With thanks to our Organisational Member Carr Gomm, for this case study.
Carr GommCounselling Service’s collaborative approach worked effectively to support client’s return to work.
Scenario
Carr Gomm Counselling Service is a workplace counselling service that offers online, person-centred counselling service to clients (staff working in the care sector) experiencing mild to moderate psychological distress. Clients may access 6-12 free counselling sessions. One week before Christmas, a client self-referred for counselling. All the counsellors were on annual leave for two weeks. The Counselling Service Manager assessed risk, suitability for the service and consider took action to protect the client, the supported person and the employer’s reputation.
Client Profile
The client was a 30 year old male, working as a support practitioner, he supported people with complex mental health conditions. The client was absent due to difficulties in emotional regulation and was experiencing triggers in the course of his work with vulnerable people. His line manager recommended counselling to support his return to work. The client had diagnoses of chronic, severe depression, ADHD and other neurodivergent conditions.
Client History
The client disclosed a history of multiple losses including education disruption, romantic and family relationships and pregnancy loss. He had made three attempts on his life.
Previous mental health interventions
Following the client’s first suicide attempt, he received NHS mental health support. This involved seeing multiple practitioners which the client found disruptive. The client found consistency of relationship helpful in the form of a three-month intervention from an NHS psychiatrist. The client received a diagnosis of chronic, severe depression which made him fear he would be admitted to a psychiatric unit. After a second attempt, the client called a crisis helpline. He was promised a call back which never came. When the client did not receive any support while on an NHS waiting list following a third attempt, he disengaged with their services.
Risk Factors
Whilst the client was not actively making plans to end his life, was experiencing severe psychological distress, therefore, ostensibly unsuitable for the workplace counselling service. His self-report outcome measure CORE-10 score was 32/40. The client was due to return to work where he faced being triggered people he supported. Christmas was a triggering time for him, having experienced a relationship ending at that time of year. There was a lack of alternative service providers for onward referral and the client had a lack of confidence in statutory services and crisis helplines. The service has no counsellors available for over two weeks.
Action and Outcome
The Counselling Service Manager risk assessed and offered the client three holding sessions over the festive period, providing emotional containment and psychoeducation. With the client’s consent, she disclosed information to the client’s line manager which enabled them to make appropriate workplace adjustments. The client returned to work with significantly reduced anxiety. The client also received eight, person-centred, video counselling sessions from a volunteer counsellor and ended counselling with a self-reported CORE-10 score of zero i.e. no distress. The client wants their experience to help others and has provided consent to share their story.
