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Ethical Reflective Statements

In: Philosophy and Psychology

Submitted By heavenlychild
Words 2746
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Introduction
A therapist is bound to encounter boredom, burnout and or therapist impairment at some point during her career. These may have a significant impact on therapist efficacy and inflict intentional or unintentional physical and or psychological harm on clients who are seeking counselling if not managed properly. Therefore, it is of great importance to recognise the signs of such problems by looking after oneself physically and psychologically, which is crucial to both the therapist’s and the client’s well-being. The author aims to explore the effects of boredom, burnout and impairment and how the author can maintain therapist efficacy through career-sustaining behaviours.
Boredom
The experience of boredom, also known as disenchantment or disengagement, as (Campagne, 2012; Ulberg, Amlo, Hersoug, Dahl, & Høglend, 2014) named respectively, affects humanity in a variety of ways. Kottler (2010, p. 169) defines boredom as the “loss of interest and momentum” and lack of stimulation in one’s work. Similarly, Campagne (2012, p. 76) defines boredom as a “loss of interest in and emotional demotivation for the professional activity itself” and stresses that it involves the loss of flow and professional motivation, which is prior to, but can eventually lead to burnout if the symptoms are ignored. In the therapeutic setting, boredom can manifest in different forms, such as, “repetition that is so difficult to tolerate, not only in the similarity of client complaints but in the therapeutic messages we relay” (Kottler, 2010, p. 173) and clients who are lifelessly silent or drone on monotonously sessions after sessions (Bergstein, 2009). Ulberg et al. (2014) takes it one step further and concludes that high levels of therapist disengagement results in therapist reacting poorer and slower to client transference and defence mechanisms than in low levels of disengagement. Likewise, the author notices reduced efficiency in the workplace when experiencing periods of boredom.
On the other hand, Bergstein (2009) suggests that therapists experience boredom from a client’s perspective and allow it to undergo a transformation into a valuable and meaningful experience, based on his experience with three child clients. Bergstein’s alternative perspectives on boredom challenge the notion that a therapist must avoid it at all costs. It introduces the possibility of meeting the client in the state of boredom (who may not actually recognise it to be boring) and exit it together, in order to reach the next milestone in the therapeutic journey.
Avoiding boredom completely is unrealistic, as it will occur in most occupations, as the author found out after working in a dream job and vocation for a few years, despite great interest and enthusiasm initially. Therefore, it is essential that the author can identify the signs of boredom, such as feelings of frustration despite previous passion in customer service, finding that time passes extremely slowly, use of creative ways to respond to or keep track of mundane questions, and simply not wanting to return to work despite an extended holiday. The author realises that taking preventative action have the potential to manage the situation before it manifests into burnout. Understanding and addressing the cause of boredom, discovering new ways of doing things, sharing knowledge and experience with colleagues, learning new skills, and adding variety to routine tasks have increased the author’s productivity in the past.
The author recognises that there is limited evidence available on the effectiveness of incorporating the boredom a therapist may experience as part of the therapy. It may be of interest for the author to investigate the feasibility, validity and reliability of Bergstein’s subjective experience of boredom further, through more comprehensive research and replicating Bergstein’s methods in her future clients when the opportunity arises.
Burnout
As stated previously, boredom is the precipitating symptom of burnout and if it is not dealt with appropriately and allowed to manifest, it will eventually become burnout (Campagne, 2012). Therefore it is logical to explore burnout and its impact on counsellors.
There is extensive literature written on various aspects of burnout, such as typology, risk factors, predictors, and the impact of burnout on therapists and in other professions (Campagne, 2012; Lee, Cho, Kissinger, & Ogle, 2010; Lent & Schwartz, 2012; Lim, Kim, Kim, Yang, & Lee, 2010). As a result, the definition of burnout has been heavily explored and refined by many authors since the term first appeared. Kottler (2010) simply and bluntly called burnout as “rustout”, which occurs when even the therapist no longer knows or cares about the clients’ current state or situation, which may happen when the therapist is displaying overconfidence or frustration regarding her clients. Other signs of burnout Kottler (2010) offered include lack of compassion for clients, unhealthy lifestyles, cynicism, physical and emotional exhaustion, making mistakes, the desire to be anywhere but in the counselling room, and denying that there is a problem.
One of the surprising factors to the author is the broad range of the risk factors of and predictors that have the potential to contribute to burnout and its impact on counsellors (Lent & Schwartz, 2012; Lim et al., 2010; Thompson, Amatea, & Thompson, 2014). Some of these include the experience and qualification of the counsellor, work setting (Lee et al., 2010; Lent & Schwartz, 2012), level of support and supervision in the workplace (Lee et al., 2010; Lent & Schwartz, 2012; Thompson et al., 2014), workload or caseload (Lee et al., 2010; Lim et al., 2010), and the clients’ personal experiences and their risk of committing suicide (Thompson et al., 2014).
While burnout in others is easily noticeable from their behavioural change, it might be more challenging to identify the signs of burnout, and acknowledge its occurrence in oneself. Therefore, it is essential for the author to be vigilant for signs of burnout and manage it before it impacts one’s effectiveness, productivity and competence. In the author’s experience, burnout is evident when losing one’s temper in front of colleagues and displaying impatience towards clients who require ongoing assistance. Furthermore, expressing suicidal thoughts or requesting for psychiatric evaluation to colleagues even in a joking, light-hearted way while working in a hospital setting, indicate self-care activities are warranted as a minimum.
As Kottler (2010) pointed out, it’s not whether a therapist experiences burnout, but the extent of burnout that is of concern. Therefore, the author needs to accept that when practicing as a therapist, burnout is not only unavoidable, but will likely become more intense than working in the current profession. It is therefore crucial that the author regularly implements and partakes in activities that promote physical and psychological well-being, beginning in her current occupation. It is hoped that by practicing this now will become a habit that will carry through to when the author practices as a qualified therapist.
Impairment
It is surprising to the author to learn that most, if not all, therapists are susceptible to impairment at some stage during her counselling career (Clemens, Horwitz, & Sharp, 2011). Kottler (2010, p. 204) defines an impaired therapist as “dysfunctional to the point of actually hurting others” and that it “affects every domain in a professional’s life”. This challenges the author to be on the lookout for signs of burnout and impairment in oneself (Kottler, 2010), seek feedback from colleagues and clients (Clemens et al., 2011), and use screening or assessment tools (Saakvitne & Pearlman, 1996; Stamm, 2009) to evaluate one’s professional quality of life and well-being. The benefit of these additional methods is that they are not limited to the author’s subjective self-assessment, and have the potential to prevent self-denial.
J worked alone for 15 years without a clear reporting structure, was displaced after an organizational restructure, and placed into a small team at another site. She had frequent unplanned and unexplained absences of various durations, in addition to workers’ compensation claims that mandated a reduced number of hours spent on computer work, and a four-day working week. The author and colleagues were often manipulated into helping her with most of her assigned tasks, and shouldered some of her responsibilities. The author struggled between helping J and completing the task herself, which would have been quicker and less frustrating. This resulted in increased stress levels, and unpredictability and uncertainty in work planning in the author for 18 months. The situation improved when Jane resigned after nine months of performance management. Having worked with someone who lacked insight into her behaviour highlight to the author the importance of not inflicting similar stress on future colleagues and clients. Therefore, the author will strive to be insightful and alert for signs of impairment. The author also intends to have a disaster and impairment action plan ready to be implemented when necessary, to minimise the impact on clients. This would outline the procedures to be implemented in case the author is unavailable to offer counselling services unexpectedly. This may include detailing location of client contact information and files, therapeutic tools, and referring clients to another colleague or therapist until the author returns (McInerney, Jools, & Williams, 2009).
Admitting that one is not functioning at full capacity and at risk of causing harm to clients, can be challenging. Referring clients to another colleague or therapist will require courage and advance planning. However, once the author acknowledges and accepts the existence of impairments, it would be wise to seek help and explore ways to cope, manage, and or resolve the impairment if possible. Knowing that not all impairments are permanent will encourage the author to take the necessary actions to minimise the impact of the impairment on oneself and clients. Furthermore, having experienced and resolved the impairment, the author is better placed in modelling the desired coping behaviour to clients who may encounter a similar problem.

Self-care
As mentioned earlier, boredom, burnout and impairment can have serious and significant implications on the therapist and have the potential to cause further unnecessary and avoidable harm and trauma to the client if the causes are not addressed in a timely manner. Therefore, it is vital that the author maintains involvement in self-care activities regularly, which have the potential to minimise the negative effects of these serious problems.
Richards, Campenni, and Muse-Burke (2010) summarised the four major self-care components including physical, psychological, spiritual, and support. Self-care involves attending to one’s physical, psychological, and spiritual well-being, by undertaking and participating in personal and professional activities, also known as career-sustaining behaviours (Lawson & Myers, 2011). The author is interested in active involvement in career-sustaining behaviours such as maintaining a healthy, balanced lifestyle by eating a balanced diet, going bushwalking, spending time with family and friends, continuing education, church participation, undergoing personal therapy, and supervision, as avenues to reduce stress levels, add variety to routine tasks, and create distance between oneself and clients’ traumatic experiences. Being involved in peer supervision or peer mentoring can ensure the author has the opportunity to hold each other accountable, and provide mutual support. In addition, having a supportive management team that encourages regular work breaks and have the capacity to provide effective debriefing after troubling and or traumatic sessions can greatly assist in maintaining one’s emotional and mental well-being. Despite being camera shy and difficulty in developing a habit in writing regularly, the author is interested in trying video journaling (Parikh, Janson, & Singleton, 2012) and creative writing (Warren, Morgan, Morris, & Morris, 2010) as self-care and professional development activities. Furthermore, practices of gratitude, mindfulness and self-awareness can all play an important role against boredom, burnout and impairment (Lanham, Rye, Rimsky, & Weill, 2012; McCann et al., 2013; Richards et al., 2010; Thompson et al., 2014).
Both Campagne (2012); Kottler (2010) believe the early detection of boredom, burnout, and impairment are crucial to sustaining the vitality and well-being of the therapist. This requires the author to be mindful of the signs and symptoms, and be actively involved in the relevant self-care activities on a continual and ongoing basis so that the author has the physical, emotional and psychological capacity to continue to practice. It must be noted that the habit of undertaking self-care practices requires time to develop, therefore the author should start looking after oneself as early as practical. As the author needs to be healthy and well to be able to look after clients, it cannot be reiterated enough that the author address causes of boredom, burnout and impairment through career-sustaining behaviours with high priority.
Conclusion
It is unavoidable that the author will encounter problems such as boredom, burnout, and or therapist impairment at some point in her career. If left unacknowledged and untreated, these problems will have a significant impact on the author and the clients who are seeking help. Therefore it is important for the author to be alert to the signs of boredom, burnout and an impaired therapist in herself, and act appropriately to limit the negative effects the problems have on the author and her clients. These problems can likely be successfully managed and potentially resolved through the author taking early preventative action by being actively involved in self-care or career-sustaining behaviours.

References

Bergstein, A. (2009). On boredom: A close encounter with encapsulated parts of the psyche. The International Journal of Psychoanalysis, 90(3), 613-631. doi: http://dx.doi.org/10.1111/j.1745-8315.2009.00150.x
Campagne, D. M. (2012). When therapists run out of steam: professional boredom or burnout? Revista de Psicopatología y Psicología Clínica, 17(1), 75-85.
Clemens, N. A., Horwitz, M., & Sharp, J. (2011). Addressing impairment in a colleague. Journal of Psychiatric Practice, 17(1), 53-56.
Kottler, J. A. (2010). On being a therapist (4th ed.). San Francisco: Jossey-Bass.
Lanham, M. E., Rye, M. S., Rimsky, L. S., & Weill, S. R. (2012). How gratitude relates to burnout and job satisfaction in mental health professionals. Journal of Mental Health Counseling, 34(4), 341-354.
Lawson, G., & Myers, J. E. (2011). Wellness, professional quality of life, and career-sustaining behaviors: What keeps us well? Journal of Counseling and Development, 89(2), 163-171.
Lee, S. M., Cho, S. H., Kissinger, D., & Ogle, N. T. (2010). A typology of burnout in professional counselors. Journal of Counseling & Development, 88(2), 131-138.
Lent, J., & Schwartz, R. C. (2012). The impact of work setting, demographic characteristics, and personality factors related to burnout among professional counselors. Journal of Mental Health Counseling, 34(4), 355-372.
Lim, N., Kim, E. K., Kim, H., Yang, E., & Lee, S. M. (2010). Individual and work-related factors influencing burnout of mental health professionals: a meta-analysis. Journal of Employment Counseling, 47(2), 86-96.
McCann, C. M., Beddoe, E., McCormick, K., Huggard, P., Kedge, S., Adamson, C., & Huggard, J. (2013). Resilience in the health professions: A review of recent literature. International Journal of Wellbeing, 3(1), 60-81.
McInerney, A., Jools, P., & Williams, J. (2009). The therapist as a person: Trauma and psychic pain in the life and work of a therapist. Australasian Journal of Psychotherapy, 28(1-2), 64-82.
Parikh, S. B., Janson, C., & Singleton, T. (2012). Video journaling as a method of reflective practice. Counselor Education and Supervision, 51(1), 33-49.
Richards, K. C., Campenni, C. E., & Muse-Burke, J. L. (2010). Self-care and well-being in mental health professionals: The mediating effects of self-awareness and mindfulness. Journal of Mental Health Counseling, 32(3), 247-264.
Saakvitne, K. W., & Pearlman, L. A. (1996). Self-care assessment worksheet. Transforming the pain : a workbook on vicarious traumatization. New York: W.W. Norton & Company.
Stamm, B. H. (2009). Professional quality of life: Compassion satisfaction and fatigue version 5 (ProQOL). ProQOL.org. Retrieved April 29, 2015, from http://www.proqol.org/uploads/ProQOL_5_English.pdf
Thompson, I. A., Amatea, E. S., & Thompson, E. S. (2014). Personal and contextual predictors of mental health counselors' compassion fatigue and burnout. Journal of Mental Health Counseling, 36(1), 58-77.
Ulberg, R., Amlo, S., Hersoug, A. G., Dahl, H.-S. J., & Høglend, P. (2014). The effects of the therapist's disengaged feelings on the in-session process in psychodynamic psychotherapy. Journal of Clinical Psychology, 70(5), 440-451. doi: http://dx.doi.org/10.1002/jclp.22088
Warren, J., Morgan, M. M., Morris, L.-n. B., & Morris, T. M. (2010). Breathing words slowly: Creative writing and counselor self-care—the writing workout. Journal of Creativity in Mental Health, 5(2), 109-124. doi: 10.1080/15401383.2010.485074…...

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...Dom Casmurro Reflective Statement My understanding of the cultural and contextual considerations of Machado de Assis' Dom Casmurro was greatly expanded by this interactive oral presentation. This presentation focused on the mythological archetypes, which providing insight that deepened the meaning of many scenarios. This presentation was very helpful covering Thetis, Aurora, Homer's cow, and Priam. This information has been highly helpful in analyzing the novel. Knowing how Bento wanted to describe Capitu to Aurora and Thetis helped me understand how he viewed her. He didn't end up describing her hair to Aurora's because, “I was yet unfamiliar with this goddess”. Aurora's hair of sunburst and sun rays were probably not a good enough way to describe Capitu's hair. Bento crossed out Thetis and nymph and instead wrote “a beloved creature, which is a word which embraces all the powers.” Thetis was one of the 50 Nereids and their leader. She had her son Achilles with King Peleus, who she didn’t really like. Bento described Capitu's undertow eyes like Thetis' because she was the goddess of the sea. The sea has an undertow current that drags people in just like Capitu's eyes dragged in Bento and made him love her even more. Homer's cow is about the sun god's Helios' immortal cows. Odysseus' crew kills the cows and Helios gets mad. He kills the crew except Odysseus because he escaped to Calypsos' island. Homer's cow was used to describe Jose Dias' eyes and how they “dragged......

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Personal Ethical Statement

...Juanita Johnson GEN/200 March 4, 2012 Personal Ethical Statement My preferred ethical lens is Rights and Responsibility lens centering toward rationality. I have the ability to identify my obligations, my duties, as well as, rights in the situation. This ethical lens taught me not to comfort anyone with a problem without going to the head first. Saying, if I was to see a co-worker stealing I should go to the boss or supervisor before confronting the person. The blind spots I have with the inventory are the Relationship and Reputation lens. From the evaluation I learned that I’m more focused on the Rights and Responsibility lens as well as the Results lens, that I am not allowing myself to see and evaluate the bigger picture of a situation. It teaches me that I’m willing to forgive a person for wrong doing whether approving the situation for results. I also learned to focus on the process and the system needed for an ethical organization. The Relationship lens give me the right to voice, notice, and have contracts honored. The strength I gained from this inventory I have the ability to make people happy. According to the Results lens, I tend to be a realist and acknowledge the very human frailties that we all have. I consider my weakness to be in the Reputation lens. The ethical coach thinks I need more understanding with the four core virtues in this lens. These virtues include: (a) Integrity, (b) Contributory Justice, (c) Retributive Justice, and (d)......

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