Psychotherapy, Boundaries and Ethics
I am frequently asked questions from readers about whether a therapist's behavior was proper or ethical and, if improper, should they continue working with that therapist? In an article in Psychology Today magazine, writer Sharon K. Anderson, therapist and writer of the column, "The Ethical Therapist," lists some of the situations that may raise concerns about whether the therapist is behaving properly or not:
1. Taking or joining the therapist on a trip
2. Meeting the therapist for coffee
3. Inviting the therapist to the wedding
4. Meeting at the therapist’s home
5. Living temporarily in the therapist’s home
6. Receiving free services from the therapist
7. Getting into a business deal with the therapist
8. Sharing patient information with others (family members, other professionals, other clients)
-Telling the patient of romantic and sexual interest, and:
-A reader reported that she did an Internet search and discovered that her therapist once had disciplinary action against her. Here, too, the reader asked if she should continue working with the therapist under question?
The main point of this blog is to emphasize the fact that it's vitally important for the therapist to maintain appropriate boundaries with the patient. First, getting involved with a patient compromises the ability of the therapist to provide fair and objective mental health services which are in the best interests of the patient. Added to this is the fact that the therapeutic relationship rests on the ability of the patient to trust that the therapist will provide and safe and secure environment for the growth in mental health.
Of primary importance is that the professional relationship is to provide for the needs and well being of the patient. In this scenario, the patient does not reciprocate. In other words, the patient is not there to cater to the needs and wants of the therapist. For example, the patient is not a friend, sexual or business partner of the therapist. It is up to the therapist to maintain strong boundaries in relationship to the patient. Violating these boundaries is unethical, harmful to the patient and even illegal.
In the event that it is discovered that disciplinary action was taken against a therapist and it is verified that the information is correct then it is in the best interests of the patient to go to another therapist. The only exception is if the therapist, at the very start of therapy, is above board and honest in reporting that action so that the patient can decide whether to continue or not.
One last word of caution: It is always important to check the credentials of a prospective therapist. They have an obligation to provide proof of being fully licensed. It is proper to ask the therapist if they are licensed, what field of mental health their licensing is in, (social work, psychology, family therapy, drug counselor, mental health counselor, psychiatrist), and proof of that licensing. Any credible therapist has their degree and licensing certificate hanging on the wall in their office.
Reader comments and questions are encouraged.
Allan N. Schwartz, PhD