Factors to consider before entering into a multiple relationship (Dual Relationship)?
Is it necessary?
Will it cause harm?
Would the additional relationship prove beneficial?
Is there a risk it could disrupt the therapeutic relationship?
Am I evaluating this objectively?
Should I seek consultation?
Am I motivated by what the client needs?
Is it consistent with the client's treatment plan?
Have I considered history, culture, values, and diagnosis?
Does it need to be documented in the file. YES always
Recognition of the power differential been acknowledged with client/
is a departure from commonly accepted practices that could potentially benefit clients. Not all boundary-crossing should be considered boundary violations.
is a serious breach that results in harm to clients and is therefore unethical.
What are some examples of how crossing a boundary can harm a client?
It can knock therapy off track.
Sabotage the treatment plan
May offend, exploit or harm client
combining roles and responsibilities. Functioning in more than one role involves thinking through potential problems before they occur and building safeguards into practice.
Examples include counselor educators serve as instructors
Role blending is inevitable in the process of education and supervision counselor trainees - but can become a problem with loss of objectivity or conflict of interests
Slippery slope phenomenon
When boundaries are poorly defined and a counselor attempts to blend roles that do not mix. The gradual erosion of boundaries can lead to very problematic multiple relationships that harm clients Once a counselor crosses a boundary the tendency to engage in a serious of increasingly serious boundary violations can occur.
Things to consider when addressing multiple relationships
1.Most often affect counselor negatively
2. Could be an ethics violation
3. Not all multiple relationships can be avoided - they can challenge us to monitor ourselves and examine our motivations
4. Always seek consultation and document reasoning
5. Few absolute answers exist - slippery slope syndrome
6. Being cautious should be for benefit of clients not for protecting self
7. Does the benefit outweigh the harm
8. Check company guidelines and policies
9. Consider the multicultural context
How can you minimize risk and p[ractice ethically and professionally when you cannot avoid a multi-relationship?
1. Obtain informed concent
2. Document thoroughly
3. Set clear boundaries and expectiations
4. Pay attention to matters of confidentiality
5. Get involved in ongoing consultaiton.
What should be considered before entering into bartering with a client?
- Talk about arrangement
- define and have a clear understanding of the exchange
- come to an agreement
- Make sure that both sides of the services are = in value and agreeable to both parties
- Evaluate if it will put you at risk professionally
- Determine the appropriate amount of time for bartering
- Document the bartering arrangement include the value of the goods or services and a date on which the arrangement will end or be renegotiated
- It is better to exchange goods rather than services (defined value)
- If misunderstandings develop get a mediator to decide
- Consult if unsure if you should get involved
What must happen in order for bartering to be considered ethical?
- The client must request it
- It is not contraindicated (to give indication against the advisability of (a particular or usual remedy or treatment).
- It is not exploitative
- The arrangement is entered into with full consent
According to ACA what, three things should be considered before accepting a gift?
- The therapeutic relation ship,
- the moetary value of the gift
- client's motivation for giving the gift
- counselors motivation for wanting or declining the give.
How can a counselor minimize the likelihood of sexual transgressions with clients
- Seek professional support
- Make it a practice to examine and monitor feelings and behaviors toward clients
- Differentiate between having a sexual attraction to clients and acting on attraction
- Establish and maintain clear boundaries when a client makes a sexual advance
What are some suggestions for managing sexual feelings toward cleitns?
- Rather than making any explicit communication of sexual feeling for clients, therapists might consider acknowledging caring and warmth within the therapeutic relationship
- Therapists do well to practice a risk management approach if they develop a sexual feelings for a client. This would involve awareness of timing in and the location of scheduled appointments, nonerotic touch, and general self-disclosue.
What are some harmful effects of sexual contact with clients?
- Once sexual intercourse begins in psychotherapy the hellping process ends
- Therapist loses control of therapy
- Mistrust of opposite-gender relationships
- negative feeling about experience
- negative impact on their personality
- deterioration of their sexual relatiohnsip with their primary partner
What are some ethical and clinical considerations of nonsexual touch in therapy?
- Only employed whit it is likely to have a positive therapeutic effect
- Used in accordance with training and competence
- Must have a foundation of client safety and empowerment before using touch
- Consider the client's potential perception of touch
- Special care when touching people who have experienced assault, neglect, attachment difficulties, rape, molestation, sexual addiction or intimacy issues
- Counselors should not avoid touch out of fear of licensing boards or the dread of litigation
- Clinically appropriate touch must be used with sensitivity to clients' variables such as gender, culture, problems, situation, history and diagnosis.