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by a BFRP, UK
During the consultation process, do we tell our clients that the information given will be treated in strictest confidence, and what do we actually mean by that? Do we literally mean that anything said will always be contained within the four walls of the consulting room? Or are we aware of professional ethics and accountability if information disclosed to us reveals that the client may be in danger, and do we make the client aware of our professional boundaries?
I recently had an experience that raised these issues. It concerned a 13-year-old girl called Clare. She was being bullied at school, and had been bullied since her first day at primary school. Her mother had also experienced school bullying, so the anxiety in the family was all the higher.
Clare opted to see me by herself. I explained that anything said would be treated in confidence with the exception of information given that might indicate that she might cause harm to herself or to any third party.
We seemed to establish a good rapport, and as I began to observe and listen to what Clare was saying I formed a picture of an intelligent, sensitive girl with great creative ability, who didn’t fit in and was struggling to find her identity. Clearly she had reached the end of her tether. She was describing strange dreams and visions, anxiety attacks and feelings of guilt, and she was slapping and scratching herself. After further prompting she told me that she had experienced suicidal thoughts on occasions over the past few months, but that they passed in and out of her head very quickly. I asked her when she had last experienced such a thought.
This morning, she replied.
As the consultation drew to a close I reminded Clare of the verbal contract that we had made and said that I would like to bring her mother into the room and share with her what Clare had told me. It was a delicate situation, but I explained that it was doing what was best for her and that clarity was needed for each party involved. I was aware too that Clare was a minor, so I had a legal responsibility to inform her parents.
When I had talked to Clare’s mother she said she was aware of the suicidal thoughts and seemed relieved that it had come out in the open. I sensed too that Clare had needed to express these feelings in a safe environment. I explained that I would need to contact Clare’s GP and that the next stage would be for them both to make an appointment to see her. I rang the surgery in addition to writing a letter expressing my concern, although I only made contact with the duty doctor on call for that day, as Clare’s usual GP was away.
Following the visit, Clare’s GP subsequently decided that Clare was fortunately not at risk, and told Clare that she would support her should she decide to leave school and opt for home education. She also encouraged Clare to continue to see me and evidently saw what I was doing as a positive supportive measure. I maintained regular contact with Clare’s mother by phone so that I was kept updated.
The remedies worked extremely well for Clare. She became stronger and more assertive, and the strange dreams, suicidal thoughts, anxiety attacks and so on gradually dispersed. She looked brighter and happier. We were able to discuss each remedy with openness and mutual respect, and Clare was able to give me specific feedback about how each individual remedy was helping her. She also liked to add the remedies to the treatment bottle herself.
Clare has now moved classes, and although some of the girls responsible for the bullying are still around, she is finding her own identity within the school group, and I now need to see her less frequently.
There are times when the client’s learning experience is also a lesson for the therapist. Clare once said to me, ‘Do you know why I like coming here to see you? It’s because you make me feel special.’ My reply was, ‘But you are special, and you have a right to be you.’ Although I had never experienced bullying in the way that Clare had, I was glad of the opportunity to give her this encouragement, because I too have suffered isolation and despair, and I could see so much of myself in her.
Editor’s note: The end of this account brings to mind Dr Bach’s comment, that ‘everyone of us has sympathy with those in distress, and naturally so, because we have all been in distress ourselves at some time in our lives.’ We would welcome any further experiences when dealing with the difficult area of client confidentialiy. Please send your thoughts or comments to the usual address.
A Case for Supervision?
As Bach practitioners we are often reminded just how simple, safe and effective the Bach remedies are. Our clients bring us their stories of restored well-being, which are coloured by their enthusiasm for learning more about Dr Bach’s work. It is all very encouraging – but the dynamics of the therapeutic and educational relationships we have with our clients are not always so straightforward. And it is not uncommon for a client’s anxieties, worries or unhappiness to stay with us, even after the client has left the consulting room.
“We never really get to grips with how little we know, until we start working with clients.” This comment is often heard among complementary therapists after they have dipped their toes into the swirling waters of client work. The client’s world is uniquely his or her own, and we as therapists are afforded a glimpse through a doorway that would otherwise be closed to us. Not surprisingly we may at times feel out of our depth, or challenged, or even frightened. These feelings are real, and while we know there is support readily at hand within the box of flower remedies, we may need other types of support as well, to help us see a path through the client’s development and to assist our own management of the relationship.
Apparently there are over 40,000 complementary therapists in the UK, and if the level of participation in Bach Centre-approved courses is any indicator of similar trends in other countries then there is a huge number of therapists world-wide. This is a very exciting development in healthcare; but to ensure its growth and value, it is essential that everyone working in this arena is doing and being the very best in terms of providing a professional practise.
A challenge to this goal is that many complementary therapists (including Bach practitioners) work independently and from home, with no links to health centres or colleagues. Apart from their own family and friends, the only people they may see from one week to the next are their clients. With whom do they share the feelings and the experiences of working with clients? Who knows just how well they are managing the boundaries of professional practise?
Several years ago I was working as a relationship counsellor with the UK organisation Relate. Regular supervision from an experienced colleague was an essential requirement in enabling me to work effectively and ethically with clients. (As any member of a professional counselling body knows it is also a condition of membership). I have left Relate now, but I have not left the practice of regular supervision. It was too valuable a process to discard; it keeps me on track.
So nowadays, instead of taking my couple work to a wise counsel, I bring the themes and issues that arise in the course of my work as a BFRP, and as a trainer and business development consultant. Supervision is my formal forum for unpicking the dynamics of my relationships with groups and individual clients; and a way of exploring the effectiveness and appropriateness of what I am doing. Being exposed to my supervisor’s very effective active listening, I also get to see her modelling best practise. She will, amongst other things, challenge, question, advise and reassure; and also provide the space for me to let go of any emotions such as sadness, anger, despair and fear, that I may have been exposed to in my work. She also helps me see if any of my feelings (we all have them!) have compromised my professionalism.
This is not personal therapy. What it is, is an honest, safe, confidential environment that supports me in delivering best practise. It also means I am not alone. There is a reality check, a place for accountability and personal responsibility. This is, if you like, a safety net – both for me as a practitioner, and for my clients.
Supervision is an inherent aspect of my own approach to continuing professional development (CPD). But for many complementary therapists, this holding space is not formalised – mainly, I suspect, because supervision is not a familiar concept, unless practitioners have, for example, a counselling, nursing or homeopathy background.
If you are one of those practitioners who is not so familiar with the idea and value of this kind of professional support, it would be interesting to know how you manage the boundaries of good practice. Here are some questions to get the ball rolling:
- What have you found effective in your own CPD?
- How have you overcome any geographic or philosophical isolation?
- What is it like to work with a supervisor who is not a BFRP? Or to work with one who is?
- Do you belong to a group that includes an element of supervision?
- Have you found participating in BFRP development days beneficial – and how?
- Have you started up a support network in your area?
- What worked and what, if anything, did not?
- What do you think are the pros and cons of BFRP Supervision?
Editor’s note: Again, we would welcome your thoughts on this subject. Please email your responses or ideas to the Centre.
We want you to use this Bulletin to keep in touch with each other. If anything wonderful, funny, interesting or just plain typical has happened to you in your work with the remedies, or if there are any questions that have been nagging away at you, or if you simply want to say hello, please write to us at the Bach Centre, marking your letter clearly as being ‘FOR PUBLICATION’.
We can’t promise to print every letter in the Bulletin, but even if we don’t use your contribution we always love to hear from you.
I have found completing the Continuing Professional Development form helpful. It has made me reflect more on exactly what I do to assist my development and also helped me to focus on what else I could do. The remedies continue to be a major part of my life and I am certain that they help me (almost daily!) maintain my equilibrium and deal with the stresses of the world.
Helen Finney BFRP, UK
Since the last (March 2003) issue was prepared, 47 new practitioners have joined the register:
- in Argentina, Graciela Elena Jalil de Rios, Marta Susana Buttazzoni, Ione Maria Aires Neto, Silvia Mabel De Serquera and Adriana Silvia Palazzo;
- in Australia, Kayleen Jaeschke;
- in Belgium, Karin Taverniers;
- in Brazil, Andréa Neiva Leite, Maria Helena De Mello Rouanet and Maria do Socorro de Borros Costa;
- in Denmark, Josefin Chaline Mørk and Elsebeth Sørensen;
- in England, Angela Smith, Patricia Howlett, Liz Bevans, Oliver Hogg, Ruth Souhamy, Janet Hardy, Lesley Woolley, Jean Partington, Fiona Garratt, Jenny McKenna and Nicki Hart;
- in France, Isabelle Quémat, Marie Ozbolt, Noëlle Buffiere, Christine Montaudié, Joel Provost, Isabelle Dulac, Sophie Picard and Nathalie Deberre;
- in Ireland, Helen Larkin O’Neill and Rachel Mescall;
- in Italy, Loredana Benni and Patrizia Scanu;
- in Northern Ireland, Chris Hoswell;
- in Spain, Carmen Lafuente Yera, Caroline Krabbe, Juana Maria Carretero Rodriguez, Maite Casco Latorre, Maria Jesús Valverde Sarachaga, Marcia Pereperez Carrilero, Montserrat Guillen Robles and Silvia Aguilera Riba;
- and in the U.S.A., Marie Synrod, Lillian Resnick and Laurie Johnson.
There are now 1,292 practitioners on the register.
This archive material has been edited to remove some out-of-date advice and information.