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What do you do when you run into a patient in a public place? How do you respond when a patient suddenly hugs you at the end of a session? Do you accept a gift that a patient brings to make up for causing you some inconvenience? Questions like these—which virtually all clinicians face at one time or another—have serious clinical, ethical, and legal implications. This authoritative, practical book uses compelling case vignettes to show how a wide range of boundary questions arise and can be responsibly resolved as part of the process of therapy. Coverage includes role reversal, gifts, self-disclosure, out-of-office encounters, physical contact, and sexual misconduct. Strategies for preventing boundary violations and managing associated legal risks are highlighted.
This book addresses training, supervisory, and therapeutic issues related to the consequences from sexual boundary violations among mental health professionals and clergy. These problems are discussed on theoretical and practical levels aimed at understanding, recovery, rehabi...
This book is for the professional who feels unsure when entering the gray areas that inevitably arise in psychotherapy practice. The author carefully differentiates between what constitutes appropriate and helpful boundary crossing rather than inappropriate boundary violation and explores the ethical and clinical complexities involved in boundary issues such as the exchange of gifts, nonsexual touch, and more.
Preceded by Boundaries and boundary violations in psychoanalysis / Glen O. Gabbard, Eva P. Lester. New York: BasicBooks, c1995.
This book explains how sexual boundary violations occur in psychotherapy, how to avoid them, and how such violations affect clients, therapists, colleagues, institutions, and families.
They open up discussions of post-termination boundaries and the role of boundaries in psychoanalytic supervision.
Thoroughly updated for its Fourth Edition, this award-winning handbook gives mental health professionals authoritative guidance on how the law affects their clinical practice. Each chapter presents case examples of legal issues that arise in practice, clearly explains the governing legal rules, their rationale, and their clinical impact, and offers concrete action guides to navigating clinico-legal dilemmas. This edition addresses crucial recent developments including new federal rules protecting patients' privacy, regulations minimizing use of seclusion and restraint, liability risks associated with newer psychiatric medications, malpractice risks in forensic psychiatry, and new structured assessment tools for violence risk, suicidality, and decisional capacity.
What's often referred to as bedside manner in medicine is really a reflection of the doctor's professionalism. This is especially true in psychiatry, where issues like countertransference can come into play. In Professionalism in Psychiatry, the authors seek to define the factors that influence professionalism and address principles that are now part of the core curriculum for medical students, psychiatry residents, educators, and practicing clinicians. The interface between ethics and professionalism is charted, including ethical issues related to research, fundraising, and the relationship between psychiatrists and pharmaceutical companies. The authors also review how the principles of professionalism can be applied to gender, race, ethnicity, and sexual orientation. Professionalism in Psychiatry is a must read for any educator or professional wanting to better understand the relationship between professionalism, ethics, and the avoidance of boundary violations.
Keeping Boundaries is an across-the-board review of the subject of boundary maintenance in psychotherapy. Using a comprehensive approach, this book examines the problem of therapeutic boundaries and boundary violations from multiple viewpoints, including historical antecedents, sociological mechanisms, object relations theory, psychodynamic theory, practical technique, and the mental health and training of psychotherapists. It covers a variety of boundary issues, including dual relationships, informed consent, fees, gifts from patients, maintaining confidentiality, avoiding abuse of power, and helping therapists to protect themselves against exploitive patients. Written in a clear and jargon-free style, this book provides the therapist with practical clinical advice supported by extensive references and clinical vingnettes.
Should a therapist disclose personal information to a client, accept a client's gift, or provide a former client with a job? Is it appropriate to exchange email or text messages with clients or correspond with them on social networking websites? Some acts, such as initiating a sexual relationship with a client, are clearly prohibited, yet what about more subtle interactions, such as hugging or accepting invitations to a social event? Is maintaining a friendship with a former client or client's relative a conflict of interest that ultimately subverts the client-practitioner relationship? Frederic G. Reamer, a certified authority on professional ethics, offers a frank analysis of a range of boundary issues and their complex formulations. He confronts the ethics of intimate and sexual relationships with clients and former clients, the healthy parameters of practitioners' self-disclosure, electronic relationships with clients, the giving and receiving of gifts and favors, the bartering of services, and the unavoidable and unanticipated circumstances of social encounters and geographical proximity. With case studies addressing challenges in the mental health field, school contexts, child welfare, addiction programs, home-healthcare, elder services, and prison, rural, and military settings, Reamer offers effective, practical risk-management models that prevent problems and help balance dual relationships.