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The Dilemma for a Two Hatter October 21st, 2011 posted by: to Professional Round Table

Question/Comment:

What are the potential challenges of therapists who are recovering from an addictive disorder attending meetings where their clients past, present, or future, may attend? We would like to hear from all professionals regardless of whether or not they have personal recovery experience.

Question posted by LCCS Staff

LCCS Response:

There are a great many opinions about this issue.  Some will maintain the position that the client has a right to attend a 12 Step recovery meeting without the distraction or confusion of having their therapist show up with a problem.  Others will support the idea that a therapist should forbid a client from attending the therapist’s “home group” because the therapist is entitled to get well in the safety of the anonymity of his or her own recovery group.

I believe that every addicted person should have the right to attend any meeting that he or she has met the eligibility requirements to attend.  If a recovering therapist accepts a client for an initial session and acknowledges an affiliation with a particular 12 Step group then he or she has surrendered their right to anonymity and as such should not force the client to avoid meetings that will intrude on his or her privacy.  I recognize that it can be a challenge for a recovering professional to be an honest and contributing member of a 12 Step meeting that client’s might attend.  Some will argue that it could threaten the professional’s quality of recovery to be inhibited by the presence of clients at meetings but it does not have to be that way.  I have found that the greater threat to recovery that professionals must face is working in the field of addictions treatment in the first place.

It is easy, when you are working in the therapy trenches, to see the problems you are helping your clients with to be far more significant than your own.  In fact, the focus on the problems of others day after day could leave you with the perception that you do not have any problems.  Far too many professionals working in the field of addiction treatment succumb to a case of terminal uniqueness and drop out of recovery all together and some become empty enough to relapse.  None of us is immune to relapse and all of us could develop terminal uniqueness for one reason or another.

I have found that the safest place for me to be is the meetings were I first embraced recovery with the “willingness of a drowning man clinging to a life preserver.”  I was willing to learn without regard for who the teacher was.  I have paid the membership requirements to attend many different 12 Step groups and would fight or the right for any man or woman to attend any meeting that they might find hope in – even if it is my home group.

We would like to hear from you about this issue and develop an open forum to discuss some of the challenges that you have face and how you have coped with them.

Sincerely,

John V. Leadem

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8 Comments | Post Comment

  1. Sandra Singer, March 23, 2014:

    I am a first year student so please forgive me if I step on toes. My belief of 12 step meetings is the word anonymous. That means the names are not important the message is. The person who is reaching out, is asking for sanctuary in a sense,if you deny him/her for any reason , you are breaking the mission statement of the group. Even if the counselor is attending said meeting it is possible to get by this one meeting. Because believe me the client will most definitely look for another meeting , if they don’t turn around and walk out then. The fact that every meeting is open to any addict any time is the hook, you can’t put restrictions on meetings, it is the first step for the addict and they won’t try that hard if they are turned away.
    Thank you for your time
    Sandra Singer
    AOD counseling student
    Intercoast College
    Orange, CA

  2. Andrea Iacono, March 28, 2014:

    I agree with Sandra and I believe that if a client is at my home group that I should share my experience strength and hope because it could help someone if not the client

  3. Kathleen Nemeth., October 23, 2014:

    This seems to be quite a complicated issue. I agree with Sandra that names are not important but the mission is. I am wondering how the “balance of power” is dealt with. If you are treating a client and that client chooses to participate in a group that you attend, how do you express yourself freely? And what if it had been a particularly grueling day with your clients, how do you express that without stepping on toes? I agree with Andrea that we are there to express our experience, strength and hope, but what about those things that are testing our resolve to stay sober? And we all have those days! I don’t believe that a client would be purposefully harmful, but what about a newcomer who is quite enthusiastic about recovery and wishes to share to all that his/or her clinician is in that person’s meeting. I see all kinds of conflict that could arise and I’m not sure how I would handle this! I believe that this (AA) is for all who want to get help and stay sober. In that it is the absolute BEST! I’m not sure about handling the ethical boundaries and I would like to know more. Everyone has the right to be sober and happy and in a meeting is the best support group.

    Kathleen Nemeth
    InterCoast Colleges
    Counseling Student

  4. Shimon Frankel, November 3, 2014:

    Sandra, Kathleen, you are shedding light on an important challenge, that of the clinician who does not want the home-group to know what is really occurring in his or her private life – especially when there is a client in the room listening. This typically occurs when the therapist is in trouble and does not know how to admit to that in front of the group and the client. This clinician will have to fragment and appear to be doing well when he or she is not. If he/she has not yet relapsed, that is probably not far behind – which only makes matters worse. The therapist will now either need to come clean with the group about a far bigger issue than the one originally challenging him/her – or even worse, he/she will lie and continue treating recovering addicts while being active and not sober. I wish this phenomenon would be completely theoretical, but unfortunately it is not. The greater issue here is a therapist who is attempting to “transmit something he/she hasn’t got.” When the therapist is more worried about looking good at a 12 step meeting that is supposed to be a safe place for vulnerability, the problem is not the meeting or the client in the room, but the therapist’s own ability to be transparent and honest with self and others. Putting the program first and working through the defects of character that get in the way of his/her usefulness. It is impossible that these inconsistencies in the therapist’s personal life will not bleed out into the therapy sessions with clients. What we have here is the case of the therapist who is attempting to help clients along a path unknown to either of them. I have not found this kind of therapy to be helpful to clients, rather the therapist’s personal flaws end up getting in the patient’s way and holding the patient back from progress. Bad for the therapist, bad for the patient. The better option is for the therapist to go to work on his/her defects that are getting in his/her way. The therapist can do this with the sponsor or supervisor. I have found the results to be that the therapist’s self disclosure of vulnerability and humility in a 12 step meeting to then endear him/her to the patients and clients even more. Clients feedback that they feel safe with the therapist and learn to trust the therapist for their willingness to personally stand behind the recovery principles they are teaching in the therapy sessions. Good for the therapist, good for the patient!

  5. Jose Ochoa, February 20, 2015:

    The question presented is an Ethical question first and foremost titled under, “The Dilemma for a Two Hatter”. The concept of the Two Hatter pertains to the Therapist Role and Personal Life in Recovery. Throughout the years I have observed many professionals compromise their professional boundaries by remaining in a 12 Step Meeting with a past or present client. According to a study conducted by the American Psychological Association our highest incidents of Ethical violations occur in Confidentiality and Maintaining Clear, Reasonable and Therapeutic Boundaries, which lead to Dual Relationship Violations. As professionals we must always adhere to the Code of Ethics of our Credentialing body when it comes to issues regarding the Client. Many “Code of Ethics” discuss Dual Relationships and Boundaries. On numerous occasions I have observed Clinicians sit in a Meeting when a client has walked in, knowing the Ethical thing to do is dismiss themselves from the meeting. As a professional we must keep in mind “the welfare and best interest of the client”. Even though we are in the Meeting for our own recovery the dynamics of that meeting change when a current/past client enters the room. To remain in the Meeting with a current/past client compromises our professional boundaries entering a Dual Relationship by becoming the Client’s peer in a 12 Step Meeting; and interfering with the client’s therapeutic process, (this now becomes an issue about the client’s recovery and not ours). To remain in a Meeting with a current/past client can be detrimental to the professional’s career in many ways. I once advised a professional to stop attending a meeting where a past client was attending because of the perception of a Dual Relationship. Needless to say the individual did not adhere to advice and later had to respond to rumors of an affair. The Meeting issue is a serious matter and must be assessed by the professional by asking themselves, “is this situation interfering with the client’s recovery?, how is it going to affect our professional relationship?. As professionals we must always remember that the professional Hat is never truly taken off in personal or public life.

  6. Shimon Frankel, February 23, 2015:

    Jose thank you for your comment. It is inappropriate and an ethical conflict for a 12 stepper to sponsor, or include in his inner recovery circle, someone he sees professionally outside the 12 step rooms. That said, our position is that the 12 step recovery rooms need not pose any boundary conflict for a therapist by profession than would any other scenario we all meet in this field when a therapist and client share a mutual community. Sharing a 12 step meeting with a client needn’t be any more or less challenging than attending the same church, dentist’s office, or grocery store. Of course, we encourage all professionals to clearly establish the parameters of what is and is not appropriate outside the therapy office – especially when they may cross paths in their shared community. 12 step meetings are only one area of the shared community however. AA and similar groups are not therapy groups at all. If you are not familiar with the “traditions” of 12 step programs we encourage you to learn more about the tradition (#8) that allows anyone including people who are therapists by profession who attend an anonymous 12 step meeting such as AA to be as much a non professional anonymous member of that group as any other member of the group who is looking for recovery and attending that group. The therapist is there for his or her own personal growth and recovery and that is it. If you have been exposed to therapists who break the traditional trust of non-professionalism in the 12 step rooms by speaking openly about their professional knowledge, or even marketing for clients in the 12 step rooms, we – like you – find this grossly inappropriate, unfortunate, and a risk to the recovery of everyone involved. Still, we do not subscribe to the belief that “to remain in the Meeting with a current/past client compromises our professional boundaries entering a dual Relationship by becoming the client’s peer in a 12 Step Meeting” – the 12 Step program calls on all members to simply share and receive experience, strength and hope. Thank you again for taking the time to comment.

  7. DeRonda Boggs, April 18, 2015:

    I feel that anyone has the right to attend a 12 step program. Working a program and understanding the dynamics it is common to cross paths with professional individuals in our personal life. keeping in mind principals before personalities. We are all there for one thing recovery. Sharing our experience strength and hope.

  8. Shimon Frankel, April 20, 2015:

    Thank you Deronda. Well said!

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