Clinical Consultation

Consultation, like continuing education, is an integral part of being a psychotherapist or counselor, no matter what our license or our level of experience. The primary tools of our trade are our temperament, core beliefs, life experience, and clinical training. The more self-aware we are of these components, the better our work with clients. I have made consistent use of professional and peer consultation, both individually and in groups, for the duration of my thirty-year career. I see consultation as a collaborative relationship founded on mutual respect, curiosity, the willingness to be vulnerable, and an honoring of our unique gifts as individuals. I offer individual and group consultation to psychotherapists and counselors of all licenses and levels of expertise, either in an ongoing format or on an as-needed basis.

Focus Areas

Development of Safety in the Consultant-Consultee Relationship

Consultation offers the greatest benefit when consultees feel respected, accepted, and emotionally safe. To make the most of consultation, whether individual or group, we must be willing to be vulnerable, to admit to what we don’t yet know, to reveal mistakes we think we’ve made, and to air uncomfortable feelings we might be having. To this end, attention is given to the cultivation and maintenance of an emotionally safe space, whether amongst a group of consultees or with an individual.

Development of Professional Presence

I believe our most important tool as counselors, therapists, and social workers is our personhood. Therefore, consultation sometimes focuses on the cultivation of a professional demeanor that is authentic, professional, self-aware, client-centered, confident, receptive, compassionate, and well-boundaried. Consultees are encouraged and supported in investing in the personal growth that leads to a well-developed professional presence.

Development of Skill

How we conceptualize a case is determined by our theoretical base, personal history, and professional experience. Consultation is an opportunity to compare and contrast various case conceptualizations and the interventions that might flow from them. My aim is to provide a space in which consultees and consultee groups can be validated for their strengths while exploring and developing their weak areas through curious exploration of thoughts and feelings about a case, sharing of ideas, respectful feedback, and modeling of interventions.

Exploration of Transference and Counter-Transference

The interventions we apply to any client at any moment can arise from unconsciousness or consciousness. Another way of saying this is that everything we do or don’t do as clinicians may have an impact, and, as such, may be an intervention, whether we intend it to be or not. We are better clinicians when our interventions are consciously considered and we can acknowledge our “natural” behavior in the therapy room may have acted as an intervention. Ron Kurtz, the founder of Hakomi Therapy, says, “Life is a sloppy probe.” In Hakomi, a probe is an intervention intended to provoke an unconscious reaction in a client so it can be made conscious, explored, and used for healing. Consultation offers a space in which to hone awareness of and to address transference with our clients in light of their therapeutic goals. It also offers a space in which to explore and make more conscious our countertransference so we can turn it into conscious interventions or soften it so it doesn’t interfere in unintended ways.

Development of Ethical Practice

The very nature of the helper role invites multiple ethical risks. To be a helper assumes there is a helpee. The helper-helpee relationship is one of unequal power, no matter how much we wish to see it otherwise. Consultation is an opportunity to develop awareness of the many subtle and not-so-subtle ways being in a position of power can be used helpfully or harmfully. We can also look more deeply at interventions we are considering that might have unintended clinical or ethical ramifications before we formally make them. And, when called for, we will consult and apply the code of ethics of our license to a situation using an ethical decision-making model.

Board Inquiry, Complaint, or Disciplinary Action

We all dread being contacted by our licensing board. However, if it happens, support is needed. This might involve support in navigating the legal consultation and malpractice insurance interface; receiving emotional or stress reduction support; support in self-reflection and case-review; or help with follow-through on disciplinary action requirements. It is best to face being contacted by our board with good support.