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A Therapist in Recovery
By Kathryn Racanelli, LMHC, AT-R and David R. Selden, LICSW
When you are a both a licensed professional therapist and a person in recovery yourself you may be faced with some interesting challenges. This situation poses challenges for a clinical supervisor as well.
The Clinician’s Perspective:
When I first got sober, I was actively working as a therapist in a treatment program. I (obviously) had not disclosed my struggle with alcoholism prior to getting sober, and was unsure how to deal with my recovery as far as it related to my ongoing work with addictions. For me, it felt more uncomfortable to withhold the fact that I am in recovery than to share it. So that was my first experience with that funny boundary. And here are the questions it brought up for me: how much should I share? At what point will I have “enough” sobriety that I can share my experience? Do I share how long I have been clean for? If I do share that, how will it impact my working relationship with other clients in recovery?
I also found myself wanting to go to as many AA meetings as possible, but at the same time wanting very much to find a meeting as far away from my clients as possible. I was able to find a number of meetings that were far enough away from my clients that I felt comfortable, and also was able to switch to a different meeting as soon as I heard that my clients were thinking about heading to the same meeting.
For the first 5 or so months, I was successful in working my own recovery in AA, entirely independent from my clients. And then it happened. I went to a speaker meeting that I thought was safe, far enough away from most of my clients. As I was walking out, I heard someone call my name, and when I turned around it was a former client, whom I definitely worked with when I was still active in my use. That horrible feeling of panic went from my gut to my throat as I tried to figure out how to handle myself. Luckily the interaction was brief; he introduced me to his sponsor, and I told him how healthy he looked, and we went on our separate, merry ways.
This could have gone very differently depending on a number of things. This was a speaker meeting, a very large one, with no expectation of each person checking in, and, I was not the speaker that day. This was also a former client, not an active one. So if I had been the speaker, if the client had been active, or if it was a meeting with chips and I had gone up for one, I would have felt much more exposed.
Another dilemma cropped up not too long after that. I had heard wonderful things about a speaker discussion meeting near my home, but I heard about it from a client who identified it as his home group. He said so many great things about it, that I did check the meeting out when I knew the client was out of town. And the meeting was as awesome as he had described. Now I had to ask myself, do I go to the meeting again, knowing that this client will likely be there? What implications would that have on our working relationship? There were several things to think about here: this meeting gave out chips and getting each month’s chip was very important to me in my first year; and this client had a very complicated story and his boundaries were questionable, to put it mildly. I had to decide for myself if I valued the meeting enough to work through any awkwardness that might arise; and if I did decide to go, how I would use the meeting, chip or no chip, share or don’t share? After going back and forth, I ultimately decided that the situation was too complicated to risk going to the meeting.
And then another aspect that I hadn’t previously thought of came up: the client was concerned that I was avoiding that town because he was using AA groups there. In other words, my decision to keep that clear boundary (by not going to the meeting) had led to my client’s concern for my well-being. He said, “I hope you’re not avoiding it because of me”. That was a fun conversation.
The “fun conversation” was complicated. I actually was avoiding the client. I was concerned how the client would hear this information. I suggested we continue the conversation. I was considering how the client manages boundaries in general.This particular client manages boundaries well so I was reassured that these issues would be handled appropriately.
I used supervision for additional guidance in navigating this process.
What obligations do we have to ourselves to work our recovery and what obligations continue as a professional to maintain boundaries that might be more in the interest of our clients?
Some of the questions I asked myself while deciding which group to attend included: Do I have more resources, such as transportation than the client. Are there other socio economic barriers (child care, work hours)?
Is this meeting a priority for me or is there another meeting that will meet my needs?
How many meetings are in the area that are accessible to the client and me?
It also became apparent that the client needs to support the anonymity of the therapist, the same as anyone supports the anonymity of anyone they meet in a 12-Step meeting. This was an important two-way conversation between me and the client.
The Supervisor’s Perspective:
Recovery from addiction must be treated the same as recovery from any other chronic illness. Time and accommodation may be needed to tend to self-care and treatment. A good supervisor will encourage this. There may be set-backs (relapses) and a supervisor needs to support a clinician through this process. All of this requires a clinician to include their supervisor in their recovery. This can be challenging. What you tell, how much you tell and when you tell your supervisor need to be personal decisions.
Your supervisor needs to understand what issues you are dealing with. Are you going through PAWS? Ideally, your colleagues and supervisor need to support you but will not be able to if they don’t understand what is happening. The clinician is obviously taking a risk here. Can the supervisor and colleagues be trusted enough to allow this level of vulnerability and sharing of personal information?
A supervisor is there to support your work as a clinician but cannot be your sponsor or therapist. These roles must be fulfilled by others.
When a clinician in recovery can engage a committed sponsor, an informed therapist and a supportive supervisor, their recovery will be much stronger. And assertive pursuit of recovery results in a more effective clinician.
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