By David Joel Miller.
How should you respond to an unavailable professional?
One thing that counselors are supposed to avoid is “creating dependence” on the part of their clients. Our goal should not be to tell the client what to do but to help them learn what they need to learn to get through life. But many clients come to expect that they will get to see their therapist at a given time and place and they are likely to experience extra life difficulties when the counselor they are used to seeing is not available.
Some simple cases first.
The counselor is just not in the office today.
This problem is especially difficult for clients who have “trust issues.”
One thing counselors try to do is engage in a “corrective emotional experience.” You did not learn some things, emotional lessons, because the people you lived with did not teach you correctly or because when they did, you got the lesson wrong.
If when you needed a caregiver they were unavailable or abusive, you grew up insecure. Now to have your therapist do this to you is extra traumatic. Why does this happen and what should you do about it?
Begin by thinking about the counselor; this is probably about them not you. Counselors are real people and real people have lives. Unless you live with them, and then they should not be doing therapy on you, there will be times they will not be available. Your regular counselor may be on vacation, out sick or may have had a family emergency.
This plays out differently in a private practice than in a large agency. In private practice, the counselor does not get paid if they do not see clients. They have a lot of financial incentive to see you. They also do not routinely have co-workers who can cover for them when they are out. So they will make an extra effort to be there or to reschedule your appointment.
In an agency, you are the client of that agency not necessarily of that particular counselor. When one person is out sick then someone else should call you and reschedule or you may get assigned a new person to see you.
As much as administrators want high productivity, meaning keep everyone busy as much as they can, too many changes of provider are not good for a client. You see someone and then after telling them your secrets, they are out sick the next week. Do you really want to repeat your whole life story to a new person?
In an agency, people go on vacation, get transferred to a new department, move or change workplaces and sometimes they retire or die. The agency should arrange for you to see someone else.
In private practice, your therapist should make a plan for who you can talk to and who you will see if they are not available. If they are no longer available you can choose to find someone else.
What if you are in crisis?
Relying on seeing your counselor when you are in crisis is a bad idea. Most counselors either have a recording or an answering person who will tell you that if you are in a crisis situation you need to call your local emergency number first. In my area, this would be 911.
There may also be talk lines or crisis lines in your area. Sometimes there are peer support lines or “warm lines” that are very useful if this is not a full-fledged emergency.
In a crisis, the counselor can’t always be there and even if they were at some point this needs to move from their office to a place where you can be stabilized.
What if you have a problem, it is not a crisis but it is getting to you, you just need to talk?
Some therapists are able to take a few calls from clients when they are having difficulties. They can’t take every call, from every client, every day, or they become a phone counselor.
Consider if you can wait till the next appointment, does this conversation need to happen now? Also, consider if this is a crisis situation? Now if it is not a life and death situation and you have tried all the tools you have been taught to cope with this problem then this may be a time for using your “support system.”
One thing your counselor should be moving towards from the very first session is called termination. That is the point when you can manage your life, problems and all, without needing to come to see a professional every week.
There are some people who do need lots of help; they may even need weekly sessions for a long time in order to keep them stable and out of a psychiatric hospital. But even then the provider should be trying to get that client to a place of needing professional’s less and less.
The fastest way to take control of your recovery is to develop a personal support system.
That support system may be other recovering people or a support group meeting. For recovering alcoholics and addicts this may include a 12 step group meeting. It may also include family members, friends or romantic partners. Sometimes this includes on-line support groups, which is fine as long as they are about recovery and not about other ways to keep your disease.
So at times, your provider is not available and you have determined that this is not an emergency, call or visit your support system.
Lastly, if your provider keeps canceling and rescheduling, consider whether you need to change providers. This is easier for people seeing private practice providers. They vote with their feet. If they don’t get what they need from the person they are seeing they make an appointment with someone else.
In an agency setting, you may need to talk this out with your counselor, their supervisor or request a transfer to a different clinician.
There is a lot more I could say on this subject but this is getting long so, for now, I need to close.
Here is hoping that this helped those of you who have been asking search engines about what to do if your counselor is not available.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books
- Why the therapist doesn’t care about your problems- unit of treatment (counselorssoapbox.com)
- 3 reasons why people keep telling you that (counselorssoapbox.com)