Why Clinical Consultation is Important for Therapists, Even After Licensure
Most of you who are in the mental health field have a strong understanding of why supervision during practicum, internship and for two years of post-graduate work is so important. The supervision process and structure are fundamental to the training process for new counselors and social workers. Clinical supervision provides education, support and mentoring through the developmental process, prepares supervisees for licensure and post-licensure work, and allows for assessment of a trainee's fitness to work in the field.
But there are times when we may find ongoing supervision after our training to be arduous, routine and unnecessary. I have felt that at times, and I am sure many of you have as well. However, what I have learned is that, while there may be times when I do not necessarily “need” supervision, I have always found it to be useful. Most importantly, though, I have recently been reminded that the structure and habit of seeking supervision and consultation provides a protective factor to therapists, as we navigate a very challenging, and often hazardous, profession.
Why I Continue to Get Clinical Consultation
To exemplify the value that I place on ongoing supervision and consultation, I am going to take a risk and share a very personal story. I do so only in hopes that this may help you make the decisions to seek consultation and take care of yourselves while working in this very hazardous profession.
I have been working in the field of mental health for 16 years. I have primarily worked with people with severe and persistent mental illness and severe addiction. I have worked in community case management, residential facilities and emergency rooms, providing crisis assessments and intervention to those experiencing a mental health crisis. In this work I have been exposed to people who are experiencing severe psychosis and mania, have made significant suicide attempts, people who are violent and aggressive, and in the worst-case scenarios, have had clients who have died tragically.
In my current work as an Emergency Room Psychiatric Clinician, I have been assaulted 5 times in the past year, I have had to intervene to prevent aggressive and violent patients from harming themselves or others almost daily, and I have witnessed the increasing decline in our community’s mental health, all the while working in a hospital with over 100 COVID positive patients, all of whom come through our Emergency Room.
Two weeks ago, I experienced something I had never experienced before. After working with a particularly aggressive client on the 20th anniversary of 9/11, while trying to explain to my wife what happened with this client and how anxious I was feeling about it, I experienced what is called a “psychogenic seizure”. While I had some exposure to clients experiencing this, I had little understanding of it. In fact, there is some discourse in the medical field as to whether these should be described as seizures, as they are not neurologically based, and are almost entirely born out of trauma and the brain, and body’s, response to trauma, or ongoing vicarious trauma.
I know that those of you who know me are wondering if I am ok, and how I am doing. To that, I say “I am doing ok.” I am better than I was two weeks ago, but I need to continue to work to understand what happened, why, and most importantly, how I can prevent it from happening again. While I currently feel “just ok”, most importantly I have a lot of hope that I am not only going to recover, but that this experience will make me a better therapist for my clients who experience similar feelings.
Professional Network of Support
But the real reason I am ok and have hope for my recovery is because I have such an amazing network of support. After making the not-so-wise decision to just get up and go to work the next day, I at least had the wherewithal to call my supervisor on for the day and let her know what was going on. She immediately recommended that I take time off, and in fact, demanded it, knowing that I would try to “just tough it out” if left up to me. She supported me as I went to see a doctor in the emergency room, and she followed up with me daily to check in.
In the past two weeks, I have spoken to no less than 25 therapists and colleagues, all of differing theoretical orientations. I have spoken with all of my current supervisors at the hospital, my previous supervisor, my own therapist, a trauma specialist in the community, co-workers, friends in the field, and my chiropractor and primary care doctor.
Having this vast network of support and insight has helped me better understand what I need for myself currently, but has also opened my eyes to a whole different approach to trauma therapy that I did not previously understand. It is because of all of these amazing skilled, wonderful people that I feel “ok, with a double side of hope” that I will not only recover fully, but likely in a way that will enhance my ability to take care of myself and better serve my clients.
Developing a Professional Network
I am not one to give myself much credit, but the one that I will take pride in is the fact that over the past 16 years I have always remained curious, open to learning, and have sought out, questioned and listened to any therapist, supervisor, psychiatrist or random person, to hear their perspectives and learn from new ideas. In doing so, I have formed a habit of seeking consultation when I am unsure of how to approach a certain issue, and in doing so, I have built an incredible web of support within the mental health community, one that I can tap into immediately when in need.
When I was young in the field, I was encouraged to “network” for the sake of finding opportunities for work. This was never something I felt terribly comfortable with, as it always felt superficial and self-serving. Instead, I sought out mentors and peers, sharing ideas, listening and supporting one another. This took a lot of time and included a lot of reciprocity. But if there is one thing that I hold as an absolute, it is this: Without this network, I would have already burnt out of the field, I would likely be very depressed and anxious about feeling like a “failure”, and I would have lost the opportunity to help so many people.
Seek Ongoing Clinical Consultation
If there is any advice I can provide to you, seek supervision and consultation before it becomes a crisis. If you are working on your licensure hours and just ready to be done, if nothing else, develop your habit of actively engaging and utilizing your supervision. This will help you learn not only how to access and utilize consultation at a later time, but will also help you build a network that I believe is so critical to your wellbeing as a therapist.
If you are already well into your career but have been feeling disconnected, for whatever reason, engage in consultation and reconnect. You will likely find that we are all feeling the same way right now, but will also give you hope that through our network of support within the field, we will continue to advance the field and continue to serve our communities and help our clients heal. In a time that has felt hopeless at times, I truly hold hope that WE can do this, but we can only do this together.
INTERESTED IN CLINICAL SUPERVISION?
If you or someone you know are interested in learning more about our Clinical Supervision and Clinical Consultation services with Catalyss Counseling, including our group and individual options, contact us at 303-578-6318.
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Chris Campassi is a psychotherapist, clinical supervisor, and blogger. Chris helps adults in the areas of depression, anxiety, severe and persistent mental illnesses, grief and loss, emergency evaluations and interventions, assessment, and diagnosing. Follow Catalyss Counseling on LinkedIn, Facebook and Instagram.