Management of incident during counselling session

Mental Health Commissioner Kevin Allan today released a report finding a counsellor in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for her management of an incident during a counselling session.

The counsellor had been providing counselling services to the public for many years. She did not have any formal qualifications in counselling and did not hold membership or registration with a counselling association.

An eight-year-old boy attended his second session with the counsellor. One of the reasons for the counselling sessions was the boy’s behaviour towards his brother. He was accompanied by his mother. An incident occurred during the session which resulted in the police being called.
The boy stated that he wanted to stab his mother. The counsellor enquired as to what the boy was going to use to stab his mother. The counsellor made a comment about him using some nearby scissors.

Mr Allan was critical of the counsellor’s decision to probe the boy in relation to his assertion that he wanted to stab his mother and, in particular, her failure to take steps to de-escalate the situation. Mr Allan considered the counsellor’s comments to the boy were inappropriate and aggravated the situation.

The counsellor picked up the scissors. The boy reached for the scissors either just before, or just after, the counsellor picked them up. The counsellor restrained the boy. The restraint resulted in the boy being pushed into a chair. While restraining the boy, the counsellor said she tried to introduce the concept of empathy to the boy by asking if he felt "powerless" and suggesting that the way he felt at that moment was the way he had made his mother and brother feel by his behaviour before. At this stage, the counsellor’s husband entered the room and took over restraint of the boy.

Mr Allan was critical of the comments made by the counsellor while restraining the boy, noting the comments to be highly inappropriate and that they did not facilitate the boy’s understanding of empathy.

Mr Allan recommended that the counsellor provide a written letter of apology to the boy and his mother. He also recommended that the counsellor, having since ceased practising, undertake prior training on best practice techniques in de-escalation and developing empathy if she were to return to practice.

The counselling profession is not regulated under the Health Practitioners Competence Assurance Act 2003 and Mr Allan also wrote to the Ministry of Health outlining his concerns about the lack of protections and risks that people may face when dealing with an unregulated provider. "I encourage any counsellor to consider obtaining membership of a recognised professional counselling body to be able to access professional standards and support."

The full report for case 17HDC02191 is available on the HDC website.