Crises can pose significant risks to the safety and well-being of counselors and their clients. Not only are you responsible for ensuring that your clients are safe, but it is also essential that you are prepared to respond and take steps toward protecting your own safety in a crisis situation.
As a counselor, you may regularly interact with people in heightened emotional states. Up to 60% of clinicians may be at risk of violence or threats of violence from clients. One study found that more than 25% of therapists experienced post-traumatic symptoms lasting longer than four weeks after surviving or witnessing patient attacks or threats of violence. Nearly 3% of them went on to receive a Post-Traumatic Stress Disorder (PTSD) diagnosis.
Client violence is an occupational risk for mental health providers. While most situations don’t result in severe injury, they can be emotionally disturbing for the counselor. For this reason, counselors must prepare for any situation where this may happen.
This post will discuss a counselor’s risks in crisis situations. and how this may impact your clients and how you interact with them. We will also provide strategies for protecting yourself and effectively supporting clients during crises.
Risks Counselors Face
Mental health professionals frequently experience stress, burnout, and professional impairment, and if this happens to you, it can negatively affect your practice and your mental and physical health.
- Emotional Toll and Burnout – Many counselors experience burnout due to the emotional toll that helping others work through their mental health struggles can take on them. This burnout can be particularly risky in crises, as you’re dealing with extreme emotions and serious trauma. Participating in so many one-way relationships can be draining, so you must ensure you take time for yourself, debrief with a trusted other, practice self-care, and talk to a mental health professional yourself.
- Trauma or Secondary Stress – Working with clients who have experienced trauma may be triggering. By dealing with trauma daily, you may develop secondary stress or trauma yourself. You can experience emotional trauma when helping clients you relate closely with, who have experienced extremely traumatic situations, or who experience a trauma you also have gone through in your personal life.
- Unpredictable Client Reactions – As you unearth complex feelings and emotions while working with your clients, you may be unable to predict how they react throughout therapy. This unpredictability is especially true with new clients. You may want to have a screening process where you can assess the risk of violence from patients. But it won’t always work. Some clients may slip through your screening.
- Physical Violence – Physical violence is a serious risk that you may face when working with clients in crisis. Sometimes, clients may direct their anger or frustration toward you rather than an appropriate outlet, resulting in threats or physical violence.
- Legal and Ethical Liability – If you don’t know how to handle a crisis, you open yourself to legal and ethical liability. Being unable to de-escalate a situation could lead to many different consequences. These may include malpractice claims, lawsuits, or disciplinary action from licensing boards.
While you mainly focus your efforts on protecting others, it is important for you to remember that a client crisis can impact you and your own mental health. Learning how to manage such situations will protect you and ultimately help your client.
Warning Signs a Client is in a Crisis
How can you tell a client is approaching a crisis situation? To ensure everyone remains safe in such events, you must know the warning signs that indicate that a crisis may happen. Not all signs will apply to every client.
Signs that a client is in crisis include:
- Emotional Changes or Intense Responses – If you notice that a client is experiencing drastic emotional changes in sessions or having irrational responses, it could be a sign that they are in a crisis situation.
- Poor Appearance – People experiencing a crisis may neglect their appearance or general hygiene. You may notice that they appear disheveled or look like they aren’t caring for themselves.
- Changes in Communication – If a client begins to communicate in a way that is unusual for them, for example, slurring their speech or speaking rapidly, it could be a sign that they are in crisis. Conversely, they may speak exceptionally slowly, indicating a need for concern.
- Unusual or Extreme Behaviors – You may notice a client report behaving in ways that are out of character for them or that could be dangerous to them or others, such as driving recklessly, having a verbal altercation, or abusing drugs.
- Witnessing Physical Harm – If you see that a client has been using self-harm or engaging in physical harm toward other people, it could indicate that they may be a danger to themselves, others, or you.
- Difficulties with Coping – Clients in a crisis may be having difficulty coping. They may use alcohol or drugs to handle what they’re going through, which can be problematic for many reasons. People using these adverse coping methods may behave in unusual or extreme ways. Some clients may even attend sessions while intoxicated, leading to potential danger to you.
- Increased Anxiety or Fear – People experiencing a crisis may be more fearful or anxious than normal. While a certain level of anxiety and fear may be typical for people with mental health issues, people in crisis often experience higher levels. They may also develop paranoia.
- Withdrawal from Family or Friends – Clients may also have withdrawn from their usual support system. This withdrawal may come up in casual conversation throughout your sessions, but it’s important to recognize this as a potential sign of an impending crisis.
Being aware of the warning signs helps you to potentially head off a crisis before it escalates into something unmanageable for your client. This awareness can help to protect your client and, ultimately, yourself.
Preparing for Crisis Situations
To protect counselor safety in crisis situations, there needs to be a comprehensive approach to help you prepare for such events. The right preparation will help you successfully evaluate and de-escalate the situation quickly.
To prepare for crisis situations consider the following:
- Developing a Safety Plan – Create a system for contacting or alerting others when you need assistance. Some psychologists, for instance, install security alarm systems at their workplaces. This system can provide a quick, easy, and discrete way to let people know you need backup.
- Training for Crisis Situations – Some companies provide specific training for crises. This training sessions teach you to recognize danger signs and can equip you with the tools you need to respond appropriately. Examples of this education may include de-escalation techniques, self-defense, and crisis intervention.
- Using Support Personnel – Whether having a second person in the room with you or just alerting people that you may be in a dangerous situation, it’s important to remember that support personnel are there for you to use. You may also consider having a designated point of contact for security or law enforcement purposes.
Remember, protecting yourself in these situations is not solely up to you. Your practice should have procedures and protocols to ensure they are also taking steps to protect counselor safety in crisis situations. These should be clearly communicated to all staff members to ensure that each person knows how to appropriately support clients through crisis situations and keep everyone safe.
Handling a Physical Crisis Situation
In some situations, you may treat a client who threatens you with violence. They may threaten you with physical violence, either over the phone, via email, or in person.
Steps to handle a physical crisis include:
- Assess Immediate Threats – First, you should identify any immediate threats. For example, if your client has a weapon or has blocked your exit. If necessary and safe, you could use the “panic button” installed in your office for times like this or use your cell phone to call emergency services. You may need to let appropriate people know that you’re in danger.
- Use Language to De-Escalate – This approach is where your de-escalation training will come in useful. Use language that acknowledges the client’s feelings and concerns in a calming, non-threatening tone.
- Give Reminders of Boundaries – You may need to remind your client that you have certain boundaries they can’t cross. These boundaries could include reminding them of the need for a nonviolent space or simply reiterating any other boundaries they may be breaking. Reminding them calmly that they’re behaving in a way that you will not accept from a client could give them the encouragement they need to rethink things.
- Create Space or Use Physical Barriers – To create a physical barrier, try to position yourself away from the client by moving to the other side of the room or behind a desk or another piece of furniture. Erecting physical barriers can help create a sense of safety and prevent physical harm to you or the client.
- Provide Options for Resolution – Usually, you’ll be able to provide options for resolving the problem. Whether that’s providing the client with referrals to other resources, offering them more beneficial coping techniques that they can use, or helping them establish a safety plan, you can use your skills to help.
Steps Counselors Should Take to Protect Themselves
Although it’s not solely your responsibility, you should play an active part in making sure you stay safe while working as a counselor, regardless of the situation. You can maintain your safety in various ways.
- Have Exit Access – When you set up your office, be sure to have a space for yourself near the door. Allow clients to choose from available seats but make it apparent which seat belongs to you. Having an assigned spot near an exit gives you a way out, regardless of the situation or need.
- Practice Self-Care – To prioritize your physical, emotional, and mental well-being, you should practice regular self-care activities that include getting enough sleep, exercising regularly, and eating a healthy diet. You should also take breaks during the day and practice stress-relieving activities, such as yoga or meditation. Some people find physical actions like “shaking off” the emotional stress can help them decompress, whereas others may use visualization exercises to distance themselves from their clients’ concerns.
- Consider Therapy – Many professionals also recommend therapy for anyone in the mental health field. It can help you work through any triggering issues you may encounter while treating your clients or in your own personal life. It can also help give you the skills and tools to separate yourself from the issues your clients may be dealing with, so you don’t internalize them.
- Set Clear Boundaries and Expectations – Another way to protect yourself is by establishing firm boundaries from the beginning of your sessions with clients. These boundaries may be related to how they should contact you between sessions or setting expectations of how long it may take you to reply to messages. By doing so, you can manage expectations and prevent any issues from occurring due to misunderstandings or lack of communication between yourself and your clients.
- Adhere to Ethical and Legal Standards – Sticking to all legal and ethical standards is crucial for protecting yourself as a counselor. These standards protect you from lawsuits from potentially angry clients. Adhering to all ethical and legal standards of care can minimize the legal and financial liabilities to your practice and yourself. It can protect your reputation and that of your workplace and ensure that you provide the best possible care to your clients.
- Develop and Applying Risk Assessment Skills – As a counselor, part of your ongoing professional development should be learning skills to help you with risk assessment. This education may include things such as recognizing triggers for your clients and the warning signs of violence so you can prepare for any situation that may occur. Outside trainers can help you with this learning, as can your overall experience.
- Utilize Supervision and Consultation – Discussing potential safety concerns with colleagues and supervisors is good practice. You should also work as a team to familiarize yourselves with and review safety protocols as necessary. In addition, you can seek advice from your peers on how to deal with difficult situations.
Build a Safe Practice
Knowing why and how to protect counselor safety in crisis situations is one of the most important but often overlooked aspects of running a successful therapy practice. Although it’s rewarding, working as a counselor comes with risks.
Working with the right clients is key to helping you develop a safe practice. All Counseling can help connect you with the people who need your services. By claiming your profile, you can be reached by potential clients and stay up to date with our regular blog filled with useful tips for growing and managing your practice. Sign up and claim your profile today.