Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Chapter 7 Managing Boundaries and Multiple Relationships

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Boundary Crossings and Multiple Relationships The rationale behind the argument to abstain from any boundary 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 clients’ detriment. There is a wide range of viewpoints on multiple relationships: –Some writers focus on the problems inherent in multiple relationships. –Another view is that multiple relationships are common, inevitable, unavoidable, normal, and a healthy part of communal life in many settings. Issues and Ethics - Chapter 7 (1)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Boundary Crossings versus Boundary Violations A boundary crossing is a departure from commonly accepted practices that could potentially benefit clients –Example: By attending a student’s school play, musical recital, or sports event, the counselor can do a lot to build a relationship with a student. A boundary violation is a serious breach that results in harm to clients and is therefore unethical. –Example: A gradual erosion of boundaries can lead to very problematic multiple relationships that bring harm to clients (e.g. sexual exploitation). Issues and Ethics - Chapter 7 (2)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Minimizing Risks in Multiple Relationships Identify measures aimed at minimizing the risks: –set healthy boundaries from the outset –secure informed consent of 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 Issues and Ethics - Chapter 7 (3)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Managing Multiple Relationships in a Small Community Practitioners who work in small communities often have to blend several professional roles and functions. They have to become an integral part of the community to be accepted as a credible mental health resource. If these practitioners isolate themselves from the surrounding community, they are likely to alienate potential clients and thus reduce their effectiveness in the settings where they work. Issues and Ethics - Chapter 7 (4)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning 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 the arrangement Consult with experienced colleagues or supervisors Issues and Ethics - Chapter 7 (5)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Bartering Additional guidelines to clarify bartering arrangements: –Minimize unique financial arrangements –If bartering is used, it is better to exchange goods rather than services –Both therapist and client should have a written agreement for the compensation by bartering Issues and Ethics - Chapter 7 (6)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Accepting Gifts Questions to consider in making a decision of whether or not to accept gifts from the client –What is the monetary value of the gift? –What are the clinical implications of accepting or rejecting the gift? –When in the therapy process is the offering of a gift occurring? –What are the therapist’s motivations for accepting or rejecting a client’s gift? –What are the cultural implications of offering a gift? Issues and Ethics - Chapter 7 (7)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Socializing with Current or Former Clients Potential disadvantages: Potential disadvantages: –Therapists may not be as challenging as they need to be with clients they know socially because of a need to be liked and accepted by the client. –Counselors’ own needs may be enmeshed with those of their clients to the point that objectivity is lost. –Counselors are at greater risk of exploiting clients because of the power differential in the therapeutic relationship. –If you develop a friendship with a former client, then he or she is not eligible to use your professional services in the future. Issues and Ethics - Chapter 7 (8)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Sexual Attractions in the Client- Therapist Relationship –Attraction to clients is a prevalent experience among both male and female therapists. –The most common reactions of therapists: SurpriseGuilt Anxiety about unresolved personal problems Fear of losing control Fear of being criticized Confusion about boundaries and roles Confusion about actions Issues and Ethics - Chapter 7 (9)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Recommendations for Dealing with Sexual Attractions To minimize the likelihood of sexual transgressions by clinicians: –Learn to recognize sexual attractions and how to deal with these feelings constructively and therapeutically. –Seek professional support during times of personal loss or crisis. –Examine and monitor feelings and behaviors toward clients continually. –Know the difference between having sexual attraction to clients and acting on this attraction. Issues and Ethics - Chapter 7 (10)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Recommendations for Dealing with Sexual Attractions –Learn about 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 sexual feelings obscure objectivity. –Recognize that direct explicit disclosures of sexual feelings can run the risk of harming clients and may therefore be unethical. Issues and Ethics - Chapter 7 (11)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Recommendations for Dealing with Sexual Attractions –Rather than making any explicit communication of sexual feelings for clients, acknowledge caring and warmth within the therapeutic relationship. –Practice a risk management approach (e.g., be aware of timing and the location of scheduled appointments, non- erotic touch, and general self-disclosure. –Be open to using supervision, consultation, and personal therapy throughout your career. Issues and Ethics - Chapter 7 (12)

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Issues and Ethics - Chapter 7 (13) Harmful Effects of Sexual Contact With Clients Clients who are the victims of sexual misconduct suffer dire consequences: Clients who are the victims of sexual misconduct suffer dire consequences: –Distrust of the opposite sex –Distrust of therapists and the therapeutic process –Guilt –Depression –Anger –Feeling of rejection –Suicidal ideation –Low self-esteem.

Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Issues and Ethics - Chapter 7 (14) Legal Sanctions Against Sexual Violators Negative consequences for therapists include: Negative consequences for therapists include: – being the target of a lawsuit –being convicted of a felony –having their license revoked or suspended by the state –being expelled from professional organizations –losing their insurance coverage –losing their jobs