DBT - dodgy to disclose?

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lingua_franca
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Re: DBT - dodgy to disclose?

Post by lingua_franca » Sun Sep 29, 2013 1:05 pm

Lancelot wrote:I would agree with others that I wouldn't necessarily disclose that it was DBT specifically. DBT points to a diagnosis of borderline personality disorder which still very stigmatised. Probably more so in clinical training because of the interpersonal issues with a PD diagnosis. I suppose you could be more general about your experiences.
The irony of this is that Marsha Linehan herself had significant mental health difficulties, and she has said publicly that her own past experience was largely what led her to develop DBT...

Buddhagirl, I have no advice to give. I can only say that I sympathise. There is a gap in my education and employment history from when I was in hospital, and I'm always cautious about how to explain that one. I feel that I learned something from the experience, personally, but it's hard to disclose something to a faceless person behind a desk when you don't even know what their attitudes are. I do agree with Miriam that if you are going to disclose something, you should be open, and not try to blur or fudge it.
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"Suppose it didn't," said Pooh, after careful thought.
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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Mon Sep 30, 2013 1:31 pm

Right, total final decision: Don't disclose DBT.

I do actually think it is a shame, if I were going to to live by my values (as DBT encourages) then I would disclose it. But the reality is there is prejudice out there (thank-you to you guys for helping me see it). I'm going to say I've had psychotherapy (which is true) and reflect upon how this makes me a better candidate, talk about how I use mindfulness and leave it at that. It means I'm going to need to prepare much more carefully for interview, but, such is life.

If I don't get on then next year I'll probably disclose.
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Re: DBT - dodgy to disclose?

Post by Ruthie » Mon Sep 30, 2013 3:09 pm

I'll leave you with some other thoughts. How much personal information would you ordinarily disclose at a job interview or in a job application process? That's all the DClin application is. As others have mentioned if you do mention past experiences of mental health difficulties or therapy then it needs to be to show you this equips you to be more suitable for the role you are applying to.

There is also the question around just how personal you want to get in applications and interviews? If you wear your heart on your sleeve and they accept you, will that colour your perceptions of why you got a particular job or place on a course ("They only took me because...") or conversely, if they reject you, will the rejection feel all the more personal? Another thing to consider is how many people you would tell in your workplace about what you are thinking of disclosing in an application form or interview? The interviewers are quite likely to become your colleagues, tutors, supervisors, managers in the future. How open would you normally be with people in these roles? Would you normally disclose this on first meeting or after you have had a chance to build a relationship with them?

Not disclosing isn't hiding anything and it doesn't mean selling out on your values by any means - you can disclose later if it feels like the right thing to do. You can even disclose it at interview when you have more opportunity to suss out the attitudes of the panel and talk about what you have gained from the experience and how it makes you a stronger candidate. It is much harder to do that on an application form.

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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Mon Sep 30, 2013 5:23 pm

Ah Ruthie, wise words.
Ruthie wrote:How much personal information would you ordinarily disclose at a job interview or in a job application process?
Really not much, I just say I have had therapy in the past then I list the advantages of it. If they ask me to elaborate I say I had PTSD but was offered DBT, I can understand the concern but I wasn't really that borderline and look how capable I am now etc, etc.
There is also the question around just how personal you want to get in applications and interviews? If you wear your heart on your sleeve and they accept you, will that colour your perceptions of why you got a particular job or place on a course ("They only took me because...") or conversely, if they reject you, will the rejection feel all the more personal?
I don't want to get very personal. I know I have a tendency (even though I just watch the urge so it rarely comes out) to over-disclose. I guess perhaps I don't have a good understanding of what is involved in wearing your heart on your sleeve. I'll ask people.
If I get in or not I wouldn't attribute it to either disclosing or not. I'd wonder obviously, but I try not to hold on to the past.

Another thing to consider is how many people you would tell in your workplace about what you are thinking of disclosing in an application form or interview? The interviewers are quite likely to become your colleagues, tutors, supervisors, managers in the future. How open would you normally be with people in these roles? Would you normally disclose this on first meeting or after you have had a chance to build a relationship with them?
Your so right, I did not think about the fact I would carry on working with them, to me they were the magical panel who decide and then you never see them again.

Truth is, I do disclose. My supervisor here knows and the lead.
I think I have the tendency to over-disclose (OUTISDE of sessions) and I need to think about how I can curb this a bit. I may be naively living in a magical world of "they should not judge me, It's better to be truthful". But at the end of the day, how wise is that? The reality is some people will judge me, disclosing is ok sometimes but do i do it in innapropriate ways? Am i taking the risk by disclosing as it can be a risky road to go down as you can then over disclose and do i ever make people feel uncomfortable? How does being open about things make me appear to my superiors? All bloody good questions i shall muse on.

And this is where the borderline comes out in me. I don't know the answers. I need to ask other people, I'm not great with boundaries :? (Just like to point out here I only ever talk about myself in a session if I want to give a brief example of how I manage something the client is presenting with. I'm hot on client/therapist boundaries and respect them and understand how important they are).
I'm doubting my ability now. *sigh*
Not disclosing isn't hiding anything and it doesn't mean selling out on your values by any means - you can disclose later if it feels like the right thing to do. You can even disclose it at interview when you have more opportunity to suss out the attitudes of the panel and talk about what you have gained from the experience and how it makes you a stronger candidate. It is much harder to do that on an application form.

Ruthie
You have found an assumption of mine I have not challenged *scurries off to find a more balanced perspective*

Thank-You so much. Really really helpful.

Post edited to remove swearing - Mod
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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Wed Oct 02, 2013 1:14 pm

I spoke to my supervisor, she said I don't over-disclose and she thinks I use supervision in a mature way. Apparently I don't go OTT with personal information but I bring up issues relevant to working with clients. So thats good, I'm going to move on from this now. Pressed submit- thats it! Done. Boom.
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Re: DBT - dodgy to disclose?

Post by Dice » Thu Oct 03, 2013 6:13 pm

Hi,

Some really interesting and useful points to think about here, thank you all for that. Buddhagirl well done on deciding what you think is best for you, I'm so impressed that you've already written and submitted your application! I am nowhere near that stage yet, it is only scribbled notes and thoughts. Ruthie, what you said about it just being a job application was helpful. I have spoken about my personal experience of mental health problems (no diagnosis mentioned unless relevant) and mental health service use in every job I have applied for in the mental health field, but then many of them have 'personal experience of...' in the 'desirable criteria' as this is standard practice in some mental health Trusts nowadays (ones near me anyway). It's been really important for me to work in places that explicitly value lived experience, despite its attendant stigma, so this attracts me to certain places of work I guess.

My personal view is that my lived experience, and with it the experience of helping other service users from a 'peer' and more power-balanced position is equally useful and complementary to my professional/ psychological experience in making me a good candidate for CP training and I will endeavour to write an application that reflects this and explains how (not 'I am a service user so I know what they are going through'). I'll try to give it lots of thought to make sure any experience I talk about, personal or otherwise, really focuses on what I learnt and how that applies to clinical psychology.

Really interesting and useful discussion, thanks everyone

Dice

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Re: DBT - dodgy to disclose?

Post by Randomswirls » Thu Oct 03, 2013 6:31 pm

I've found this discussion interesting as I'm hoping to apply next year and all my experience will be around me being a service user as I am currently a peer support worker and peer trainer within my trust recovery college. So I will have no option but to disclose. I have had increasing contact with psychologists all of whom have been very positive about me applying and in some senses it worries me but the longer I work the more I get used to it and the more benefit I feel my lived experience brings to the clients I work with!

Good luck

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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Fri Oct 04, 2013 10:58 pm

It's been really important for me to work in places that explicitly value lived experience, despite its attendant stigma, so this attracts me to certain places of work I guess
I can see this. Stigma is horrible to experience, especially as we should be trying to reduce stigma! How often we talk about respecting diversity but previous diversity appears to be a problem if it involves mental health. Ah well, give it another decade or two.

I think previous experience is a real benefit, only recently has it not been compulsory to have personal therapy during training. Self reflection and self awareness are really important. Got my fingers crossed for you Dice!


Randomswirls: really glad to hear you have had good responses from other psychologists. I have had good responses also and agree with you that you get used to being on "the other side of the fence" more everyday, and use past experience to benefit your clients. I'm surprised sometimes just how ok people are with it.... Then also surprised when people judge and form stupid opinions.

Ranting a bit now but in my IAPT service the clinical lead really support the 2 pwps currently suffering from depression as those two have some of the best recovery rates. She said to me that their experience and my past experience makes us better therapists and it is in the services best interests to give a little more support to get a lot of good quality therapy back. She talks about it in terms of protected characteristics. It makes for a really supportive environment. I think when I move on I may well get a shock!
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Re: DBT - dodgy to disclose?

Post by maven » Sat Oct 05, 2013 12:56 am

Buddhagirl wrote:only recently has it not been compulsory to have personal therapy during training.
Personal therapy has never been compulsory in clinical psychology training. Psychoanalysis, counselling psychology and some forms of psychotherapy maybe, but not CP.
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Re: DBT - dodgy to disclose?

Post by greenamber83 » Sat Oct 05, 2013 9:37 am

Hi Buddhagirl,

I just wanted to say thanks for opening up this discussion - it's been an interesting read for me as I was diagnosed with borderline personality disorder in the past and know only too well how it feels to grapple with the who do I tell / how much to I tell / how specific do I get questions. It is something which is so inherently stigmatised and believed by many MH professionals to be 'untreatable' even now that part of me wishes I could shout from the rooftops - 'look at me now'.

I'm currently only in the early stages of my psychology career (finished conversion last year, been working as a support worker on an acute adult MH ward and have just started as a voluntary AP). I disclosed that I had experience of inpatient wards on a personal level for my current job - as one of the essential criteria was this I had to really but I used it in that way, explaining that although it was personal and not professional experience, it had taught me various things. I didn't disclose any of it for my voluntary AP role because honestly I didn't feel it was necessary. I would talk about it in the future with colleagues if I felt I needed / wanted to. I have told my manager at work the specifics because it came up in conversation once and I had built up that level of trust that I needed to do so, but I was honestly surprised by the emotions doing so stirred up in me again.

I'm not sure exactly what point I'm trying to make (if any at all!) but I guess I just wanted to say that I do think an open and honest discussion is important, if only amongst others working within mental health who have personal experience. There is a case for reducing stigma and breaking down this sense of 'us and them', most definitely. I definitely think personal experience gives certain insights but that we need to be wary of how much we disclose and in what circumstances. I know how difficult not over-disclosing can be - I spent most of my adult life doing this and it's hard to un-learn! I know that when it comes to me applying to the DClinPsy in the future that I will want to mention it at least because it has been a huge motivating factor for me in wanting to do clinical psychology and has definitely coloured what I am like as a person / working with others.

Best of luck to you :).

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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Mon Oct 07, 2013 12:31 pm

greenamber83 wrote:. It is something which is so inherently stigmatised and believed by many MH professionals to be 'untreatable' even now that part of me wishes I could shout from the rooftops - 'look at me now'.
Right there with you. Even if they think it is treatable there is often an underlying stigma and this comes out in how your treated. I think a lot of it is the name 'personality disorder' - who you are is inherently disordered. Ugh.

I would talk about it in the future with colleagues if I felt I needed / wanted to. I have told my manager at work the specifics because it came up in conversation once and I had built up that level of trust that I needed to do so, but I was honestly surprised by the emotions doing so stirred up in me again.
I think its great you can work on wards now, I know a lot of people would not go near them again even as staff!! It is scary telling other people, perhaps it is like how gay people feel/felt disclosing their sexuality. The fear of discrimination.

In supervision though and on the internet (if your sure it's relatively anonymous (we can never take into account stalkers!)) I think its good to do. If you had recently been bereaved for example and the issue of death came up in a session and it was impacted on you, then you would probably bring that to supervision, why not talk about issues surrounding attachment/abuse/whatever.
I just wanted to say that I do think an open and honest discussion is important, if only amongst others working within mental health who have personal experience. There is a case for reducing stigma and breaking down this sense of 'us and them', most definitely. I definitely think personal experience gives certain insights but that we need to be wary of how much we disclose and in what circumstances. I know how difficult not over-disclosing can be - I spent most of my adult life doing this and it's hard to un-learn!
I also think so....to a certain extent. However, there will be times when it is seen as "inappropriate over-disclosure" even if it is not. Whether it is or it isn't there will be times where it counts against you. Which is awful really. I think having coming from being in therapy I sometimes make the mistake that people working in mental health and are kind and non-judgemental and I have learnt the opposite in fact - some have massive egos and are really small minded.

Just as an example my self harms scars on my arms are pretty bad and I wore long sleeves in my current PWP job for about 9 months, then I had had enough and now just wear mind-length and I've had 90% really good responses. People have come up to me and said things like 'I've just listened to your session, I'm surprised someone who has arms like yours could talk like that on the phone' (not even joking). I've had a supervisor said I should not wear short sleeves in clinic if I don't want because I should not need to hide who I am! (I think thats a step to far, I wear long sleeves), people coming and asking me how to work with self harm, loads of stuff. I've also had people constantly asking me I'm okay with the work loads and trying to stop me from taking on this that and the other and people say to others that I am not fit to be a PWP. So the point of this long paragraph is to point out that sometimes people engage the brain and it reduces stigma, and other times you get it in the neck...as you will know.
I am hopeful though, discrimination gets less and less with every generation, give it 10-20 years and it will be different.
I know that when it comes to me applying to the DClinPsy in the future that I will want to mention it
Do it :)
"Nothing is more important than guarding the mind. Let us constantly keep watch over it, curbing it with mindfulness and vigilance."-Dalai Lama

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Re: DBT - dodgy to disclose?

Post by Will » Mon Oct 07, 2013 10:12 pm

I think the topic of self-disclosure in any professional relationship is a huge one, and it's been debated since therapy was invented. It's not it's not something I'm particularly well versed in but I wanted to share some thoughts this thread has prompted.

In any therapeutic relationship I think it's important to remember the potential impact that a disclosure could have on the client. The therapeutic modality you're working in will influence on this, and it's a widely discussed topic in the psychodynamic literature due to the nature of that kind of work. However I think in any therapeutic relationship, a disclosure made by a therapist can have a huge effect and needs to be carefully considered beforehand. A client you're working with might have a response to finding out that you're married, a home owner, a vegan, whatever. My rule of thumb is to really question why I'm wanting to disclose that about myself - what's the benefit to the client? What's my rationale? Will it help them to relate to me? What are the potential risks?

In my opinion, disclosing to a client that you've experienced mental health problems is a big deal. It could be incredibly positive and powerful - but it could also be really problematic for a therapeutic relationship. I think you'd need a very clear rationale before disclosing something like that because ultimately, the therapeutic relationship should be about the client. It isn't a space for a therapist to reflect on and share their own experiences, however relevant they might be. Jumping in with a "hey me too!" can shut down discussion or prevent a client from using the therapeutic space to formulate and understand their own experiences. Simply because a client and a therapist share an experience does not mean that they experienced it in the same way. For some people, a well boundaried and clearly contracted therapeutic relationship might be the first predictable and positive interaction they've ever had. Blurring the boundaries of a relationship can be incredibly difficult for a client and might trigger all kinds of responses.

Having experience of mental health problems or services can be highly valuable - however it doesn't qualify you to be a clinical psychologist or mental health professional. Therapeutic work should utilise the ability to apply psychological models and theory to help a person to formulate and understand their difficulties, hopefully supporting them to move forwards from there. Whatever our own experiences (and we're human, many of us will experience some difficulties at some point in our lives) it's important to be able to manage that appropriately so that a therapeutic relationship with a client isn't damaged as a result. Supervision can play a vital role in that and that's why it isn't optional for psychologists or most registered mental health professionals.

From the perspective of applying for CP training, I think it's vital to be able to demonstrate that you've considered these issues. I think it can be very useful to reflect on your own experiences and relate that to why you're interested in applying for training - but the thinking shouldn't stop there. I think it's also important to demonstrate why you feel you're ready and able to do a demanding job, working with people who might have complex needs.

Disclosures can be accidental and can happen outside a clinic room. The internet is not an anonymous place. Clients can (and do) google their therapists, and it often doesn't take much to track someone down. Using the same email address or username makes a person pretty easy to follow. Forums like this aren't private, threads are googleable and I'm sure that people who access services follow the discussions. The same applies to Facebook, Twitter, etc. and even the smallest bit of information might be misinterpreted or misconstrued. I'd really suggest that people check out the DCP's e-professionalism guidance on social media (http://www.bps.org.uk/content/e-profess ... chologists).
In supervision though and on the internet (if your sure it's relatively anonymous (we can never take into account stalkers!)) I think its good to do. If you had recently been bereaved for example and the issue of death came up in a session and it was impacted on you, then you would probably bring that to supervision, why not talk about issues surrounding attachment/abuse/whatever.
I just wanted to pick up on this point BG. The internet (and this forum) isn't supervision and shouldn't be used as such. Personally, I try to conduct myself on here in the way that I would at a conference, surrounded by other professionals - I aim to be relaxed and friendly and I'm happy to share my perspectives on issues under discussion. However I want to do that in a way which is professional and within what I feel are appropriate boundaries for the environment. It may be very appropriate to discuss personal experiences with a supervisor, however this is something that would be agreed with them and negotiated as part of the supervision contract. In my opinion supervision isn't a substitute for personal therapy and if personal issues are being discussed, the focus should always be on how the work with the client might be affected.

(sorry, that turned into a bit of an essay!)
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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Mon Oct 07, 2013 10:55 pm

All good points about self disclosure, although I'm not quite sure why you felt the need to talk about it on this thread. When I say self disclosure I mean outside of sessions. I'm really hot on therapist /patient boundaries and hardly ever self disclose, I wouldn't even say I was going on holiday or where too.

As for self disclosure on the Internet there are differing ways to perceive that. I don't use the Internet as a conference I use it to talk about things I would not talk about irl sometimes, other times I use it to talk about things I would talk about irl. The Internet has different rules... You can moderate your tiny corner to death but it will only change your tiny corner.
"Nothing is more important than guarding the mind. Let us constantly keep watch over it, curbing it with mindfulness and vigilance."-Dalai Lama

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Will
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Re: DBT - dodgy to disclose?

Post by Will » Mon Oct 07, 2013 11:17 pm

Because I think that the issues around making disclosures are just as relevant when with a client, posting on the internet, conducting oneself in a team or applying for jobs/training. I feel like it's important to be able to demonstrate the ability to think about how these things might impact.

It wasn't intended to be a direct reply to any one post, more a general response to wider issues around the way we use forums and social networking sites, intended to provoke further reflection and discussion.
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Re: DBT - dodgy to disclose?

Post by Buddhagirl » Mon Oct 07, 2013 11:41 pm

Will wrote:Because I think that the issues around making disclosures are just as relevant when with a client, posting on the internet, conducting oneself in a team or applying for jobs/training. I feel like it's important to be able to demonstrate the ability to think about how these things might impact.

It wasn't intended to be a direct reply to any one post, more a general response to wider issues around the way we use forums and social networking sites, intended to provoke further reflection and discussion.
Well that sounds very wise :)
"Nothing is more important than guarding the mind. Let us constantly keep watch over it, curbing it with mindfulness and vigilance."-Dalai Lama

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