1. Issues and Ethics in the Helping Professions, 9th Edition
by Gerald Corey, Marianne Schneider Corey, Cindy Corey, and Patrick Callanan
with Michelle Muratori, Johns Hopkins University
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2. Managing Boundaries and Multiple Relationships
Chapter 7
Managing Boundaries and Multiple Relationships
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3. Boundary Crossings and Multiple Relationships
The rationale for abstaining from 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.
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4. Boundary Crossings and Multiple Relationships
The viewpoints on multiple relationships vary:
Some focus on the problems inherent in multiple relationships.
Others view them as common, inevitable, unavoidable, normal, and a healthy part of communal life in many settings.
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5. Boundary Crossings versus Boundary Violations
A departure from commonly accepted practices that could potentially benefit clients
Example:
Attending a student’s school play or sports event to build a positive relationship with him or her
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6. Boundary Crossings versus Boundary Violations
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
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7. 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
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8. Minimizing Risks in Multiple Relationships
Identify measures aimed at minimizing the risks:
Seek supervision when needed
Document in clinical case notes
Examine your own motivations
Refer when necessary
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9. Managing Multiple Relationships: 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.
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10. Managing Multiple Relationships: Small Community
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.
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11. 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 appropriate length of time for arrangement
Document arrangement and consult with experienced colleagues or supervisors
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12. Bartering Guidelines to clarify barter 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
If a misunderstanding develops, the matter should be dealt with by a mediator, not by you and your client
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13. Accepting Gifts
When deciding whether or not to accept a gift from a client, ask yourself:
What is the monetary value of the gift?
What are the clinical implications of accepting or rejecting the gift?
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14. Accepting Gifts
When deciding whether or not to accept a gift from a client, ask yourself:
When in the therapy process is the offering of a gift occurring?
What are my motivations for accepting or rejecting a gift?
What are the cultural implications of offering a gift?
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15. Disadvantages of Socializing with Clients
Therapists may not challenge 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.
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16. Disadvantages of Socializing with Clients
Counselors 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.
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17. Sexual Attractions 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.
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18. Sexual Attractions in Therapy
There is a distinction between finding a client sexually attractive and being preoccupied with this attraction.
Neglecting to attend to family-of-origin issues can lead to blind spots such as being attracted to clients.
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19. Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
Learn to recognize sexual attractions and how to deal with these feelings constructively and therapeutically.
Seek professional support during times of loss or crisis.
Examine and monitor feelings and behaviors toward clients continually.
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20. Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
Know the difference between having sexual attraction to clients and acting on this attraction.
Learn about the possible adverse consequences for clients and therapists who engage in sexual activity.
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21. Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
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.
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22. Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
Rather than making any explicit communication of sexual feelings for clients, acknowledge caring and warmth within the therapeutic relationship.
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23. Dealing with Sexual Attractions
To minimize the likelihood of sexual transgressions:
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.
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24. Harmful Effects of Sexual Contact With Clients
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, and/or PTSD
Feeling of rejection and low self-esteem
Suicidal ideation
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25. Legal Sanctions Against Sexual Violators
Negative consequences for therapists include:
Being the target of a lawsuit
Being convicted of a felony
Having license revoked or suspended by state
Being expelled from professional organizations
Losing their insurance coverage
Losing their jobs
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