I was strongly attracted to the Symposium first by its title, then by its rundown, and, more importantly, by the familiar names as the speakers. Its focus on “clients with complex needs” hit a click on me, as I fully shared the notion that our clients had complex needs – a seemingly monotonous group of clients could actually come from different family backgrounds, have different predisposing and precipitating factors to their disturbance, and require different kinds and periods of treatments. The titles of the keynote address and various sessions suggested that discussions would encompass a wide spectrum of clients both longitudinally (from adolescents to married adults who might also be parents to the elderly) and horizontally (covering the active working force as well as those who suffered from incurable diseases, people who intended to give up their own life as well as those who grieved for the death of someone close to them, and people of different sexual orientations). And then there were speakers well known for their efforts and achievements in their respective fields and whom I had been looking forward to listen from. There were also fellow graduates from the Counselling Programme sharing their experience and insight in areas of their expertise.
In his keynote address, Dr Samson Tse led us on a journey to different corners of the world to appreciate arts and crafts as well as ordinary structures viewed at extraordinary angles. Through this interesting journey, he demonstrated how we could draw meanings out of seemingly weird happenings and that things could be construed differently when viewed from different angles or depths. I believe everyone goes through numerous meaning making processes everyday, but selectively and casually – we might impose our own meanings into others’ experience and dismiss some of their moves/gestures as meaningless. But as professional counselors, we should always try to comprehend things through our clients’ eyes and from their “frame of reference”, respect their moves and gestures as there might be meanings in every one of them, and go further from there to help them find solutions meaningful to them. To this end, widening our perspectives by meeting more people and travelling more places (like Dr Tse did) would definitely help. So, thank you, Dr Tse, for reminding us that we should look wider and deeper, as “interior matters”.
When we can appreciate the meanings behind our clients’ behaviours, there is a better chance that we can help them remain hopeful when there appears to be not much hope. Concerning those who really feel hopeless for various reasons and who have contemplated or intend to commit self-harm or suicide, it was disappointing at first to hear from Dr Paul Wong that various therapies which might have been thought to be effective in suicide prevention were actually not supported by evidence. But it was comforting to learn that Cognitive and Behavioural Therapy and Dialectical Behavioural Therapy, which sounded more familiar to me, had been proved helpful. And then came the surprisingly positive piece of news that simple gestures such as sending a post-card to clients to express concern and to invite their contacts could contribute to a reduction in suicidal deaths. This latter finding reminded me of what a client once told me, that she gave up harming herself after calling me at her impulsive moment as I had previously asked her to do. What impressed me most in Dr Wong’s presentation was the magic done by interdisciplinary and integrated programmes such as the “community-based suicide prevention programme” in Cheung Chau and a similar programme run in the Eastern District in reducing suicides. So I gathered that professional counseling coupled with community monitoring and care was what we should aim for to rekindle our clients’ hopes and enthusiasm towards themselves, the world and their future. I cannot agree more with what Dr Wong highlighted – “it takes a society to save a soul in despair”.
My encounters with cancer have not been rare – through my beloved family members and friends. This underlined my special interest in the discussion on what support and hope there could be for patients with incurable diseases. The speaker, Dr Rico Liu, being a fellow graduate from our Counseling Programme, added to my expectation from the talk. Before knowing Rico, I never thought that public hospital doctors would care to be trained up in counseling with their precious leisure time and have the passion even to start up an alumni association for fellow graduates. And before listening to his talk on the topic, I never felt that it was realistic to expect doctors to go beyond prescribing medicines and performing operations to try to give psychological support and hope to patients and their family members. Rico planted a hope in me, by presenting a model of integrated care team in the hospital in which physical care was integrated with psychosocial care. He demonstrated how the public health care system could help to give hope to patients and their family members that people suffering from “terminal” cancer could actually maintain normal functioning until the really “terminal” days, that they could “live with” the “incurable disease”. Now I know that I can rely on Rico and other passionate colleagues of his to expand the humanistic approach in his hospital in treating incurable diseases to other hospitals and to departments treating other illnesses.
For those left behind by close family members/partners due to the latter’s suicide or sickness, bereavement counseling may help them make meaning of their present and to bring back hope to their future life. In her talk, Dr Amy Chow shared with us her findings and insight on how best to work with bereaved persons. It was interesting to note that motivation came to play as it was related to “hope (agency)”, one of the two components (the other component being “hope (pathway)”) of goal-directed thoughts. And, to my surprise, only around a quarter of widows in a study had suffered from chronic depression or grief. It was fully understandable why differentiated care was advocated for different target groups according to their risks of developing chronic depression or grief. I was touched by a photo showing two gentlemen presenting a note of appreciation to Dr Chow – “單腳踏實地…歸家漸開眉”. With the permanent departure of one’s partner, it would take one much strength to face the world on his/her own, not to mention smiling from the heart. The grieving process would certainly be made easier with the support of bereavement counseling groups, which offer helping hands to bring the mourner back to solid ground. With Hong Kong’s population ageing, I am hopeful that the Chinese version of the Inventory of Complicated Grief, when finalized by Dr Chow, would be able to better identify the high risk group for targeted bereavement counseling.
When it came to the concurrent sessions, I really wished that I could be transformed into the monkey king and split myself into three pieces so as to save me the trouble of deciding which session to attend. While I would like to listen to how counseling was being carried out in various settings, I also wished to keep myself abreast of how counselors were helping the specific populations of adolescents and sexual minorities. However, I made a difficult decision to give these up in order to join the workshop on “movement to music”, partly due to my keen interest in music, singing and dancing, and partly due to my personal experience about the effectiveness of music in facilitating the smooth running of group sessions. I knew I had missed something from the other concurrent sessions, but I came out of Dr Rainbow Ho’s session feeling charged and satisfied. Dr Ho demonstrated how movement to music could soften the boundary between the counselor and the client in a session and invoke responses from a highly restrained client. For myself, it was wonderful being in a group of fellow counselors in that session moving to different types of music and in their own styles. The personal restraint and interpersonal boundaries were softened, and the internal sentiments released. I strongly believe that music partnered with movements could make a “magic wand” to bring out unspoken words and hidden emotions.
For the future of counseling, I agree that a proper registration system would definitely help in the wider recognition of counselors as professionals, thereby encouraging more people to seek counseling when they have psychological or emotional disturbances. But before this can be realised, the concerted efforts of all in the field are important in raising our own status in the society. First, there was our Counselling Programme started by Dr H Y Ng in 2002 and of which Dr Samson Tse has taken the helm since 2008. With their leadership and the teaching team’s insistence on striving for the best, the Programme has never failed its reputation as a high quality training ground for counselors. I have taken pride in having survived through the Programme, which Dr Ng had repeatedly told us not to expect to be able to “roll through”. In the cover article she wrote for the launching issue of the Alumni Association (AA) Newsletter, Dr Ng revealed that her uncompromising standard set for the Programme had originated from her most respected teacher, Dr Erik Kvan, who had told her to “do something decent”. Then, it would be the responsibility of every one of us as counselors to maintain a high standard of practice. In order to do this, among others, we must continue to upgrade ourselves in the field. In this regard, I am thankful to the AA for acting as the coherence agent among fellow graduates from the Programme and providing continual learning opportunities for us, thus contributing to raising our counseling standards as well as professional image. When our work in counseling is well recognized in the society, who would still care whether we are registered under any administrative system?
To echo Dr Tse’s appeal in his keynote address of the Symposium that we should dig to the “interior” and try to make meanings out of it, I wish to quote the words of wisdom from Dr Ng in her cover article mentioned above: “look beyond appearances, and seek wisdom from within”.
March 2011
Christine Tang (2007 graduate)
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