limited due to a person’s living arrangements, or life circumstance. Many people cannot afford a convenient mode of transportation to attend a counselling session. For example, in rural areas, the problem can worsen with some people having to depend on the therapist’s mode of transportation into their area before they can acquire mental health services. The dependency could lead to spotty access at best, and an inconsistent therapeutic relationship at worst. For counsellors working within a rural area, a plethora of other ethical concerns can arise, such as multiple relationships, limits on resources, isolation, and community expectations. Online counselling could not only offer larger variety of therapists for the rural clientele who can specialize, but can subdue altogether some of the ethical issues around rural therapeutic practices.

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*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The Unique Ethical Issues of Working Within the Aboriginal Community

Posted by: Lisa Shouldice on July 13, 2015 2:10 pm

I have had the honour and privilege of working within the First Nations, Métis and Inuit populations throughout my career as a psychotherapist. I use a predominantly relational, emotion and solution-focused approach in working with clients. Throughout my ethical courses and training, both 12 years ago in my Masters Degree, as well as subsequent conferences and workshops over the years, I have been able to create an ethical, foundational way of thinking and being as a mental health practitioner. However, the multi-cultural work I do involved learning ethics on the job and within the urban Aboriginal community. Due to the trauma I encountered extensively within this community, the ethics of working with clients that have experienced complex trauma, helped and led the ways at times, but are only a beginning. I truly believe it is necessary to create a new ethical code to practice effectively within this wonderful community.pow-wow-249204_640

In order to be a trusted mental health provider within the urban Aboriginal community, it is important to become a visible presence in that community. When invited I attended ceremonies, Pow Wows and traditional Teachings. This allowed Aboriginal people to see me as a presence, interact with them and observe me with other people and Elders within their community. This is an important piece as a mental health provider because Aboriginal people have every reason not to trust me, as a Caucasian person that is part of mainstream Canadian culture. There is also a different relationship with “authority” as traditional Elders and leaders live within and are a part of the community. There has also been many years of racism, oppression and subsequent intergenerational trauma, all impacting the Aboriginal relationship with “authority”, especially in mainstream, Canadian culture. When your face is seen in the community and people begin to chat with you, word of mouth spreads quickly. While I believe word of mouth endorsements are powerful among all peoples, it is especially important when working within oppressed communities.

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*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Being Digitally Aware

Posted by: Dawn Schell on June 10, 2015 2:03 pm

You have a Facebook page designed for your professional practice. You notice that one of the followers is a current client. They post many comments that identify themselves as your client. How would you handle this?social-media-488886_640

In this day and age of social networking this is an increasingly likely scenario. And if we are to be good digital citizens and demonstrate our e-professionalism we need to think about how to handle social media ethically.

What are the options for handling the above-mentioned situation ethically while working to maintain the relationship with the client?  We could ‘block’ our client but what are the implications of that action for our relationship? Or would it draw even more attention to them? Do we post something publicly that addresses the client’s comments? Or..?

Our CCPA Code of Ethics (B 2) states, “Counselling relationships and information resulting therefrom are kept confidential.”

Hmm. How to preserve the client’s confidentiality and actually put a stop to the situation?

There is no easy answer for how to resolve this scenario!
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*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Personal Responsibility

Posted by: Asa Don Brown on May 23, 2013 4:28 pm

“Personal responsibility is the willingness to completely accept choices that we have made throughout our lives.”
                                                                                    ~ Asa Don Brown, Waiting to Live

Personal responsibility is the ability and willingness to accept our past, whether good or bad as a marker within our history.  It is also recognizing that our history does not have to define us or be the determining factor of our lives.

PERSONAL RESPONSIBILITY IS NOT

Responsibility is not identifying with our past failures or successes.  Nor is it allowing others to place the past upon our person.  Responsibility cannot be the acceptance of other’s failures or successes.  We may have all had a moment in time, whereby we slough off personal responsibility, transfer personal responsibility or blame others for our failures or the successes in our lives.   Personal responsibility is not the denial of our successes or of our failures, rather it is the willingness to take ownership of our personal history.  

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*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA