Other Poor Communication Standards

The other poor communication standards that were identified in the study are outlined in the table below:

Complaint	Number	%
Confidentiality/ privacy breach	25	10.1
Rude/ insensitive manner	22	8.9
Inappropriate communication	21	8.5
Wrong/ misleading/ inadequate information	11	4.4
Not informed and/or consent invalid	8	3.2
Failure to consult a colleague	1	0.4

Rude/ insensitive manner

Second on the list of most complaints is a rude or insensitive manner. This can often stem from compassion fatigue and practitioner burnout. When constantly exposed to distressing content, you can begin to disassociate and become detached from your innate sensitivity and care towards others. Stoewen (2020) outlines the symptoms of compassion fatigue in the description below:

“With compassion fatigue, the caring, feeling, and acts of compassion decline, replaced by an outwardly impassive detachedness. The person becomes more task- and less emotion-focused, and may increasingly pull away from others, becoming socially isolated…..Compassion fatigue can give rise to a gamut of negative emotions, including anger, annoyance, intolerance, irritability, skepticism, cynicism, embitterment, and resentfulness. These symptoms often lead to interpersonal problems, including difficulties getting along with others and problems with intimacy, resulting in hurt feelings, disappointments, and disconnection. There may be mood swings, tearfulness, anxiety, irrational fears, melancholy, sadness, and despair, and in some instances, even suicidal thoughts or gestures. As well as changes in emotional valence, there may be changes in cognitive functioning. The ability to think clearly, use good judgment, and make decisions may decline. It can become difficult to concentrate on tasks. There may be lapses in memory or forgetfulness. Over time, the person may develop a negative self-image and feelings of inadequacy and helplessness”

It goes without saying that not all causes of a practitioner being rude and insensitive are because of compassion fatigue. They could just be a ruder person – but it is important for you as a professional to buffer yourself against the potential consequences of compassion fatigue and being considered rude. Some ways to prevent complaints of being rude and insensitive are as follows:

Self-care routine and having appropriate boundaries
Not absorbing and taking on clients’ issues – learning to be clinically detached from the issue but still connected to the client
Not being invested in client outcomes, you are there to facilitate their healing journey, not do it for them
Use manners
Not interrupt others
Ask for honest feedback on your communication from a friend or colleague
Get signed consent from clients to film a session and then ask your supervisor to review the content and give feedback on your communication
Do not minimise the client’s issues or concerns, insult or make demeaning comments towards clients
Make culturally appropriate eye contact and show interest in what the client is saying, do not constantly check the time or pick up your phone during the session
Don’t be judgemental or critical of the client’s situation
Be mindful of when the session is coming to a close and do not end it abruptly
Use the preferred pronouns and names that the client wishes to be called by

Inappropriate communication

There are many examples of inappropriate communication in therapy, ranging from minor slip-ups to breaches in the therapeutic relationship. Most of the things listed below will be obvious to you, but if you catch yourself doing them, it might be a good idea to take it to a supervision session to uncover why.

Eye rolling
Interrupting constantly
Sarcastic remarks
Sexual remarks or body language
Ignoring emails from other professionals
Texting during sessions
Inappropriate jokes
Failure to listen
Passing blame
Excessive calls outside of the session to the client
Ignoring supervisors’ input
Overuse of jargon
Dismissive body language
Failure to acknowledge achievement
Gossiping
Lack of informed consent
Ignoring clients perspective
Using offensive language
Excessive personal stories
Overlooking non-verbal cues
Emailing during conversations (including online)
Overuse of emoticons in professional emails
Selective information sharing
Unresponsiveness to client concerns
Using slang in formal documents
Ignoring the treatment plan and goals
Talking over client
Disregarding company policies
Not following up on assigned homework
Failure to apologize for mistakes
Overcommitting and underdelivering.
Neglecting personal hygiene
Public displays of frustration
Overusing acronyms
Dismissing new ideas
Revealing confidential information
Making assumptions without clarification
Disregarding client’s preferred communication channels
Dismissing diversity and inclusion efforts
Ignoring client feedback
Excessive use of text abbreviations
Making light of serious issues
Excluding clients from important conversations and decisions about their care (when not appropriate)
Failure to provide clear instructions
Failure to adapt communication to different audiences
Downplaying the importance of diversity training
Refusing to accept constructive criticism
Excessive negativity
Excessive positivity
Dismissing mental health concerns
Refusing to collaborate with other health professionals
Failure to share relevant information when working collaboratively
Undermining clients authority
Deflecting responsibility
Failure to use inclusive language
Disregarding clients input in decision-making
Using shaming language
Failure to acknowledge cultural differences
Failure to uphold confidentiality
Excessive use of fillers in speech e.g. “um” and “ah”

Wrong/ misleading/ inadequate information

This point highlights the importance of providing accurate and evidence-based information. It is recommended that you are trained in at least one therapeutic modality (CBT, ACT, Somatic Therapy, Strengths Based etc) and are able to provide clinical reasoning behind your interventions. If you are not able to provide clinical reasoning as to why you chose the intervention and back it up, you could be putting yourself (and your client) at risk. As counselling is a semi-regulated industry and is becoming more tightly regulated as the years progress, we must be up to date with the industry and be able to justify the chosen treatment plan and interventions.

We can do this by maintaining our ongoing professional development points, staying up with the latest industry information and having a professional and supportive supervisor you trust.

Not informed and/or consent invalid

The NSW Department of Justice defines consent as follows:

That the person seeking treatment has the capacity to provide their own valid consent.
That the person understands the nature and effect at the time the intervention is required.
That the person does ‘know’ what the intervention is.
That the person understands what the treatment involves.
That the person is aware of other options and, if choosing between options, the person must understand what each option is, what each option involves and the effects of each option.
That the person understands the ‘effect’ of the treatment.
That the person is aware of the main benefits and risks of treatment

Most people understand information from their mental health care provider about their condition and proposed treatment and can provide consent to treatment. However, the practitioner needs to be aware of the following components involved to form valid consent:

The client must be considered competent – that is the therapist needs to determine whether the person has understood the information provided.
Consent needs to be given voluntarily – that is freely and without coercion.
It must be specific – with the scope of what is agreed to being made clear.
The information provided must be understood – that is communicated in language that the client comprehends

Consent needs to be obtained regularly, and you can do this by explaining the therapeutic intervention and the clinical reasoning behind it to the client. You then make a note in your client’s file that consent was obtained before providing treatment; this can be a simple check-in that you do every session. Having shared treatment goals for the sessions and regularly revisiting and adjusting the treatment plan as required is part of gaining informed consent. More information will be provided on case conceptualization and treatment planning in future courses.

References

Stoewen DL. (2020). Moving from compassion fatigue to compassion resilience Part 4: Signs and consequences of compassion fatigue. Can Vet J. 61(11):1207-1209.

https://www.psychologycouncil.nsw.gov.au/informed-consent#:~:text=The%20client%20must%20be%20considered,agreed%20to%20being%20made%20clear.