I just wanted to write a quick post to say thank you for all the feedback I have received for my blog. I really appreciate all the comments, tweets and Facebook messages and read them all. I have had an enormous amount of support and am so pleased that so many people find this blog interesting and keep coming back to read more! Keep letting me know your suggestions for future topics. I hope this finds you healthy and happy 🙂
There are academic research studies published about the various reasons why people choose to become therapists. Have a Google, it is rather interesting. If you would like to know why I became a therapist read on…….
Aged 19 I had a very promising career in opera and classical music ahead of me. The pleasure I got from singing gradually reduced over time as the pressure increased. I became more and more disillusioned with the classical singing world and eventually decided that despite my talent, this it was not what I wanted for my career anymore. I was then at a loss. Even if I had wanted to pursue a musical career it had started to become apparent that it was too physically demanding for me (I now know this is due to Ehlers-Danlos Syndrome although I was undiagnosed at the time) My life had revolved around music from the age of six. What on earth was I going to do now?
I remember getting out a piece of paper and a pen. I thought that if I made a list of all the things I enjoyed, that it might be helpful. The first two things I wrote down were;
I briefly entertained the idea of becoming a veterinary receptionist, but did not know where my career would go after that. I then realised I was more of a dog person than an animal person.
I was then left with just people. I love people. I really do. I have always been fascinated by why people behave or think in certain ways. Just for my own pleasure I would watch anything to do with psychology on television and read anything I could get my hands on. I don’t remember but apparently when I was in infant school, before I started studying music, I would tell people I wanted to be a psychiatrist. People very close to me had experienced psychosis and depression, so I was also aware that mental health problems were very real. One of the main issues I had with my career as a classical singer, is that I did not find it meaningful. Although I greatly appreciate the benefits of entertainment for others, I was so wrapped up in my own performance nerves that I could not appreciate it. I had this urge, and still do – to help people. I did not feel I was helping people with my singing voice.
The next natural step was to find a way to combine psychology with my love of people. I did some career research and decided that I would like to go into psychological therapy. I did not feel that a counselling course would provide me with enough depth or breadth to enable me to make informed decisions about which type of therapy I’d like to study (that is not to say I do not think counselling can be helpful for others. I sometimes refer people on to counselling if I feel it may more appropriate for them than CBT, and during my career in mental health I have met many people who have found counselling beneficial). It was very important for me to become and member of the British Psychological Society and so I enrolled to start BSc Psychology. Ironically before beginning my degree I became very depressed. This was before IAPTs existed and I saw a psychologist within the NHS and had what I now realise was CBT based therapy. I then went on to have cognitive-behavioural therapy to try and help manage chronic fatigue. I kind of fell in love with it (CBT not the fatigue!). People close to me had also had CBT. Whilst it is not a miraculous cure, it really had a meaningful effect on my life and my nearest and dearest. I wanted to offer the same support to others, with a therapy grounded in a solid evidence base. I still kept an open mind and studied many different perspectives during my degree. I graduated and worked in different roles in mental health. I got to witness the impact of CBT on lots of different people. My love and respect for CBT only deepened, so I took the plunge and trained did my post graduate diploma in cognitive behavioural therapy – and the rest as they say is history!
I have been asked my quite a few people to write a post on how I feel when I have to break a client’s confidentiality. Read on to see how I have felt in this situation, and why it’s good for other professionals to be pedantic.
To date I have never had to break the confidentiality of a client who I am seeing for cognitive-behavioural therapy. In all the situations that I have encountered where it has been essential for me to inform my client’s GP (or somebody else) about something, I have been able to discuss it with them first.
However, In previous roles working in mental health I have had to break my client’s confidentiality either without their consent, or without attempting to gain their consent in the first place. Breaking confidentiality only ever happens (or should only ever occur) when the client or others are seriously at risk. Whenever I have had to do this, it has been my client’s health and life that could potentially be threatened, because if I had not taken immediate action and/or if by asking them for consent I would have put them at further risk. I will not discuss individual cases on here, for confidentiality reasons (I mean this sincerely, no pun intended). More to the point, this post and blog is about my own thoughts and so it is not even necessary.
There is no doubt that when I have broken someone’s confidentiality I have felt guilty. Although I have always felt very confident that my actions were essential and definitely within my client’s best interests, there is no getting away from the guilt. The clients I have worked with, I have built good long standing relationships with, over many months and in some cases years. Sometimes I have been the only person they have really trusted, and to go and do something that puts that trust in jeopardy is so difficult. I have been lucky, my clients have always understood the reasons for my actions and we have come out on the other side, but for other professional-client relationships this is not always the case. I can only speak for myself here, but I have only broken my client’s confidentiality when I have felt that if I did not, their life may have been at risk or they were likely to become seriously unwell. Although in all good therapeutic relationships your client is always told that in exceptional circumstances there confidently may be broken, it still does not mean this is an easy thing to do. The thought of somebody doing it to me – no matter how good their intentions, makes me feel vulnerable, scared and almost invalid as a person. It’s horrible to think I may have made other people feel this way at some point or other.
I have had positive experiences when I have needed to obtain information about my client without their knowledge. Other professionals have thoroughly checked me out and my reasons for wanting the information before releasing it. Good. This is the way it should be. I would not want somebody to tell me private details about someone else, without them making sure I was who I said I was first, and that it was essential for me to have the information. In these situations the more pedantic someone is the better.
Breaking confidentiality is never nice, should never be unwarranted, but at the end of the day, sometimes it is necessary to literally save somebody’s life – so I’ll take the guilt any day.