05/08/2008

eCounseling Clients in Crisis:

(By Anthony Centore Ph.D.) All eCounselors provide some crisis counseling. Crisis situations are a common concern for eCounselors - and rightly so. To be ethical, counselors of all philosophies and practice settings need to handle these situations carefully. If you haven’t been concerned, consider that failures to make efforts to prevent client suicide account for 42% of the dollars paid in malpractice settlements.1 Thankfully, one can make prevention efforts and handle crisis situations successfully with eCounseling. Emphasis on Crisis In contrast to in-person clients who visit a counseling center (which is a safe and neutral environment separate from their life-issues), eCounseling clients receive help from within the settings where their problems take place. Hence, when a client says, “I hate my apartment, it reminds me of my ex-husband,” she is saying this from inside that apartment. This can increase the intensity of the counseling process. In addition to the uncontrolled setting, eCounseling clients seek help during a problem, not after it. They may seek help at odd hours of the night or morning when they feel the worst. eCounselors can be contacted by clients who just experienced violence, clients in fear of violence, or clients feeling guilty over committing violence. And, perhaps most unsettling, eCounselors are sometimes contacted by persons seriously considering suicide. I’m not saying eCounselors are overwhelmed with emergency calls - that is a common misperception. In fact, emergency calls (such as the suicidal caller) are quite rare. One crisis hotline recently reported that out of more than 500 calls a month, only 10% of callers reported being suicidal. The majority of callers were not in an emergency, but simply felt they were having a personal crisis. The fact is, a client can be in “crisis” whether she is a stressed-out teen or a panic-stricken elderly woman calling because she can’t make her mortgage payment.2 Helping Suicidal Clients eCounseling is obviously not the gold standard treatment for clients in a life-threatening crisis. However, it is certainly better than no treatment at all, and could be a lifesaver for persons who refuse, or are unable to receive, help in another manner. This idea is not new. The Samaritans, a group in England, “provide emotional support to any person who is suicidal or despairing” through telephone and online care.3 Similarly, 1-800-SUICIDE is just one of several U.S.-based hotlines that has been providing crisis care for decades. Responding to an Emergency An important issue when dealing with suicidal, or homicidal/violent, clients is whether a counselor is able to respond effectively to an emergency situation. With some preparation, eCounselors can be sufficiently equipped to respond. eCounselors, like in-person counselors, should have an official intake process where clients provide their address/location, multiple contact methods, and an emergency contact person. Electronic filing makes this information easy to retrieve, and electronic payment (i.e., credit card; a common eCounseling payment method) provides a verified client address. Hence, in a situation where there is a threat to a client’s self or others, eCounselors can be well equipped to contact relevant local agencies, and even warn parties in potential danger. Preparing for the Unexpected Here are some more specific preparation tips: Before you begin taking clients… * Have a reliable suicide assessment tool on hand * Make public (by posting online) a policy explaining if or how you provide care to suicidal/violent clients * Recommend (by posting online) alternative treatments for persons battling suicide (in-person care, hospitalization, etc.) * Prepare a thorough informed consent processes that includes confidentiality limits Before an Emergency occurs… * Establish contact with a counselor local to the client in case in-person care is needed * Obtain accurate client information including name, location, and permanent address * Obtain back-up contact methods, including the contact information of several people the client knows and trusts * Obtain the contact information of emergency services that are local to the client * Create an agreed-upon emergency plan with at-risk clients Anthony J. Centore, Ph.D. serves as the Special Assistant to the President for the 50,000-member American Association of Christian Counselors, and is an Adjunct Graduate Professor for the Center for Counseling and Family Studies at Liberty University. He has authored numerous book chapters, articles, and is a columnist for Christian Counseling Today magazine. Anthony is author of The Clinical Training Guide for Online Counseling and Telephone Counseling. Anthony is Director of www.eCounseling.com and practices counseling in Boston and Cambridge, Massachusetts. See www.ThriveBoston.com

05/08/2008

Book Review: Shattered Vows (Dabra Laaser):

No one likes to talk about sexual betrayal. Let me rephrase that. No one likes to talk about sexual betrayal when it happens to him or her. Not long ago, Debra Laaser experienced a wife’s worst nightmare. And today, she is ready to tell her story. And a well-told story it is, written with clarity and eloquence surprising for a first time solo-author*. But this work is neither a biography, nor a collection of Deb Laaser’s memoirs; it is a survivor’s guide for the sexually betrayed. With exercises throughout, the book over-delivers. There are illustrations, charts, figures, and interactive forms. There are lists of useful web pages, and descriptions of relevant support groups. There is a depression self-assessment tool, and a “thinking it over” section at the end of each chapter lists 4-5 reflective questions for the reader. For readers seeking “how-to” knowledge, Debra answers a plethora of questions including: How quickly should I forgive? In whom should I confide? What do I tell the kids? Should I be sexual with my spouse? It is as if Debra walks side-by-side with the reader, showing her how to understand, feel, respond, grieve, trust, not trust, accept help, gain control, heal, forgive, and rebuild. Even with a short glance, the reader can’t help but take away something useful. I have already recommended this book to a client. —– —– —– *Debora previously co-authored Open Hearts with her husband, Mark Laaser. * * * Anthony J. Centore, Ph.D. serves as the Special Assistant to the President for the 50,000-member American Association of Christian Counselors, and is Director of www.ecounseling.com. He has authored numerous book chapters, articles, and is a columnist for Christian Counseling Today magazine. Anthony practices counseling in Boston and Cambridge, Massachusetts. See www.ThriveBoston.com

05/08/2008

eCounseling.com Update: First Quarter 2008:

Since AACC sponsored its official launch in November 2007, eCounseling.com has become the premier Christian counseling website on the Internet. The Best Christian Counseling Content Today eCounseling.com contains nearly 1000 Christian counseling articles (many taken from the award-winning Christian Counseling Today magazine), with over 100 easily searchable topics. Add to the article database a growing collection of several hundred Christian counseling videos, and eCounseling.com is nothing short of a revolution for the field of Christian counseling. Telephone and Online Counseling If great content was all eCounseling.com offered, we would be very pleased. But information is just the beginning. In addition to providing the best Christian counseling content on the web, eCounseling.com is the most state-of-the art website on the Internet for providing counseling by telephone, email, and text-chat. Since November, our growing network of online counselors have set their counseling rates, scheduled sessions with clients, provided counseling, and received immediate payment for their services. We could not be happier with our early results. User feedback shows that the website is completely functional, and user-friendly. FREE Counselor Profiles And there’s more. eCounseling.com has recently begun to offer a FREE profile for counselors who want to advertise their in-person counseling practice. This free profile includes: counselor name, credentials, a biographical statement, a greeting to clients, phone number, email address, office address and map, and the option to post a photo. And, COMING SOON: a FREE profile will also soon be offered for support and recovery groups who want to advertise their meetings and services. eCounselor Training Last month, the Director of eCounseling.com, Dr. Anthony Centore, recorded a 6-hour DVD training course on Telephone and Online Counseling. This will be offered by the AACC in the near future, and is a must-have training program for anyone wanting to begin providing telephone or online services (professional counseling, life-coaching, or even lay counseling). Also, Dr. Centore’s recently released clinical training guide, “The Therapists Clinical Guide To Online Counseling and Telephone Counseling” is a content-rich resource that is getting great reviews. Groups Coming Soon This is just the beginning for eCounseling.com. We are improving the website every day, always making it a more functional and enjoyable experience for our many visitors. Your Feedback Matters Here at AACC we think the eCounseling.com project is going well. But we still want your thoughts and feedback on how we can make the website even better. Visit eCounseling.com, create your FREE profile (who doesn’t benefit from free marketing?). Let us know what you like, and if there is anything you would change. eCounseling.com was developed for counselors like you (and your clients), so let us know your thoughts! * * * Anthony J. Centore, Ph.D. serves as the Special Assistant to the President for the 50,000-member American Association of Christian Counselors, and is an Adjunct Graduate Professor for the Center for Counseling and Family Studies at Liberty University. He has authored numerous book chapters, articles, and is a columnist for Christian Counseling Today magazine. Anthony is author of The Clinical Training Guide for Online Counseling and Telephone Counseling. Anthony practices counseling in Boston and Cambridge, Massachusetts. See www.ThriveBoston.com

05/06/2008

The Place and Importance of Pastoral Care:

n these days when counseling has gripped the popular psyche, pastoral care has been denigrated and devalued in favor of its big cousin…even by Christians. Yet this seems sad for pastoral care. Pastoral care should have been complemented rather than eclipsed by Christian counseling, with its qualifications and professionalism. There can be no doubt that: * pastoral care pre-dated counseling, certainly in the form that we know at the present time * pastoral care could prevent much that now arrives on the desk of a counselor from ever getting that far. Click here

05/06/2008

Men Counseling Women:

Although a book could easily be written on the subject of men counseling women, on a page or two it is necessary to get straight to the main dynamics of transference and countertransference in therapy. (And while I am not a Freudian or psychoanalytic therapist, I do believe that all counselors should know and respect the operations of the defense mechanisms and transference/ countertransference dynamics.) Click Here to Read