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BCFIV Perspectives: What Makes a Good Practitioner Makes
a Good Training Program
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"To be good is noble, but to teach others to be
good is nobler - and less trouble". Mark Twain
Training in family violence is the topic of this issue of
the Newsletter. It is a complex but important topic, and we
invite you to take the time to think about the many issues
involved. It is certainly no less complicated for the battered
woman who after years of abuse has finally mustered up the
courage, resources, and resolve to try to garner some support
for herself and her children, only to encounter a maze of
choices and practitioners with various levels of training
and experience, not to mention diversity in terms of political
and ideological views.
Family violence is commonly understood to be multi-determined.
That is to say, family violence is not easily nor appropriately
reduceable to one simple, single cause. Family violence often
involves a variety of family and social issues such as alcohol
and substance abuse, power inequality, and particular personality
traits. The sequelae of family violence include the full range
of clinical symptoms such as fear, anxiety, depression, anger,
lowered self-esteem, and social isolation, ranging from mild
to extreme.
The practitioner in family violence should have a good understanding
of the role various factors might play contributing to violence
in the family. Similarly a knowledge of child development
and the development of the personality over the life span,
an understanding of the impact of witnessing violence on children,
as well as the impact of child physical and sexual abuse,
both specifically and in terms of cumulative effects, is important.
The clinician should know about factors contributing to healthy
family relationships such as communication and problem-solving
skills. Understanding of alcohol and substance abuse and the
diagnosis and understanding of mental disorder and psychological
adjustment would be essential. Ethical issues are also center
stage, with clinicians often being obligated to warn potential
victims, and needing to consider related issues of confidentiality
and informed consent. Clinicians also need knowledge and awareness
of ethnic and cultural issues, for example, traditional gender
roles in particular cultures or views about appropriate methods
of discipline. Critical thinking skills are essential to all
clinicians working in this area. There have been attempts
to spell out a specific curriculum in the area of violence.
As an example, HealthCanada funded the development of a curriculum
guide in the area of violence titled "Violence Issues: An
Interdisciplinary Curriculum Guide for Health Professionals"
(1994), an admirable attempt to clearly spell out what the
practitioner should know in the area.
The "helping professions" make up the majority of practitioners
working in the field of family violence. Traditionally this
term has included mental health practitioners from the fields
of psychiatry, clinical psychology, counseling psychology,
social work and nursing. Such individuals are typically trained
in a university setting and have one or more graduate degrees.
They may or may not have specialized training in family violence.
Psychiatrists are medical doctors with specialized training
in psychiatry, providing them with expertise in the area of
psychiatric diagnosis and the treatment of mental disorders,
often with an emphasis on "biological treatment" or the use
of medications. Psychiatrists often have a private practice
and/or work in a hospital setting. Their training emphasizes
the biological aspects of mental disorders and their treatment.
Psychiatrists are regulated by the B.C. Medical Association.
Clinical psychologists receive training in both research
methodology and clinical practice (therapy and assessment),
often in what is called a "scientist-practitioner" model.
Thus, a clinical psychologist should know the research literature
in his or her area(s) of expertise as well as modes of treatment
and assessment. Many clinical psychologists work in government
settings or in private practice. Clinical psychologists vary
extensively in the different theoretical perspectives and
treatment approaches they use and typically treat a wide range
of individuals, families and groups. To currently practice
as a psychologist in B.C. one must have a Doctorate and be
registered with the College of Psychologists.
Social workers may have a Bachelor's Degree or a Master's
Degree in Social Work in order to practice in B.C. Social
workers often take an activist role with their clients, with
home visits, concern about vocational and other practical
matters in the life of their clients, often bringing together
various resources to help the individual or family. The B.C.
Association of Social Workers promotes standards of practice
and ethical commitment for social workers in B.C.
Traditionally counseling psychologists and counselors in
general have focused on work with "normal" populations. With
strong roots in vocational guidance, counselors have traditionally
emphasized short and medium-term counseling and psychotherapy
with normal and mildly to moderately emotionally disturbed
clients, with a goal of problem resolution, problem-solving
skills and behavior change. A developmental perspective is
typical, with a focus on the strengths and adaptive strategies
of an individual across the life span. Counselors typically
have at least a Master's Degree (the minimum requirement to
join the Association of Clinical Counselors of B.C.). Nurses
and psychiatric nurses are another professional group providing
treatment in this area. The B.C. Association of Counselors
of Abusive Men have contributed an informative article to
this issue. ACAM is a group of counselors whose clinical work
focuses on work with men who abuse their partners and/or children.
Many practitioners in the area of family violence are "para-professionals",
a term used to denote the non-traditional training these individual
receive. Many para-professionals are individuals who themselves
have been victims of family violence and want to use their
experiences and knowledge to help others. Others are individuals
who by virtue of extensive work experience have become knowledgeable
practitioners without formal training.
In addition to the formal and standardized training available
in the university setting, there are a number of other important
training facilities in our province. The Justice Institute,
for example, plays an important role in providing continuing
education and training for mental health and criminal justice
professionals in a variety of important areas, including family
violence. The Nicola Valley Institute of Technology and the
Counselor Training Institute, both of which are included in
this issue, take a fairly pragmatic approach to training,
with an emphasis on skills rather than theory. Both offer
specialized programs in the area of sexual abuse, with the
former specializing in First Nation education. The Vancouver
Society for Male Survivors (see the article in this issue)
has specialized in the population of men who have survived
sexual abuse. They also offer much needed training to mental
health professionals wanting to develop or increase their
expertise in the growing area of male survivors.
This newsletter profiles the professionals and other individuals
who work in the area of family violence and the various settings
in which formal and more short-term, skill-specific training
is available. For both individuals with formal training and
for those who bring a different form of expertise to their
work, such as drawing on their own experiences, training must
be an ongoing pursuit and an integral part of work in this
complex area. Many clinicians believe that training never
really ends. The complexity and challenge of working with
others necessitates that the clinician continue to ask questions
and acquire knowledge. The value of one's own experience and
the willingness to share this with others encountering family
violence is likewise increased when it is accompanied by a
foundation of knowledge and skill acquired through appropriate
channels.
Clients should ask questions in deciding to work with a
particular clinician or in a particular setting. Observe how
the practitioner responds to questions about his or her expertise
and training. The qualified and competent practitioner should
welcome and respect your questions.
Family violence is a large puzzle. There may be many participants
in the attempt to sort the pieces out and put them into place,
a process that will be all the more efficient and worthwhile
if each participant has a sense of the larger picture and
a competent and honest assessment of where their contribution
can best be made. In addition, whatever the background or
training an individual clinician may have, training should
be seen as an integral and ongoing component of clinical practice.
Andrea Kowaz, Ph.D., R. Psychologist
BC Institute on Family Violence
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