INFORMED CONSENT

In the first place…people need to be informed

Regarding seeking services for health issues, I cannot stress enough the importance for people to feel respected. I believe that we can all relate to that. When seeking help, regardless of what these services are, we want to feel treated respectfully and equally. Nothing angers people more than when they experience a lack of respect and even more so, when they feel treated differently compared to others.

The expectancy of being treated fairly and equally is even more important when people seek help for mental health issues as those who seek this type of help feel vulnerable and dependent on the service providers and sometimes they, or their family members are desperately seeking solutions.

Times have changed. No longer does a patient have to rely upon the diagnosis of one single medical doctor and fully accept this as the truth when not having been given the opportunity to ask questions about the diagnosis and the treatment options. Patients (clients) have the right to ask questions and have the right to seek additional information when they feel that they are not fully informed. One cannot provide consent, which means to agree with something, when they are not fully informed on what the treatment is about and what the consequences are.

Before offering a service, mental health professionals must obtain informed consent from all their clients. This means that as a client you will be informed about the services, the person doing the service and their academic background and experience in the field, as well as the approaches implemented by the mental health professional. Clients also have a right to be informed on the potential benefits and adverse consequences and on treatment alternatives.

Most, if not all mental health professionals (counselling therapists/psychotherapists, psychologists, and social workers) who work directly with clients will first obtain informed consent before starting the first session. A client is asked to sign a form, but no one is obligated to sign before they feel fully confident about what they sign for and no one is required to sign unless they feel that the service is according to their expectations.

Unfortunately, the consent form is often seen as a “formality” and too often administrative staff at agencies get this out of the way before “the real work starts” and before the client sees their therapist. This is not right. To provide consent is more than signing a form. It means that the service is explained to clients and includes the questions asked by clients and that these questions are answered by the therapist. The exchange of information forms an important part of the session and is the most important building block of a respectful professional relationship.

Some clients have been frustrated or disappointed about the counselling therapy services offered to them. They have a right to voice a complaint. When I hear about it, I always ask the client “did you tell your therapist, and what did they say?” But I understand that most clients are not discussing their experience with their therapist, and that is a shame as it is a missed opportunity to learn from each other and to improve the quality of services.

Regarding first responders, I often hear from them that the therapist lacks knowledge about the first  responders’ profession, and I argue that this is right, but that it may be on both sides: Many clients also lack knowledge about what is counselling therapy and who are the people offering this type of service  and what constitutes an effective service.

Providing feedback to your therapist determines the level of success of your sessions. Therapists like myself learn from their clients. As I am also an educator and provide training to mental health professionals, this feedback will be incorporated in the training I offer to my colleagues.

I have found, however, that some clients are hesitant to ask questions and to provide feedback. I hope that with writing about this, more people feel confident to speak up. Questions answered on both sides make the service more effective and increases the trust in the professional relationship. In addition to asking questions, therapists who are asking of their clients to offer feedback on the session obtain valuable information to fine-tune the services.

I want to stress to people seeking mental health services that the service is there for them. Transparency about the service and an exchange of information in the presence of open feedback provides the right dynamics for a successful outcome.

As always, questions and comments welcome,

Elisabeth

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