Abstract
Counselors do a complex job of maintaining the well-being of their clients. Mental health, which specialists contribute to, is an essential part of a happy and fulfilling life. At the same time, the fact that counselors are aware of various methods of maintaining well-being and crisis coping strategies does not mean that they are not susceptible to such suffering. The paper explores the issue of counselors’ impairment, which negatively affects the work of professionals. The purpose is to study the phenomenon, understand its causes and implications, and discuss methods to solve the problem. To achieve the goal, topical scientific sources covering the issue of impairment are studied. The author also closely monitors impairment risks using self-assessment tools and develops an individual plan to prevent them. Impairment can have severe consequences for consultants, up to sanctions in the case of misconduct. For this reason, specialists should focus on prevention and take care of their well-being.
Introduction
Studying the impact of working conditions on employees is crucial in any sphere since an employee’s health is critical to success. At the same time, counselors provide significant assistance in maintaining people’s well-being. However, they are not always sufficiently protected from the negative aspects of their work. During counseling, the ability of a specialist to cope with the constant challenges of the profession influence the clients’ health. Despite all the efforts that counselors make to maintain the well-being and health of their clients, they may neglect to care for themselves, which entails impairment.
Impairment Definition
During their practice, counselors show care, empathy, sympathy, and compassion unilaterally. In some cases, this work aspect can lead to excessive emotional involvement or psychological overload and interfere with work. The American Council Association (ACA) has carefully examined the issue of impairment and how to prevent it. The results are presented in the document Preventing counselor impairment: Vulnerability, wellness, and resilience, which is the basis for all impairment studies (Lawson, & Venart, 2005). According to this document, the counselor’s impairment assumes the presence of a negative impact that impedes the performance of professional duties (Lawson, & Venart, 2005). This condition differs from stressful situations when work does not deteriorate.
Several factors can cause a counselor’s impairment and make them defenseless. Moreover, the myth that counselors as specialists in maintaining mental health are less susceptible to such suffering only contributes to their vulnerability (Lawson, & Venart, 2005). The ACA study identified such major causes as physical illness, personal crisis (burnout, traumatic events), substance abuse, and mental disease (Lawson, & Venart, 2005). Posluns and Gall (2020) discuss the causes in more detail and draw attention to stressful working conditions, such as the client’s lack of progress, a large number of cases, or problems in relations with the team. Robino (2019) discusses practice features in the modern world and highlights the global compassion fatigue (GCF) factor. It is associated with anxiety arising from the impact of international events and the accompanying information overload (Robino, 2019). Thus, many reasons can cause counselors impairment, often unnoticeably for specialists themselves.
Symptoms and signs of impairment depending on the reasons that caused it. For example, burnout symptoms are fatigue, excessive emotionality, loss of purpose, difficulties in making choices, and other signs (Bray, 2018). In the case of physical or mental illness, it is worth paying attention to any symptoms beyond the norm. With impairment, the mood and behavior of the therapist change significantly, affecting all aspects of life and primarily practice. Since counselors may not notice changes, their colleagues or supervisors who have seen signs can take action.
The main sign of impairment and its distinguishing feature, from other conditions, for example, stress, is the effect that it has on the specialists’ practice. Impairment prevents the therapist from conducting normal work processes, communicating with clients, and helping them. Difficulties in the performance of their duties, as a result, can lead to professional violations. Moreover, impairment affects a therapist’s personality by influencing self-esteem and beliefs and preventing professional and personal development (Posluns & Gall, 2020). Since the health of their clients depends on the counselors, impairment contributes to the deterioration of their condition.
Given all the harm and danger from an impairment, it is necessary to monitor its signs closely. This requirement is enshrined in many existing codes of ethics (Zur, n.d.). For instance, according to American Psychological Association (APA) (2016), “Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner” (2.06). The main essence of all the rules and instructions in codes is that the counselors should monitor their condition, and at the signs of impairment, their own or colleagues should take actions to eliminate it.
Impairment Implications
As already noted, with impairment, the practice of a counselor suffers significantly. Implications include deterioration of patients’ conditions, slowing down or stopping the professional and personal development of the therapist, and similar situations. As a result, this condition can provoke the appearance of professional errors and violation of ethical standards. According to Lawson and Venart (2015), “Impairment in and of itself does not imply unethical behavior. Such behavior may occur as a symptom of impairment, or may occur in counselors who are not impaired” (p. 243). However, given the specifics of the therapists’ work, the importance of ethics cannot be underestimated.
Ethical violations, including the temporary inability of the counselor to fulfill a duty, require a solution. In particular, colleagues can attempt an informal solution to the problem by attracting the violator’s attention to it (APA, 2016). If an informal resolution is not applicable, the violator’s colleagues may appeal to the committees on professional ethics, which will conduct an investigation and impose sanctions depending on the severity of the breaches (APA, 2016). Counselors who value their work are responsible for ethical conduct and take measures that prevent violations, including those emerging due to impairment.
Ethical violations include a wide range of actions and errors, which differ in their severity and frequency. Ahia and Boccone (2017) examined 28 states, including South Carolina, and the history of their violations from 2009 to 2013, finding nearly 1,000 violations. Among the most common were non-compliance with continuing education (CE) requirement – 31.53%, dual relationships – 17.39%, and unprofessional conduct – 9.35% (Ahia & Boccone, 2017).
According to the same research, such violations as dual relationships, unprofessional conduct, defrauded an insurance company, professional misrepresentation, violated confidentiality, and misuse of psychological testing occurred in South Carolina (Ahia & Boccone, 2017). Wilkinson et al. (2019) conducted a similar study covering 2010-2014, and their results also confirm the lack of CE and dual relationship as the most common violations. At the same time, 4 cases are documented in South Carolina. Ethical violations lead to sanctions, which once again emphasizes the importance of preventing impairment.
Impairment Prevention
The measures that can be taken against impairment are its monitoring and prevention. Self-monitoring allows counselors to identify signs and take steps to return to normal behavior. As mentioned, counselors’ colleagues and supervisors are also essential and can take part in monitoring. Self-assessment tests are practical tools for tracking propensity for impairment. ACA study, for example, highlighted The Professional Quality of Life (ProQOLIII) and Self-Care Assessment (Lawson & Venart, 2005). They help assess the current state of the counselor, the existing risks, and directions for improvement.
The preventive measure of impairment for counselors is the practice of self-care. It is associated with lower levels of stress and a reduced risk of professional burnout (Posluns & Gall, 2020). Moreover, self-care positively affects self-esteem, including professional activity and quality of life. Understanding this aspect as the key to good practice and personal well-being is necessary for counselors who want to achieve professional success. Moreover, given the risks that neglect of self-care entails, it needs to be studied during the training of counselors.
Self-care involves measures and behaviors that contribute to reducing stress and help to maintain mental and physical health. It requires understanding and knowledge of personal needs and finding methods that will help meet them. According to Posluns and Gall (2020), self-care practices address a few main areas: “awareness, balance, flexibility, physical health, social support, or spirituality” (para. 10). The development of these directions contributes to the prevention of stress, burnout, and, accordingly, impairment. At the same time, it is essential to follow a holistic approach and include all the measures necessary for the counselor without neglecting individual areas.
Self-Assessments
To understand my own condition and assess the risks of impairment, I used several tools for self-assessment. For instance, the multidimensional scale of perceived social support (MSPSS) created by Zimet et al. (1988) is a tool allowing evaluation of whether a person receives enough support from family, friends, and in general. My results showed the following: a significant other – 5.5, family – 5.75, friends – 5, and total – 5.41. Although indicator 5 refers to the average level of support, it is its highest value, so the level of social support that I get is high.
Meaningful events in life, sometimes even joyful as the end of school or marriage, can lead to stress, affecting the body’s general state. The life change index scale created by Holmes and Rahe (1967) measures the level of stress and the likelihood of the disease on its background. The assessment using this tool showed me a result of 123 – a low level of stress and a probability of disease – 30%. However, given that 150 is an indicator of average stress levels, it can be assumed that I should take care of myself more carefully since one extraordinary event may increase my vulnerability.
Some tools are devoted to several aspects of life simultaneously, which makes the assessment more comprehensive. For example, I used the self-care assessment worksheet presented by Saakvitne and Pearlman (1996) and Robertson and Microys’s (2001) life balance assessment. These tools have shown me that there is still a lot of work to be done to achieve better results in all areas. In particular, I had a few “5” ratings meaning that I was doing something frequently for self-care assessment questions. Mostly the results were average, only in the work and balance above. A similar situation with Life Balance, since I entirely painted only a few sections on 100%. Using the results of the assessments, I created a personal wellness plan for myself.
Wellness Plan
I have the highest rates of self-care in the field of work, balance, and emotions. At the same time, the balance assessment includes high indicators in the social, intellectual, and emotional spheres. This result is confirmed by other tools – MSPSS and Life change index. I like that there is a high level of social support in my life. Given the stage of life, the moderate financial sphere indicators are quite satisfactory, and I think it will only improve. The areas I want to change are physical and psychological self-care.
The steps I intend to take are:
- Regularly eat healthy nutritional food.
- Include regular exercise in my routine.
- More walking and relax in nature.
- Show more interest in intellectual pursuits in various fields, such as art.
Thus, in half a year, I want to improve my physical health by introducing healthy eating habits and exercises and maintaining psychological health through an inspiring and exciting rest. I will share my plans with the family and ask them for support, saying that these steps are essential for my well-being and will be easy to achieve with their help. In particular, we can follow a diet and look for ways for a pleasant and diverse rest together. I intend to assess my progress in February or March 2022.
Conclusion
The work of the counselors involves significant requirements for behavior, manifestations of empathy, and care for clients since therapists are responsible for the patient’s health. At the same time, work processes can be disrupted if the counselors cannot care for themselves. Causes of the impairment may include illness, personal crises, or other reasons, and consequences often involve professional misconduct. To avoid impairment, counselors should monitor their psychological and physical health and take care of themselves.
References
Ahia, C. E., & Boccone, P. J. (2017). Licensure board actions against professional counselors: Implications for counselor training and practice. Vistas Online. Web.
American Psychological Association (APA). (2016). Ethical principles of psychologists and code of conduct. Web.
Bray, B. (2018). The battle against burnout. Counseling today. Web.
Holmes, T.H. & Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11(2), 213-218. Web.
Lawson, G., & Venart, B. (2005). Preventing counselor impairment: Vulnerability, wellness, and resilience. In VISTAS: Compelling perspectives on counseling. Web.
Posluns, K., & Gall, T. L. (2020). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International Journal for the Advancement of Counseling, 42(1), 1–20. Web.
Robertson, R. & Microys, G. (2001). Life balance assessment and action planning guide. Web.
Robino, A. E. (2019). Global compassion fatigue: A new perspective in counselor wellness. Professional Counselor, 9(4), 272-284. Web.
Saakvitne, K. W., & Pearlman, L. A. (1996). Transforming the pain: A workbook on vicarious traumatization. WW Norton & Co.
Wilkinson, T., Smith, D., & Wimberly, R. (2019). Trends in ethical complaints leading to professional counseling licensing boards disciplinary actions. Journal of Counseling & Development, 97(1), 98-104. Web.
Zimet, G.D., Dahlem, N.W., Zimet, S.G. & Farley, G.K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30-41.
Zur, O. (n.d.). Codes of ethics on therapists’ impairment, burnout and self care. Zur Institute. Web.