Personal connection is crucial to our work as therapists. We know how important empathic relationships are to mental and physical health. Being fully present during our client’s healing journey is the essence of our work.
But our life relationships are much more than a means of working with clients. We need rich connections in our personal lives and with our colleagues to be good therapists. Our professional interactions help us keep well informed, well supported and well educated to do this challenging work.
Doing our best work means recognizing our own needs for support across the whole gamut of challenges in working with clients. If we have a high standard of care, we need to work through what is happening with a client — or within us – all the time.
Clinical consultation – meeting or talking with a colleague or a group about your work – can only enhance your practice as a therapist.
Common Myths about Clinical Consultation
There is no downside I can think of to bringing a case to a colleague or clinical consulting group for feedback. But too often, clinicians do not get the help they need. Either they don’t know of a safe place to turn, or something like fear holds them back.
Roadblocks and misconceptions to clinical consultations include thoughts like:
• My peers are going to judge me as inadequate
• I will feel embarrassed or ashamed
• I will be seen as less capable than my peers rather than their equal
It is normal to feel, “I don’t need this.” We may have a protective impulse to guard ourselves against the appearance of “doing things wrong.” The downside is that this fear cuts us off from what we all need in order to do the best for our clients and our profession: each other’s experience and support.
Quality Clinical Consultation is the Secret to Successful Clinical Practice
“Consultation is always an opportunity for further growth — clinically, business-wise, or both,” writes Rebecca Wong in A Therapist’s Guide to Clinical Consultation in Private Practice. “Consultation involves a collaborative discussion rather than the straight up offering and receiving of advice.”
We all need a confidant for support in a range of forms, for many reasons:
• To benefit from each other’s experience
• To talk through challenging or difficult interactions with clients
• To work through issues triggered for the therapist (countertransference)
• To learn and use new techniques to help your clients and yourself
Even today, before working on this article, I was on the phone for consultation with one of my amazing mentors. I regularly bring to her the most intricate of my complex trauma cases to process. Sometimes all that’s needed is a small amount of support. At other times, I am offered a different way of looking at something that I hadn’t thought of before.
Just having someone remind you of your strengths when you have a challenging caseload or validate that what you are doing or thinking is on target, can give you the professional encouragement you need to bring your ‘A’ game. This is support you wouldn’t have if you didn’t make consultation part of your self-care system.
What Does Good Clinical Consultation Look Like?
Good consultation can take many forms – from phone calls between colleagues, informal meetings with colleagues who are friends, through to paid group or individual clinical consultation sessions. Because client confidentiality and safety come first, the wrong place to seek this input is on social media.
I agree with Wong who says sites like Facebook can be “a good place to seek out WHO to consult with. But when it comes time for actual case consultation and those nitty gritty case details…. Not Facebook.”
I lead consultation groups for colleagues. As the leader, I am responsible for the safety of the group. Most professional groups are fee-based because the members make a firm commitment to come regularly and be present for each other, and the leader of the group is working to support rich discussion. The facilitator’s job is to ensure confidentiality and maintain everyone’s safety in the room.
I am sure there are some therapists concerned that they may be exposed to judgment about their work. It’s important to have full confidence that everyone knows explicitly, this is a place to hold issues in safety and to accept and honor any issues that a member may be struggling with. I work from a strengths-based perspective. So I’m going to talk about the abilities and skills that each member brings in providing care.
From my perspective, if a colleague is getting clinical consultation, that is a strength right there. Colleagues in consultation care about themselves, about their clients, and they are aware enough to get support for this work.
As therapists, we don’t need consultation just to make it through each day. Regular consultations are an important and invaluable gift of self-care.
If you have fears or concerns you do not feel safe bringing to a group setting, you may want to have an individual consultation. You just meet one-on-one with a trusted colleague. Some feel more secure meeting individually and feel like they get undivided attention for that time.
How Good Clinical Consultation Impacts Work and Life
A few of the people I have met in formal groups have become wonderful friends. These relationships are just so fulfilling and rich. For instance, I am in a group of a few colleagues who meet regularly for breakfast – usually one Sunday every other month or so – it’s our time together.
It takes hard work to create and maintain connections, and build a self-care support system. But it’s worth it to me, because this is what allows me to work as hard as I can. People sometimes ask me, how do I fit in the classes and the caseload I have each week?
I can because of this support system. Our work itself is very rewarding – but the inherent reward is not enough to sustain our best work and prevent burnout.
I still need interaction – I still need people – because what we do is so human. I believe we all do!
Why I Host Clinical Consultation Groups
I am an open proponent of clinical consultation – and hold regular group sessions as part of my work — because it’s so important. It’s what makes us good therapists. It’s my hope and my suggestion we all consider it.
“Good Self-Care for Therapists” by Robyn Brickel
“A Therapist’s Guide to Clinical Consultation in Private Practice,” by Rebecca WongHTherapists Spill: “How I Cope with Stress” by Margarita Tartakovsky
The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-Care Strategies for the Helping Professions (3rd ed) by by Thomas M. Skovholt and Michelle Trotter-Mathison
Women talking photo available from Shutterstock