Boundary Crossing and Multiple Relationships
the rationale for abstaining from boundaries and crossings or multiple relationships involves the potential for therapists to misuse their power to influence and exploit clients for their own benefit and to the client’s detriment
Boundary Crossing and Multiple Relationships
- The viewpoints on multiple relationships vary
a. some focus on the problems inherent in multiple relationships
b. others view them as common, inevitable, unavoidable, normal, and a healthy part of communal life in many settings
Boundary Crossings versus Boundary Violations
Boundary Crossings:
a. a departure of commonly accepted practices that could potentially benefit clients
b. Example
- -attending a student’s school play or sports event to build a positive relationship with the child
Boundary Crossings versus Boundary Violations
a. a serious breach that results in harm to clients and is therefore unethical
–Example
a gradual erosion of boundaries that leads to sexual exploitation of the client
Minimizing Risks in Multiple relationships
Identify measures aimed at minimizing the risks:
- -set healthy boundaries from the onset
- -secure informed consent if clients
- -discuss both potential risks and benefits
- -consult with other professionals to resolve any dilemmas
- -seek supervision when needed
- -document in clinical case notes
- -examine your own motivations
- -refer when necessary
Manage Multiple Relationships Small Communities
- -Therapists who work in small communities often have to blend several professionals roles and functions.
- -They have to become an integral part of the community to be accepted as a credible mental health resource.
- -If therapists isolate themselves from the surrounding community, they are likely to alienate potential clients and thus reduce their effectiveness in the settings where they work.
Prior to Establishing a Bartering Relationship
- evaluate whether it puts you at risk of impaired professional judgment
- determine the value of goods or services in a collaborative fashion
- determine the appropriate length of time for arrangement
- document arrangement and consult with experienced colleagues or supervisors
Bartering Guidlines
- -minimize unique financial arrangments
- -if bartering is used it is better to exchange goods rather than services
- -both therapists and clients should have a written agreement for the compensation by bartering
- -if a misunderstanding develops, the matter should be dealt with by a mediator, not by you and your client.
Accepting Gifts
when deciding on whether to accept gifts from a client ask yourself
- -what is the monetary value of the gift
- -what are the clinical implications of accepting a gift or rejecting the gift
- -when in the therapy process is the offering of the gift occurring
- -what are my motives for accepting or rejecting gifts
- -what is the cultural implications of offering a gift
Disadvantages of Socializing with Clients
- -the therapist may not challenge clients they know socially because of a need to be liked and accepted by the clients
- -therapist’s own needs may be enmeshed with those of their clients to the point that objectivity is lost
- -therapists are at greater risk of exploiting clients because of the power differential in the therapeutic relationship
- -former clients may need you more as a therapist at some future time than as a friend
Sexual Attraction in Therapy
- -attraction to clients is a prevalent experience among both male and female therapists
- -simply experiencing sexual attraction to a client without acting on it makes the majority of therapists feel guilty anxious and confused
- -there is a distinction between finding a client sexually attractive and being preoccupied with the attraction
- -neglecting to attend to family -of -origins issues can lead to blind spots such as being attracted to clients
Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
- -know the difference between having a sexual attraction to clients and acting on this attraction
- -learn the possible adverse consequences for clients and therapists who engage in sexual activity.
- -establish and maintain clear boundaries when a client makes sexual advances toward you
- -terminate the therapeutic relationship when a client makes sexual advances toward you
- -recognize that direct explicit disclosures of sexual feelings can run the risk of harming clients and may therefore be unethical
- -rather than making any explicit communication of sexual feelings for clients acknowledge caring and warmth within the therapeutic relationship.
- -practice a risk management approach
- -be open to using supervision consultation and personal therapy throughout your career
Harmful Effects of Sexual Contact with Clients
Clients who are victims of sexual misconduct suffer dire consequences
- distrust of opp sex
- distrust of therapists and therapeutic process
- guilt depression
- feeling rejected low self-esteem
- suicidal ideation
Legal Sanctions against sexual violators
Neg consequences for therapists include:
- being a target of a lawsuit
- being convicted of a felony
- having license revoked or suspended by the state
- being expelled
- losing their insurance
- losing their jobs
