Interview with Christine Senediak
Deb Gould

> Christine is a Senior Clinical Psychologist and the Course Coordinator at the NSW Institute of Psychiatry

In your clinical supervision experience, what self-care issues do most therapists struggle with?

Self care is an interesting concept as most counsellors work very hard to care for their clients often at the expense of their own well-being. One issue that comes to mind straight away are boundary concerns. Keeping a safe and professional distance from the client’s issues can often be a struggle. Counsellors need to be aware of the limits of their practice and know when to refer on to another professional or agency. This can be either when the problem gets too big, when it is not in their area of expertise or touches on a ‘self’ or personal issue. For example, a counsellor might find themselves in a position where they are over identifying, over doing or even in some cases, over protecting their clients.

In this current working environment, many counsellors are in positions where they work with multi problem families. This means that they often are forced to work with very complex clinical issues where positive change can be slow and difficult to achieve. I find that counsellors get emotionally drained from this kind of work quite easily, especially when they have little ongoing support or opportunity for debriefing. Many take on complex cases without adequate training but because there is a sense that there is nowhere else for the client to go, they continue to work with the individual or family. Vicarious trauma can also be a problem in clinical practice. Hearing a client’s trauma story without adequate opportunity to debrief and process the material presented in a session can lead to a counsellor feeling overwhelmed and stressed.

In general I find that self care if often overlooked for many counsellors and is only addressed when it becomes a problem, either through personal ill health, stress or burnout... basically when it is too late. So if someone is feeling exhausted, irritable or pessimistic in their workplace, displaying tardiness or poor work performance or basically withdrawing from being involved for fear of even getting more work to do, action needs to be taken. My recommendation is good, safe and regular clinical supervision from a trusted and respected health professional.

What strategies can you suggest to ensure that as therapists we take care of self?

Clinical supervision offers an opportunity for the counsellor to have a regular and safe place to discuss any aspect of their clinical practice. My approach to supervision is to help the counsellor develop a reflective approach to their clinical work so that they can observe the processes in play in their workplace. This means that when something happens at work with a colleague or client, he or she can think about how this came about and respond thoughtfully rather than react impulsively. Reflective supervision helps the counsellor ‘get in touch’ with how they are thinking, feeling and practicing as a clinician. A good supervisor is not one who jumps in and always gives advice about what to do next, but one who can listen, ask the right kind of questions that will help the counsellor generate their own solutions.

Clinical supervision not only facilitates theoretical learning, it allows the counsellor to identify issues that need to be addressed while offering an opportunity to explore options for intervention. Everyone working with clients in a counselling context should have the opportunity to receive regular clinical supervision: it should be considered an essential part of their work rather than a privilege and only entered into when there is a problem.

> Christine Senediak

Christine is a Senior Clinical Psychologist and the Course Coordinator for the Child and Adolescent postgraduate programs, Family Therapy postgraduate programs, and Clinical Supervision education programs at the NSW Institute of Psychiatry. She has completed specialist training in the area of family therapy and is currently enrolled in her PhD undertaking research in clinical supervision.

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