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Even though many people believe that counselors and psychologists should be able to help people with any problem they are going through; however, those people do not realize that these professionals are not specialized in all areas. All counselors may have some knowledge in a variety of areas but that does not mean they are capable of proving counseling services in those areas. For instance, it would not be wise for a parent to ask a school psychologist for advice on how to improve his or her marriage. They may have taken a course or two in marriage counseling and have some understanding on marital issues but this does not make them an expertise in that area.
As a day treatment counselor, there are many questions and concerns I have to address with my clients. Some of their concerns deal with their behavior, their grades, their participation in school, and their ability to connect with others. Sometimes I am faced with a situation I feel that someone else could be a better assistance to my client. I work for Therapeutic Inventions, which is a day treatment-counseling group that assist students that are having trouble in school with their behavior. This particular client was known for his erratic behavior throughout the school day. Some days he would go all day without any incidents. Even though no issues occur on some days, his teachers normally say he kept to himself that day and did not want to be bothered. On most days, this client had the tendency to be very disruptive in class, quick tempered, and have no regards for consequences for his inappropriate behavior. Many of the strategies and techniques I used to redirect him were not having much effect on his behavior. Like many days, when I ask him why he behaves the way he does, his normal answer was because my friends tell me to do those things. Many times, I tried to use examples of why he should not listen to his friends when they tell him to do inappropriate things. One day I decided to ask him can he show me his friends that encourage him to misbehave so I could talk to his teachers about the situation. He responded with, “I can’t.” I responded with, “They will not get in trouble; it is only so the teacher can help you better.” He responded with, “I can’t show you them because they are in my head.” I was not sure if he was making excuses or not but after talking to him, I realized he was not joking. One reason I determined he was not joking was because on the days he was disruptive, he normally talked out loud randomly and typically in an aggressive manner.
When dealing with a child that has psychological issues and the person helping them is just a day treatment counselor, the counselor is more than likely not equipped to handle a situation of this magnitude. According to Ferentz, “Clients are entitled to get the best possible care. Working with someone who has an expertise in addressing their presenting problems and symptoms is one way to increase the likelihood that they will receive that high level of quality care.” It was obvious to me that I had to refer this client to the school psychologist because I did not have the expertise to assist him in the way he needed. One reason listed as a potential reason to refer a client to someone else is, “A counsellor may refer a client on if, for example, the difficulty the client is experiencing is outside of their knowledge base,” (McMahon, 2014). I contacted the parent to schedule a meeting citing, “I would like for you to come in so I can give you an updated on the client’s behavior (used his actual name) and to determine if an alternative behavior plan is necessary.” At the meeting, I reviewed all the client’s good and poor behavior. I checked with the parent multiple times to make sure that she did not feel like her son was unfairly being targeted the teachers. Lastly, I read her the many remarks her son made about his friends in his head that tells him to do bad things. I explained how I was not able to assist him in this matter because I have not been trained to handle cases similar to this one. Surprisingly, she acknowledged that her son does hear voices but she did not think it was a concern because the voices never told him to hurt others just to hurt himself or to misbehave. She went on to say that she was working with him every night on why he should not listen to them. I tried my best to sympathize with her by saying I know you are doing your best to help him just as I do my best to help him but sometimes the best thing is allowing someone else with more experience assist in the process. She agreed, therefore, I respectfully suggest meeting with the school psychologist as the first step in assisting my client.
At this current time, he is no longer my client and I have not been privileged to know if he was diagnosed with any disorders. He is still at the school I serve as a day treatment counselor but he has been moved to a self-contained/alternative education program. Whenever I see him in the hallway, I asked him how he is doing and many times he respond with something like, “good as long as I take my meds.” According to the alternative education teacher, he is doing much better. Many days he keeps to himself and not as disruptive as before. He still lacks focus and motivation in class but his behavior is tolerable. Due to the improvement in his behavior, especially his need to hurt himself, I believe referring my former client to the school psychologist had essential and ethically significance. If I chose to ignore his comments about the voices my client hears and dismiss it as nonsense, then any harm he may have done to myself or others would have been my responsibility. It would been my responsibility because I am accountable for my client’s safety and the safety of other students. There are three standards in my company’s code of ethics that relates to this situation. These standards are “provide care and services that are necessary and effective, place the welfare and safety of our clients and families as our highest priority, and remain aware of personal skills and limitations; be willing to recognize when it is in the best interest of clients to be released or referred to another program or individual,” (Our Ethic Code, 2019). I was not able to provide the services needed to help my client based on his current mindset and ignoring his behavior would not had resulted in placing his welfare as a priority. In addition, I realized that it was better to refer my client to someone else. Therefore, neglecting to refer my client to someone else with more expertise would been unethical and irresponsible.
Ferentz, L. To refer out or not to refer out, that is the question! The Ferentz Institute. Retrieved from https://www.theferentzinstitute.com/2013/10/16/to-…