Magazine article Behavioral Healthcare Executive

Breaking Down Barriers: Agencies Need to Encourage Professional Staff to Be Themselves

Magazine article Behavioral Healthcare Executive

Breaking Down Barriers: Agencies Need to Encourage Professional Staff to Be Themselves

Article excerpt

It takes a lot of guts to write about transforming professionals' relationships with the people they serve, as clinicians often view their boundaries with service users as "sacred." Yet the issues we discuss this month come up in nearly every recovery training we've done for professional staff. We're supposed to be challenging you to think beyond what's comfortable, so we are challenging you to open the minds of professional staff in your organization.

Professional staff mostly are good folks who entered this business because they believed they could help others. But when we talk about the importance of "mutuality" (that is, meeting service users on equal ground as opposed to the traditional hierarchical positioning) in our trainings, professionals often respond with a conversation about boundaries. When we talk about giving service users choices and allowing them to take risks, professional staff start talking about liability. When we talk about the importance of forming relationships with people using services, professionals talk about not having time, telling us that the organizational priority is getting paperwork done on time. If we talk about holding the hope for everyone to recover, professional staff say that the people they see are sicker than everyone else's.

These types of responses are the expected first line of resistance. Yet time is money, and managers, supervisors, and executives who understand the power of recovery want transformation to happen sooner rather than later. To find out what really can help professionals adopt a recovery orientation, let's turn to the people who know best--those receiving services.


We often ask service users what professionals do to help them recover. A person might stop and think for a minute and then say something to the effect of "Well, he helped me in several ways, but I guess the most important thing he did was be a real person to me." By talking with people using services we've learned that a "real" person connects with a service user on a personal level, sharing details from his/her personal life. The therapeutic relationship is a partnership and is not defined by the traditional professional boundaries.

It's interesting that one of the most important aspects to helping someone recover could be as simple as being a "real" person. Perhaps the most important and effective thing professionals can offer is something they have had all along--themselves. All the stuff in the DSM-IV and the information drug companies give us are helpful, but without their real selves showing up, professionals aren't able to connect with people in ways that inspire them to recover.

How have we missed this? Before we knew that people can recover, mental healthcare organizations emphasized "clinical distance," "professional boundaries," and "avoiding dual relationships." We know we are treading on sacred ground, and many of you probably are squirming in your seats. But stick around. Jennifer, currently clinical director at Recovery Innovations, has some thoughts that might speak to you.

Jennifer's Experience

"When I graduated and began working, I found that the recommended treatment included a mental health professional giving someone a pre-made treatment plan. The person was usually asked to collaborate on the plan but not 'too much' because the professional was the one who knew exactly what the person needed. …

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