In graduate school, I learned that most counselors will experience three things in their careers: a client who dies from suicide, a client who overdoses, and a client who sues. I remember hoping that I would be the exception to the rule. Throughout my career, I have done everything in my power to circumvent this Graduate School prophecy. But fate had other plans: one of my clients filed a complaint against me last year.
Shame broods in secret. In my experience, one of the most shameful and isolating events is when an advisor has client complaints. Anyone who speaks openly and honestly about the complaint process often encounters judgment and criticism. In an effort to fight silence and stigma, I share my story with the hope that it will provide guidance and support to other counselors who are going through this difficult and arduous process. I want to remind others that they are not alone on this trip and at the same time offer a road map for one pass. It will be fine.
One of the things that helped me to deal with the complaint process was to conceive it in relation to Elisabeth Kubler-Ross's grief cycle. I tell my customers that the stages are the timetable for mourning. If I had a road map, I would have a direction in front of me and I wouldn't be stuck or lost. I didn't know when I would find acceptance, but I knew that if I just kept moving forward it would be on the horizon.
Denial and Shock
When I checked my emails in a target parking lot at the beginning of last year, I saw a message from the Department of Regulators (DORA) in my inbox. In Colorado, DORA is the governing body that awards licenses to vendors while also handling consumer complaints. My heart started to beat fast. I was dizzy and sick. I went to the store to return an item at the customer service counter and I had to move my legs forward and make my mouth speak. I felt that everyone around me could see a massive letter "G" on my forehead. My hands started to tremble as I drove home so I could read the email on my desktop computer. When I read the whole DORA message, I started to cry.
A few weeks earlier, I had hired a new customer in my practice. Interestingly, my intuition immediately indicated that this customer would be a challenge. The second session underpinned my feeling that building a therapeutic relationship with this client would be a hard road. The third session did not take place – the customer was a no-show-no-call. When I reached the client via text message, she said that she did not want to schedule a future session with me, so she released her from therapy that afternoon. I felt that this would not be the last time I heard from this customer. My intuition was correct.
I received an email from the customer that evening criticizing how I had dealt with the interaction. She thanked me for her help, but asked me to explain my "side of the story". Since I had already released her from therapy and felt that a possible future relationship between the counselor and the client would be negatively affected by the exchange, I told her that I was no longer comfortable working with her. Again I felt that this would not be the last time I heard from this particular customer. My intuition was correct again.
negotiations
DORA led me because of a lack of communication and abandonment. I immediately contacted a friend and former colleague who worked with an organization that carried out assessments for DORA. I knew that she also went through the client complaint process a few years ago. While I was preparing for our discussion, I read everything I could find on the internet about the complaint process, the termination of the mandate, the HIPAA and the laws on mental health. Nothing was clear and most of the information seemed contradictory.
I presented the matter to my friend on the phone. Like many others I would speak to on the way, she thought it likely that the case would be dropped. Fortunately, the complaint was not based on an oral exchange; Settling the case would not depend on speaking my word against the client's. My friend advised me that I might have to go to a lawyer and we discussed my official response to the complaint, which I immediately typed in and distributed over the weekend.
The following Monday, I collected the customer's file and submitted it to DORA along with my response to the complaint. I also contacted my insurance provider to inform them of the complaint. All the while, I hoped the case would be dismissed, so this nightmare would end. Because of the quality of my case and the costs involved, I initially decided to stop practicing law, but my insurance company encouraged me to contact a lawyer if the case continues.
Depression
I could only think about the complaint. It consumed me. I would fall asleep and think about it and wake up the next morning to continue my thoughts from the night before. Or I woke up in the middle of the night just as often, and my fear increased rapidly when I remembered that this wasn't a dream – it really happened to me. I prayed that everything would go away. I wanted to return to a feeling of normalcy. I started to rethink myself and the image I presented to my clients at work. I was nervous and afraid that something else would happen. I feared that this would not end.
I had been in the field for seven years and had never had such a problem before. I had served in challenging and demanding environments, including detoxification, inpatient treatment, and prisons, and I had never before had a client complain to a manager or other colleague about my work.
Since the personnel in our work are professional and the professional personal, it can be difficult to separate the two. This makes it difficult to prevent internalization during the complaint process. I felt like a bad advisor and therefore a bad person. At the same time, I was confused because other clients told me that I was an incredible therapist who had helped them change their lives for the better and become the best versions of themselves. I tried to make room for all of these experiences and to live in horror, but it was tedious and difficult.
Fearing judgment and criticism, I knew who I was sharing my problems with. I was in a vulnerable place and I was already attacking and punching myself without anyone else adding to the punishment and suffering. Like most therapists, I am tuned to non-verbal signals and underlying speech tones and have always looked for them when I told my story to other counselors. I mostly chose to keep the experience to myself and a few confidants, but I knew that was not enough. I also needed the perspective and guidance of other professionals in this busy time, so I shared this with the people in my therapists' support groups. The majority of the people I told were empathetic, not judgmental and supportive, but there were some whose faces dropped when I told them. There were others who tried to use my story as their personal case study, which was disappointing and discouraging.
I felt like I was dreaming as I watched this whole experience from a distance. I believe that this was a necessary coping strategy at the time. I had to share the experience so that I could go to work every day and meet with clients in my private practice. I compared it to being charged by your company and coming to work every day to know what is happening around you and in you.
I was constantly wondering what I could have done differently. I read the mental health laws and searched the HIPAA forums, but nothing was transparent and straightforward. I tried to look up articles, podcasts and research on the grievances process, but could only find a research article from the 90s on the effects of the grievances problem on psychologists. It helped to know that my experience with the process was normal and valid, but it didn't alleviate my fears.
anger
I have two licenses in Colorado, which is an advantage for my work – unless I go through the complaint process. My double license made it double difficult because my case had to go in front of both boards. The two admissions boards can have different opinions and sanctions, but I learned early on that once one board of directors makes a judgment, the other often follows. I received an email informing me that the Colorado State Board of Licensed Professional Counselor Examiners would be the first to review my case in May. I submitted my paperwork in February so it would be months before I found out the solution to my case. I learned that the complaint process is a lengthy waiting game.
Meanwhile, I expanded my practice and interviewed contract therapists. Then, in April, I received an email from the Colorado State Board of Addiction's counselors telling me that my case had first gone to the chamber without my knowledge. I was blind. I was in the middle of interviews, but luckily I had a break and drove home. I did it about halfway before driving to the side of the road to read the rest of the email. My mind was overwhelmed. I felt that my sense of reality was breaking down.
The Board of Addiction Counselor Examiners found me "guilty" of the allegations and forwarded the case to the Colorado Office of Expedited Settlement. I found a lawyer online and emailed him from the street side. I felt powerless and out of control and had to find a way to regain my sense of self-government. I knew it was the way for me to take action. I didn't want to regret what I could or should have done, so I was finally ready to get legal help for this fight.
The following week, I met with the lawyers and found out that they received three to five complaints a day. In the past, they would only have received three to five complaints a month. After our meeting, I looked up the list of disciplinary therapists on the DORA website, and the numbers were breathtaking. There are approximately 26,000 advisors in Colorado and more than 11,000 have received disciplinary action.
I was angry – with myself, with the system, with the job and with the client. I felt so much anger that I wanted to scream and run, both at the same time. I considered leaving everything behind – leaving the consulting profession, giving up my licenses and taking a different, safer and easier route.
Mainly I thought, "Why me?" I felt like I was in a victim mentality like I had in the past when I tried experiences. Having become a victim in my past, it is easy for me to take on this role when I am in pain and suffering. I blame others and switch off.
Anger is an uncomfortable emotion, but I knew I should have it right now because it would lead to motivation, change, and movement. I could use it or let me eat it alive. It was only my choice.
Acceptance
Like many grieving people, I got stuck in the anger phase for some time. Anger feels powerful and motivating, as opposed to sadness, which is tiring and stressful. However, I keep going back to the saying: "Anger is like taking a cyanide pill and hoping that it will kill your enemy." In the end it only hurts you. My anger at myself, the clients, the system and the profession would not serve me. In the end it would eat me alive if I allowed it.
One day I went home from work when it suddenly started to rain. I had nothing completely unprepared to keep myself dry. However, it was just a mild shower, so I said aloud, "If it continues to rain, I'll be fine." It started to rain more heavily. I fearlessly said again: "If it continues to rain, I'll be fine."
And then it started to pour. I was halfway home, caught in a storm without a raincoat. I could only surrender. I was broken up. The armor of anger I had shown fell off as I started to cry. "I surrender," I said aloud. "I get it. I'll always be fine." I started to smile as tears mingled under the raindrops that ran down my face. Nature can ask us to let go of our resistance and surrender.
At that moment, I triggered my anger and found that I had focused most on myself. I started the slow process of forgiving myself and coming back home to believe that we were all doing the best we could. I never wanted to hurt the client and I had no malicious intent in my actions. I had done my best at that moment and with the situation.
I found acceptance by meaninging the experience and discovering that it should realign me with the calling and purpose of my soul. It became clear to me that I couldn't deviate far from my resume before the universe pushed me back on my trail.
Lessons learned: Seeking support, asking for help, finding allies
It is difficult to share what it is like to go through the complaints process, but it is also incredibly necessary. As with any grief process, we need sources of support to ground and anchor ourselves when we feel that we are floating or losing sight of our true selves. As professional consultants, we can make mistakes, but that doesn't make us bad people. We need to be reminded of our goodness and wholeness.
It is important to surround ourselves with real and unconditional love and to have a safe place to cry and scream without fear of judgment or criticism. If we just lie on the floor and want to give up, our support systems can lift us up and keep us moving. Finally, it must be remembered that counseling is extremely difficult work.
I only regret that I did not contact a lawyer earlier. I wonder what would have happened if I hadn't been put off by the nature of my case and the cost. Although I now realize that I had to go through this process to realign my priorities and career path, I sometimes wonder if it would have been different if I originally had the help of a lawyer in formulating my response to the complaint Would have taken.
Retaining lawyers in the appeal process earlier might not have helped me avoid the guilty verdict, but it would probably have given me more peace of mind. In fact, I felt relieved and relieved to see a lawyer and speak to my lawyers. As I mentioned, I was restless at night and often woke up. After the first meeting with my lawyers in the afternoon, I got my first full night's sleep after two months. I understand how important it was to have the ability to rest in order to endure the trauma of the complaint process. Sleep heals.
I later contacted the Colorado Counseling Association (CCA). I remember saying "DORA protects consumers, but who protects advisors?" That was my answer. I attended an event sponsored by CCA and learned about the lobbying it does to support and help consultants. Specifically, it is about changing the vague and subjective language of the clause in the "Best Practices" statute of mental health, which in my case and in many other cases is a collective category for disciplinary measures. There were more people at my side here who were passionate about advisors and changed the system.
During the complaint process, someone told me that the tower that I had built with everything I thought was true collapsed and fell, leaving a pile of rubble and debris behind. My belief in my career was initially built on shaky and stony ground, so it was inevitable that they would all eventually collapse. After the collapse ended, I had to decide what to do with the rubble. I could choose to walk away from the bricks and stones in the rubble, or I could use them to build a new tower on stronger ground.
I am still under renovation and know that it will be a slow and methodical project. I meet the requirements of DORA and look to the future. I am not sure if I would ultimately like to keep my two licenses. At the moment, however, I have decided to keep it. But I know that the choice is mine – no one else's. I now have a solid foundation on which to build my tower.
With every placement of bricks and stones I feel stronger and more powerful than before this experience. My battles, scars, and wounds will affect how I build my tower, but they won't stop or control construction. As Carl Jung said: “I am not what happened to me; I am what I want to be. "
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Jessica Smith is a licensed professional counselor and licensed addiction counselor in a private practice, Radiance Counseling (radiancecounseling.com) in Colorado. Contact them at [email protected].
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ACA Members: Are you facing a dilemma regarding ethics, business practices, or risk management? Contact the ACA Ethics and Professional Standards Department at (800) 347 6647, extension 321, or email: [email protected]
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