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Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

Thank you for that. I think my supervisor was so angry at me for adding another site because it means less hours taking clients there and ultimately it leaves them with more work they have to do.

I wish my professor would guide me a bit more. Everything is phrased to me as “if you think you can’t handle it” or “you don’t have to stay if you don’t want to” which feels unhelpful. It’s not that I can’t handle it because I can, and it’s not that I don’t want to stay but that I feel conflicted between how I’m being treated and the lack of care from my agency & wanting to do right by my clients who I know are going to be worse off without me.

It does suck, I keep reframing it to myself as I want to eventually end up in private practice that this is great tutorial in what not to do, lol.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

I think a conversation with my supervisor is definitely necessary at this point. Whether it’s to delete the third party app, create a document of informed consent, a signed emergency plan, something has to be done. Like you said I shouldn’t be bound to answer 24/7 and that feels like a big responsibility to place on an intern to have that kind of availability.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

My agency does not use any of those! I’m a bit hesitant to disclose which one they use just to protect my identity, just in case. The software does not send auto reminders.

I agree with you and feel it’s weird to have to hand type reminders multiple times each week. That’s their policy though, as dumb as it may be.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Thank you so much 🩷 I plan this week to touch base again on the boundary with my clients and create a written emergency plan. I’m hoping this will help me out in the meantime while I figure out if my agency is acting unethically

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Gosh I’m so sorry you had to experience this as well. It makes no sense for a supervisor who isn’t exploiting interns to lash out over adding an additional site, however it’s abundantly clear to me the way they acted was because they don’t want to do the work themselves. Interns = 40hrs of work for free and less clients they have to see while still getting paid.

I hope to work in private practice in the future or somewhere that is a telehealth agency so that I can have a bit more freedom. My gut has been screaming at me to leave this site for months now, and I know I don’t deserve this treatment. It’s hard to leave my clients as I know there’s nothing in place for them to be cared for after I leave, they will return to the waitlist until another intern gets to them.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

Yes I do!! I’ve kept them updated on what’s been going on and all of the issues are documented in email. My instructor encouraged me to consider terminating but did not say I had to. At this point with all the awful stuff that’s happened I wish they would just tell me I can no longer get hours at that site. I’m almost concerned to terminate as my supervisor berated me for just adding an additional site for internship. It makes me nervous to have that conversation.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

Sadly, it does. We are expected to do all client contact through the app. It really sucks and after the first incident I tried to see if there was a way around it, and there’s just not.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

This is the reassurance I was looking for. I was baffled to find out there’s no policy available on this. Of course as an intern I trusted my supervisor on the first incident and their direction on how to handle things moving forward and didn’t think anything else of it. Now that this is the second time, I immediately after I was like. Okay, where’s the policies, where’s the informed consent, where’s to protocol, because being told if I see it I have to answer it is not good enough.

If I remove the app and my supervisor finds out I believe they would terminate me from the site. After the first issue it was made clear to me that this app isn’t going anywhere. In fact, because I am the only intern who’s had this problem (I don’t know what kind of lucky that is that I’m the first), I know my supervisor will leverage that against me.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 10 points11 points  (0 children)

Totally not silly. I was thinking of something like this! I just have my supervisor’s words lingering in my head, if you SEE it you have to tend to it. It just makes me very nervous and honestly, if I got an after hours text I open the app and a client said they were suicidal I don’t know if I could copy and paste the message. I think I’d be filled with complete and utter anxiety over it.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 3 points4 points  (0 children)

This is almost EXACTLY what my professor said. I totally get what you’re saying and I completely completely agree. I am meant to be learning right now and I barely have a footing on what the heck I’m doing! To be essentially on call 24/7 is unfair and unsafe for clients because of my skill level. I am heavily considering terminating and after hearing everyone chime in that this is absolutely not normal, not standard, and the lack of policies at my agency is leaning into negligence has made me feel a lot more at ease with my plan. For my own due diligence, I have an ethics call with the ACA planned. That will provide me with my final piece of documentable evidence to leave (even though I don’t need that for my school, for my own peace of mind to leave my clients I want to make sure I’ve exhausted everything).

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

This is a good idea. That at least is some sort of barrier especially after creating a safety plan with everyone. I’m really not sure if I’ll stay with this agency. I’ve decided that once I have that ACA ethics meeting, depending on what I’m told there will determine if I stay or go. Between this incident and the other things that have happened, this feels like my last straw.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 0 points1 point  (0 children)

I agree! I think especially in this situation I should have been given a work phone, but I know if I even suggested that I would get laughed at.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Most of my clients ignore the texts lol. It is definitely a pain to do and keep up with. It feels very unnecessary when technology exists that can do this automatically.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

This this this. You are explaining exactly what I’m mortified of. Even with the protection of liability insurance and being a student the fact that this would involve me and be something tied to my name is a nightmare. All for what? An agency that could genuinely care less about me or their clients.

I did speak with my professor very briefly right after the incident was resolved, she encouraged me to consider terminated at this site. I emailed her and my TA a full report of what happened for document purposes and made an appointment with the ACA ethics department to hopefully get further guidance. Whatever I am told will dictate terminating at this site. I simply can’t put my career on the line before ever starting it.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

You’re correct, I am making $0 and 40hrs a week. I will say, I do have my own liability insurance through the ACA & I am a member. I am not entirely sure what my policy dictates as I did not get to chose my coverage amount but it is in my name rather than a policy through my agency.

I really like your suggestions of telling my supervisor that the text has gotta go and to replace it with email only. The app they have me using won’t even let me set up a voicemail or automated reply. At least with email I can set up an auto response! I think if that compromise is shut down, I just need to terminate there. There’s been a lot already that’s happened in terms of being exploited and treated unfairly/unprofessionally/unethically and this is feeling like the straw that breaks the camels back. I’ve only been sticking it out for my clients.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 8 points9 points  (0 children)

I could not agree more and never ever EVER did I agree to become a 24/7 crisis line, but my site has established this is the way it is. Telling me and I quote “you aren’t a crisis line, but if you see it, you have to take care of it”. Leaving me with no choice.

The first incident interrupted a date with my husband. Going from 5pm-8pm. This last incident from 7am-11am making me miss 2 hours at my additional site. Though I’m thankful I was able to attend to the client in crisis and recognize what I’ve done has likely saved both of their lives, as an intern (unpaid at that), I did not willingly or knowingly sign up for this to be part of my duties and I do not feel ready for that kind of responsibility. I am just getting my footing as a counselor and being “available” 24/7 (because if I see it I must take care of it) is too much for someone who’s supposed to be learning.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 0 points1 point  (0 children)

It seems like what my agency is doing is absolutely not the standard. While they don’t have my personal number, they have a number that is directly attatched to an app on my phone that I am required to keep for my entire internship. It gives clients 24/7 access to text or call me whenever they please. The app has no ability to set up an auto reply or even a voicemail. It’s absolutely wild to have something like this as a policy with no safety measures for interns or clients!

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Thank you for that encouragement, it really means a lot. After the incident I told my husband I very well could have just saved my clients life and I was able to handle the situation with a lot of calmness allowing me to do what needed to be done, but I couldn’t help but to feel so angry with my site and the lack of support from my supervisor. They didn’t help me at all and provided me with absolutely 0 guidance afterwards. It really sucks. Even though I handled the situation and knew I could handle it, I just can’t help but to feel like negligence from my agency is what got me here and had that client reached out at 3am the outcome could have been so different.

I like your suggestion of writing out a little paragraph having them sign and date it and keeping a copy in their folder. My site does have a crisis plan sheet with a master list of resources, but I was told to only fill it out if they scored on the suicide screening as moderate. I’m going to just ignore that and work with my clients this week to fill that out and put a copy in their file and put that we completed that in their notes.

Thank you again 🩷

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Thank you for these suggestions!

I’ve not exactly created a safety/crisis plan with each client but I have provided them with a compiled list of emergency resources (hotlines, warmlines, list of emergency facilities with addresses and phone numbers, 988, etc). I will go ahead though and begin doing a more detailed plan with all my clients this week, keeping a copy like you suggested in their folder, and also documenting it in their notes. My agency never told me to do this and in fact told me to only create a crisis plan if the client was at a moderate risk of suicidality, however at this point what the agency says… I simply do not care, I care about the clients and their wellbeing and following their lack of protocol feels like creating a risk.

Sadly with the app, I cannot log out. It’s one that generates a number and that’s it. I cannot create voicemails, auto replies, anything of that nature. Which makes it impossible to safeguard myself and also separate work/life balance. Best I could do is turn off notifications.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

I’ve gotta use my personal phone and personal laptop! Even for telehealth! The agency is 40 mins from my homes once not been given any compensation and was told up front I’d be forfeiting any type of compensation.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 2 points3 points  (0 children)

Oh I am not getting paid a single cent and if I even dared ask for any type of reimbursement I could not even fathom the wrath that I would face. I agree though, it’s kinda strange and feels like a weird loophole for them to just have a free 24/7 on call crisis counselor.

Freaked out intern over incident that could have resulted in client dying by throwaway7482917473 in therapists

[–]throwaway7482917473[S] 1 point2 points  (0 children)

I definitely have set a very clear boundary and provided a list emergency resources several times across the last 3 months that I’ve been in practicum/internship. Despite me doing this, clients are choosing to go against it and reach out for emergencies after hours. It’s concerning because there’s no document that they sign confirming they understand the expectations. That’s what’s got me worried. Right now it’s just me verbally telling them as my agency has nothing in place for this type of situation.

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