Lessons From Bad History and Good Sense

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By Gary Schoener

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Lessons From Bad History and Good Sense

  1. 1. Lessons From Bad History and Good Sense Gary R. Schoener Licensed Psychologist & Executive Director Walk-In Counseling Center Minneapolis, Minnesota
  2. 2. The law isn’t justice. It’s a very imperfect mechanism. If you press exactly the right buttons and are also lucky, it just may show up in the answer. A mechanism is all the law was ever intended to be. Raymond Chandler , American author, 1953 The Long Goodbye , chapter 8
  3. 3. Outcomes of legal cases… <ul><li>Relative skills & prep. by each side </li></ul><ul><li>Jury or tribunal/panel hearing the case </li></ul><ul><li>Judge or hearing examiner’s rulings </li></ul><ul><li>Chance events; happenings in hearing </li></ul><ul><li>Physical appearance & demeanor of all </li></ul><ul><li>Whether judge/jury believe key people </li></ul><ul><li>Role of media coverage or context </li></ul>
  4. 4. A few important notes <ul><li>When faced with possible legal risk, remember that the key is to do your thinking and get consultation </li></ul><ul><li>The standard of care is what a reasonable and prudent professional like yourself would do in the same or similar circumstance </li></ul><ul><li>The most important courtroom is the mirror in your home into which you look in the morning and evening </li></ul>
  5. 5. Why Things Go Wrong… <ul><li>Poor training & preparation of those who will staff a new program; </li></ul><ul><li>Various types of psychopathology in staff or leadership; </li></ul><ul><li>Failing to adequately assess & deal with pathology; </li></ul><ul><li>Unusual stress affects staff member or leader’s ability to do the job; </li></ul><ul><li>Inadequate staffing or program design; </li></ul>
  6. 6. BOUNDARY CROSSINGS <ul><li>Myth of the Slippery Slope : There is not good evidence that one boundary crossing leads to another – however, if boundaries are being broken down there may be a succession of crossings. </li></ul><ul><li>Myth of the Small Violation : Some times a seemingly minor crossing is ignored – it could be the beginning of a major breakdown or simply the one visible sign of it. </li></ul>
  7. 7. … Reasons Things Go Wrong <ul><li>  Attempting to be all things to all people – particularly challenging patients – failure to locate or create alternative programs (e.g. DBT in the USA); </li></ul><ul><li>Leadership over-promises complainants or others as to what they can do; </li></ul><ul><li>People who are inept do dumb things and don’t get consultation; </li></ul><ul><li>People act too fast without planning; </li></ul><ul><li>People stick to a policy, even when it does not fit a situation. </li></ul>
  8. 8. <ul><li>Practical training re: boundaries with videotapes, role play, presentations by offenders and victims; </li></ul><ul><li>When a trainee shows evidence of impairment have a thorough assessment done; plan rehabilitation and review student’s future; </li></ul><ul><li>Deal with abusive faculty & admin. – those with “regal bearing” who “can do no wrong” are bad models. </li></ul><ul><li>Trainees benefit from learning of faculty mistakes from their own experience. </li></ul>Issues in Training
  9. 9. <ul><li>Criminal justice background checks; </li></ul><ul><li>Obtain a broad release permitting you to interview anyone about their work history, skills, character and ethics ; </li></ul><ul><li>Ask for and provide honest feedback about strengths & weaknesses ; </li></ul><ul><li>Ask reference to specifically reflect on the specific job and what reservations they might have ; </li></ul><ul><li>Be clear with applicant about the major challenges & stressors – what the “real” job is like. </li></ul><ul><li>Use role play or get a work sample. </li></ul>Hiring of staff
  10. 10. <ul><li>Ensure that your supervisors are trained in supervision; have consultation group; </li></ul><ul><li>Set up supervision plan & probation for a new staff member based on their strengths and weaknesses ; </li></ul><ul><li>Review the plan periodically ; </li></ul><ul><li>Have back-up supervision & a clear standard that consultation is obtained; </li></ul><ul><li>With lacunae in training or skills, develop a plan for additional training, supervision, etc. & evaluate success </li></ul>Supervision
  11. 11. <ul><li>Have policies related to key areas where there are boundaries challenges; </li></ul><ul><li>Define who is a patient and what rules apply to those who are family members or connected to the patient; </li></ul><ul><li>Define boundary issues with regard to former patients; </li></ul><ul><li>Have a standard that staff, when in doubt, obtain consultation. </li></ul><ul><li>If there is an area of special challenge, address it through a staff discussion. </li></ul>Policies & Procedures
  12. 12. <ul><li>Failing to empathize with the anxiety involved in a complaint; </li></ul><ul><li>Jumping to a premature conclusion –failing to investigate; </li></ul><ul><li>Promising a response within a time frame which is unrealistic; </li></ul><ul><li>Failing to give a simple human apology for what has happened or the apparent impact; </li></ul>Common Errors in Handling Complaints ….
  13. 13. … more common errors <ul><li>Getting so legalistic that all comfort or sense of comfort is lost; </li></ul><ul><li>Hinting at an outcome or giving false reassurance when things are uncertain; </li></ul><ul><li>Not allowing the complainant time to think over a choice; not having them talk it over with their support people; </li></ul><ul><li>Being careless in what information is put out to the staff or the community. </li></ul>
  14. 14. Challenges of the Internet <ul><li>Complaints/grievances may end up being “public” on the internet </li></ul><ul><li>Great new hazards re: boundaries; </li></ul><ul><li>Be aware of your web-presence – google yourself, staff, your program; </li></ul><ul><li>If there is false information, contact site administrator to get things changed </li></ul><ul><li>Collegial discussion – develop standards </li></ul>
  15. 15. Consent & Disclosure Issues <ul><li>What ground rules will you have for a given unit, program, or practice as far as googling? </li></ul><ul><li>If you do google someone, will you disclose this to them? </li></ul><ul><li>What rules if any will you ask patients to follow as regards the internet? </li></ul><ul><li>Will you ask them to maintain any privacy or respect any boundaries? </li></ul>
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