Ethics

Over the past few weeks here, I have observed some less than stellar clinician-client interaction. Yesterday, a counselor here started an argument with a client over donating a Safeway gift card to the common pool of cigarette money. There were many conversations going on simultaneously and the client did not know what she was requesting of him. The counselor refused to explain her request and the client refused to comply. Later on, while I was leading a group, the client raised the issue of quitting smoking. He wanted to stop smoking and wanted to announce it to the group. The counselor, upon hearing this, clarified that his smoking privileges had been revoked because of the previous argument. The client was attempting to usurp the power of the counselor by quitting smoking. As this is the main punitive measure here, the client was deftly starting a power struggle between himself and the counselor.

The counselor sensed she was being had and then proceeded to do what is ethically indefensible. She went on a ranting tirade about the client in which she berated him for lying, stealing, and other relapse behaviors. The client was not permitted to speak through this interaction and lashed out in some passive-aggressive ways (sighing loudly, tapping on his chair, having a smug smile). After that interaction was over, I closed the group that was interrupted and did a life-space interview with the client. I engaged him socially, as well, in order to deescalate the situation. Although I feel I did all I could, this is a persistent problem with the staff here. There is an emphasis on confrontation in the literature, but this confrontation was neither therapeutic nor rational. The client was in the right and felt victimized by the system. I can only hope that this incident does not threaten his transitional work.