Boundaries
What are professional boundaries?
Professional boundaries prevent harm to clients and provide structure and safety
True or False
When thinking about ethical considerations in touch, it is essential for professionals to have some understanding of the possible usefulness of touch, the harm of withholding touch, and the possible negative consequences of touch
True
How do you define gifts?
Gifts can be defined as:"Something that is bestowed voluntarily and without compensation"(Zur, 2005, pg.4)
What is authenticity?
Authenticity is defined as: "A quality of genuineness, real and not of doubtful origin" (Donaghy, 2002, pg.40)
What is the difference between boundary crossings and boundary violations?
Boundary crossings can be when the therapist engages in limited self-disclosure for the purpose of helping the client. Boundary crossings can become boundary violations when clients are risk for harm. Boundary violations can be accepting an expensive gift from a client and engaging in extensive self-disclosure
What could therapists do when certain touching makes them feel uncomfortable?
Therapists could talk with the child about personal boundaries, emphasizing how everybody has different ways that they like or do not like to be touched
Gifts can be given by therapists or clients. Provide some examples
Examples: poem, drawing, book, music CD, homemade cookie, homegrown fruits, framed picture, baseball ticket, piano, car or large sum of money
Is authenticity possible?
It is possible to achieve authenticity, but not as an entirety, inauthenticity is also important. We need to understand that authenticity is a matter of degree rather than an absolute so it seems that we also need to consider how the level of authenticity can vary in different areas of our lives
What are your thoughts on this following example of boundary violation?
The Too-Friendly Family
A psychological assistant providing home-based services for a family with a seriously disabled child became friendly with the child’s mother. With the agreement of the supervisee, the mother made sure that their eligible bachelor brother came over during the time that the assistant was at the home providing services (Knapp & Slattery, 2004)
The supervisee attempted to improve her social life through her contacts with the mother of the client, but she should have met the client's needs. She allowed the mother to cross a boundary that detracted from the treatment goals and jeopardized the working relationship
What guidelines are associated with the use of touch in therapy?
1.Whose needs are being met by the touch, the child's or the clinician's. Touch should always be considered in the interest of the child
2. Is touch needed and necessary to keep the child safe? Are there any precautions that can be taken to avoid an unsafe situation?
3. Is touch needed to keep the therapist safe?
4. Be clear about personal views and institutional policies on touch in therapy
5. Take into account the client's culture and gender when deciding how touch will be perceived by the child and child's parents
6. Consider the child's diagnosis, abuse history and the family's history of abuse
7. Discuss touch with child and parents
8. Use informed consent procedures with parents and obtain children's assent
9. Consult with other professionals about touch used in therapy
10. Document touching in therapy
What does the ACA Code of Ethics say about gifts?
According to the ACA Code of Ethics, counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, the client’s motivation for giving the gift, and the counselor’s motivation for wanting to accept or decline the gift
Does authenticity mean that the therapist must be totally honest with the client?
Whatever moves the relationship from disconnection to reconnection to new connection serves as a guide for all interventions. Often not disclosing can have a significant negative impact on the therapy relationship
What would you do if you were in this situation?
A psychologist was assigned to assist a family in learning how to handle their child who was often disruptive during meals. During their first day of work, they found that the family had set a place for them at the table and asked what they wanted to drink with their meal (Knapp & Slattery, 2004)
When psychologists come into the houses of clients during dinner, they appear to assume the role of guests because the family is polite and offers food and drink. The psychologist may eventually focus more attention on the social demands of the situation and less attention on their real purpose which is to help modify the disruptive behavior of the child. These challenges to boundaries can occur and may have implications on the therapist-client relationship. However, the informed consent takes on greater importance. Before services begin, psychologists can reiterate the purpose of their presence in the house. For example, the therapist could say the following: Remember, I will be there to help Johnny learn to behave properly during meals. Although I will be at your house during dinner, I will not be a dinner guest, but will be focusing my attention on helping Johnny
Why do therapists limit the use of touch?
Therapists limit the use of touch because of safety needs and to not break the therapeutic relationship
How can therapists approach to clients when they provide them with a gift?
The therapist could express genuine appreciation towards the client when they provide them with a gift and when appropriate explore the meaning and intent of the gift and seek consultation when necessary
Are there any rules that inform our decisions from moment to moment about the ways we mutually and authentically engage with clients?
There are no specific rules, but we must carefully and thoughtfully follow the movement of the therapy and of the mutual impact that the client and therapist have on each other and stay in tune with the ongoing process
What are your thoughts on this following case?
An Emergency Transport
A psychologist was working in a private residential facility for children and because an emergency left the cottage staff temporarily understaffed, the psychologist had to transport the child client back to their house cottage. The child client who was an orphan saw that the psychologist had a baby seat in the back of their car and asked them questions about their children (Knapp & Slattery, 2004)
Given the emergency situation at the residential facility, the psychologist could not refuse to transport the child, but it did have an impact on the course of therapy. The knowledge that their kind and caring psychologist was also a parent activated fantasies on the part of the child of being adopted by the psychologist. The child had sense of loss because they did not have a nuclear family of their own. The client may have had these feelings even if the psychologist's status as a parent was not disclosed, the timing and manner of the disclosure were taken away from the psychologist
What would you do if a client touches you because of their rituals?
Allowing the client to touch in a way that makes them feel safe and sets boundaries
What are the cultural considerations regarding gift-giving?
The therapist would need to understand the meaning of gift-giving within the cultural context. The therapist must be aware that turning down a small gift can be disrespectful towards an individual who comes from a culture that gift-giving is important. Therapist's must be sensitive towards different cultures' gift giving customs and rituals. Therapist's ignorance may impact with developing trusting and helping therapeutic relationships
What are the diversity considerations regarding authenticity?
All clients require a therapeutic safe space for genuine and authentic self-reflection where they could give voice