Fluent Essays

Your textbook presents several examples of situations where objectivity and transference might impact a therapeutic relationship. There is often a continuum that ranges from emotional objectivity to transference that can completely impair judgment. Select a scenario from the Cooperative Learning Exercise on page 260 of your textbook, or provide an example from your experience where there was a real or potential loss of objectivity or transference. In your initial post, describe the difference between emotional objectivity and transference. Describe the scenario you selected and explain where or how the loss of objectivity or transference might occur in the scenario. 241 C H A P T E R 10 Boundaries and the Ethical Use of Power Ms. Wicks: But Maria. I do care about you. I am worried you are placing yourself in harm’s way. If it would be easier for you, I would be willing to let you stay with me for a while. C ertainly Ms. Wicks is a very caring and concerned counselor. Ms. Wicks has consistently demonstrated a real care and concern as well as a desire to help. However, it appears that her level of concern and her felt sense of urgency about the situation may be clouding her profes- sional judgment. Knowing the boundaries of a professional relationship and being able to operate within those boundaries while expressing professional care and concern is not always an easy process. The power of the helping relationship can be quite awesome and often times seductive. When such power is not restricted by the boundaries of the professional relationship, it invites misuse and abuse of the client. OBJECTIVES ● The chapter will introduce you to the concept of professional boundaries and the conditions under which boundary crossing and violation may occur. After reading this chapter, you should be able to do the following: Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 242–●–ETHICAL PRACTICE IN THE HUMAN SERVICES • Describe what is meant by the concept of professional boundaries. • Describe the difference between boundary violation and boundary crossing. • Explain how simple identification and transference can interfere with the maintenance of professional boundaries. • Describe what is meant by “dual” or “multiple” relationships. • List questions for reflection that can guide a practitioner’s decisions regarding the ethics of dual relationship. • Explain why sexual intimacy with a client is clearly a boundary violation. ● SETTING AND MAINTAINING PROFESSIONAL BOUNDARIES A professional relationship is a special entity. The professional relationship is definable and does require unique dynamic and role definition. However, the intensity of the emotions shared, the isolation provided, and the level of intimacy sometimes experienced can challenge the boundaries of a profes- sional relationship. Under these conditions, it is possible for ethical prob- lems to occur as the helper blends professional role and relationship with more personal involvement. The concepts of boundaries and boundary viola- tions have received increased attention as a result of the increasing litigation and ethics committee hearings related to violation of boundaries (Parsons & Zhang, 2014). Setting and maintaining professional boundaries are essential steps in preventing such personal involvement and the maintenance of an ethical relationship. But the issues involved with the setting and maintain- ing of professional boundaries is neither clear-cut nor black and white. For example, the American Counseling Association’s Code of Ethics (2014) does not strictly prohibit extending the nature of the boundaries between coun- selor and client but rather directs its members to: “consider the risks and benefits of extending current counseling relationships beyond conventional parameters” (ACA, 2014, Principle A.6.b). While there are numerous terms used to discuss the issue of boundaries and boundary extensions in profes- sional practice, two terms, boundary violations and boundary crossing, appear to dominate the literature. Fasasi & Olowu (2013) suggest a distinction between boundary viola- tions and boundary crossing. While both involve a counselor’s deviation from strict adherence to a professional role, boundary violations typically result in the exploitation of a client. Boundary violations, such as what occurs when helpers become sexually involved with clients, are almost always harmful; however, nonsexual boundary transgressions may be just as harmful. When the practitioner’s needs are given primacy at the client’s expense, it is unethical. Whether it is something as subtle as the rearrangement of Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . Chapter 10. Boundaries and the Ethical Use of Power –●–243 furniture or seating arrangement in order to bring the helper into closer physi- cal proximity to an attractive client or a pause in the conversation that may be inferred as having sexual innuendo, decisions by practitioners that are directed to satisfy their professional needs at the expense of the client are violations of professional boundaries and need to be avoided (see Case Illustration 10.1). Case Illustration 10.1 Changing Seats: Moving Closer Allison, a 32-year-old recent divorcee, has been working with Dr. Manel for the past 5 weeks. Their sessions have been focusing on Allison’s sense of grief and her anxiety about establishing or reestab- lishing herself as a single woman. For each of the past five sessions, Allison sat on the sofa with Dr. Manel directly across from her in a large overstuffed chair. Allison has, in each of the previous sessions, disclosed fears that she is not attractive and would often break down in tears when she considered the possibility of being alone. At these times, Dr. Manel would allow Allison to cry and, when appropriate, would challenge her conclusions that she would forever be alone. Allison entered the current session more upset than she had been in the previous three or four. Allison sat and shared with Dr. Manel that she had just received divorce papers and that she wanted to die. Allison began to sob and stated, “I can’t stand this! He doesn’t love me. No one could ever love me. . . .” At this point, Dr. Manel moved from his chair and took up a seat on the couch next to Allison. As soon as he sat down, Allison flung her arms about his neck, placing her head on his shoulder. Dr. Manel, wiping her tears, stated, “I think you are lovable.” In reviewing the case of Allison and Dr. Manel (Case Illustration 10.1), one must wonder whether Dr. Manel’s change in seating and verbal com- ment were meant simply to support a client in crisis or were in response to his own interest in physical contact. While such crossing of professional boundaries is clearly unethical, the extension of boundaries in the form of boundary crossing is less clear in its ethical implications. Boundary crossing places the helper outside of a strict professional role; however, it does not occur with the intent of client exploitation (Parsons & Zhang, 2014). Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 244–●–ETHICAL PRACTICE IN THE HUMAN SERVICES Boundary crossing occurs when the helper finds herself simultaneously operating from both a professional and nonprofessional role. This might be the case when a school counselor receives and accepts an invitation to attend her client’s graduation party or even when unexpectedly she finds herself at a social gathering with a client. In these situations, what was once a professional helper-client relationship may now have moved to a casual social encounter. It is important that as professional helpers we monitor the nature of the relationship we have with our clients and take steps to ensure that the boundaries are those that reflect our standard of ethics and clearly serve to uphold the welfare and dignity of our clients (Kitchener & Anderson, 2011). Accepting gifts from clients, participating in social activities or events provided by the client, engaging in investment activities or bartering profes- sional services for goods or client service all blur the boundaries of a pro- fessional practice. Throughout these situations, it is essential we reflect on the question of “whose needs are being met?” Clearly, placing the personal needs of the helper above that of the client invites unethical practice. Iden- tifying whose needs are being met by the decisions and actions of the help- ers will help to identify the potential for boundary violation. It is essential that our primary goal is to do that which is in the best interest of the client (Gutheil & Brodksy, 2008) and remember “that in choosing our profession we made a decision to serve others and have our needs met by those whom we do not we serve; we will fulfill our professional obligations” (Gottlieb & Younggren, 2009, p. 570). All of our professional codes of ethics highlight the need to attend to the issue of boundaries and the need to assure that we protect against the creation of an exploitative relationship and eventual harm to our clients (see Table 10.1.) Table 10.1 Boundaries and Mixing of Multiple Relationships Professional Ethical Standards Statement on Multiple Relationships American Counseling Association (2014) A.6.b. Extending counseling boundaries Counselors consider the risks and benefits of extending current counseling relationships beyond conventional parameters. Examples include attending a client’s formal ceremony (e.g., a wedding/commitment ceremony or graduation), purchasing a service or product provided by a client (excepting unrestricted bartering), and visiting a client’s ill family member in the hospital. In extending these boundaries, counselors take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgement is not impaired and no harm occurs. Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . Chapter 10. Boundaries and the Ethical Use of Power –●–245 Professional Ethical Standards Statement on Multiple Relationships A.5.d. Friends or family members Counselors are prohibited from engaging in counseling relationships with friends or family members with whom they have an inability to remain objective. A.5.b. Counselors are prohibited from engaging in counseling relationships with persons with whom they have had a previous sexual and/or romantic relationship. A.5.e. Counselors are prohibited from engaging in a personal virtual relationship with individuals with whom they have a current counseling relationship (e.g., through social and other media). American Association for Marriage and Family Therapy (2015) 1.3. Marriage and family therapists are aware of their influential positions with respect to clients, and they avoid exploiting the trust and dependency of such persons. Therapists, therefore, make every effort to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Such relationships include but are not limited to business or close personal relationships with a client or the client’s immediate family. When the risk of impairment or exploitation exists due to conditions or multiple roles, therapists document the appropriate precautions taken. American Psychological Association (2010) 3.05 Multiple relationships a. A multiple relationship occurs when a psychologists is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person. A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists. Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical. (Continued) Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 246–●–ETHICAL PRACTICE IN THE HUMAN SERVICES PROFESSIONAL OBJECTIVITY: ESSENTIAL TO PROFESSIONAL BOUNDARIES Professional Ethical Standards Statement on Multiple Relationships b. If psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code. c. When psychologists are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, at the outset they clarify role expectations and the extent of confidentiality and thereafter as changes occur. Table 10.1 (Continued) ● The effective, ethical helper places the concerns and needs of the client as top priority. Placing the client’s concerns as a priority (i.e., altruism) rather than the concerns of the helper (i.e., narcissism) requires the helper to distinguish his or her personal issues and emotional needs from those pre- sented by the client. The ability to be empathic, while emotionally objective, may be difficult to maintain. However, if the helper’s objectivity becomes compromised, the professional nature of the relationship may be threatened. The ethical helper must be aware of the various situations that can compro- mise professional objectivity and know when referral to another helper, who can maintain objectivity, is indicated. Professional objectivity can be compromised by a number of situations (see Exercise 10.1). While some, such as simple identification and transfer- ence, reflect a distortion of reality on the part of the helper, a more com- mon form stems from the development of a dual relationship with the client involving both a professional and personal tone. Each of these conditions is discussed in some detail. Simple Identification A subtle form of loss of emotional objectivity is simple identification. Simple identification occurs when the helper identifies himself or herself Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . Chapter 10. Boundaries and the Ethical Use of Power –●–247 with the client. It typically occurs when some element or characteristic of the client or the client’s experience and story, causes the helper to relate to the client’s experience as his or her own. Under these conditions, that helper can begin to view the client as himself or herself (see Case Illustration 10.2) and thus fails to discern the important difference between his or her experi- ence and that of the client. Exercise 10.1 Threats to Emotional Objectivity Directions: After considering each of the following, share your response with your colleagues or classmates in order to identify ways of preventing such loss of objectivity. 1. Identify one person with whom you have a personal relationship and discuss how that relationship could block your emotional objectivity and thus interfere with you being an effective helper. 2. How might your own social roles (e.g., son, daughter, mother, father, ex-boyfriend, girlfriend, struggling student, etc.) be the source of interference and loss of objectivity when working with some clients or specific types of problems? 3. Identify a number of themes or issues that arouse an emotional response in you (e.g., themes of emotional dependency, victim- ization, authority, power, etc.) and which might prove too close to your own emotional experience for you to remain objective while working with a client presenting similar concerns. Case Illustration 10.2 Mr. Watkins: A Case of Simple Identification Mr. Watkins was an elementary school counselor. One student with whom he had special concern was Jamal. He felt Jamal needed his help because the other fifth-grade boys “always teased Jamal and pushed him and took his things.” According to Mr. Watkins, the other boys were always mean to Jamal. Mr. Watkins was absolutely sure that Jamal (Continued) Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 248–●–ETHICAL PRACTICE IN THE HUMAN SERVICES Mr. Watkins’s (Case Illustration 10.2) objectivity was certainly compro- mised, and his pursuit of Jamal was a violation of his professional boundar- ies. The problem was that Mr. Watkins was not “seeing” Jamal as he was but rather was seeing himself in Jamal’s experience. Jamal looked like Mr. Watkins. He was small and somewhat frail looking. He wore thick glasses and appeared nonathletic. Because Mr. Watkins “identified” with Jamal on the basis of physical similarity, his emotional objectivity was destroyed, and he assumed that what happened to him as a fifth grader was most likely hap- pening to Jamal. Clearly, such loss of emotional objectivity needs to be identified and confronted if one is to be an effective, ethical helper. Exercise 10.2 provides you with an opportunity to anticipate the conditions under which you may fall prey to simple identification. was devastated by all of this. Well, the reality was that Jamal was fine. In fact, Jamal went to Dr. Thomas, the director of counseling, and asked that Mr. Watkins stop calling him down to the office. Jamal felt it was embarrassing, and he didn’t understand why Mr. Watkins kept telling him that he “could protect me from the bullies in school.” Apparently, while the boys certainly did tease Jamal, he teased the other boys as much as they teased him, and the fifth graders generally liked Jamal and included him in their activities. (Continued) Exercise 10.2 Condition Eliciting Helper Identification Directions: As noted, simple identification occurs when the helper identifies himself or herself with the client. It typically occurs when some element or characteristic of the client or the client’s experience and story causes the helper to relate to the client’s experience as his or her own. Below you will find a number of descriptors of client char- acteristics or client issues. Place a check mark next to those character- istics or elements with which you have some personal experience or history. Next, identify how your identification with that element may influence your objectivity. Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . Chapter 10. Boundaries and the Ethical Use of Power –●–249 Element or Characteristics Helper Experience or Characteristics Impact on Helper Objectivity (Example): Client is a freshman in college. His father wants him to be an engineer and join his firm. The client wants to be a music major but is afraid to upset his dad. He is thinking that he could double major, recog- nizing that he does like engineering and may be able to use the music as a performance option. Helper was a star athlete in high school. His father has always prepped him to play in col- lege, even though he did not want to play in college. The helper still resents the fact that he went to the col- lege his dad wanted him to and played football there though he truly did not enjoy it. The helper is extremely con- frontational with the client. The helper suggests that compromis- ing and doing a double major is a failure of mature assertiveness. The helper keeps push- ing the client to confront his father and simply say NO, it is my time to define my life. 1. Client experiencing a personal loss (via divorce or death or breakup) 2. A client who has been teased for being overweight, underweight, an early developer, or a late developer 3. A client who is in an unhappy relationship or work situation 4. A client who is the one in the family to whom every one turns when there is a problem (Continued) Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 250–●–ETHICAL PRACTICE IN THE HUMAN SERVICES Element or Characteristics Helper Experience or Characteristics Impact on Helper Objectivity 5. A person who is currently having sexual difficulties (impotence, pre- mature ejaculation, low libido, limited opportunity, etc.) 6. A person whose beliefs (religious, political, sexual) have brought a sense of isolation 7. Identify a significant experience in your life, and in the space to the right identify a type of client or client condition with which you may identify. (Continued) Transference A more complex distortion occurs with transference. In this case, the helper forces the story of the client to fit some aspect of his or her own life. This is a major distortion of reality and occurs below the conscious level of the person distorting. It often results in the person, in this case the helper, using the context of the helping relationship and presence of the client to express feelings, beliefs, or desires that the helper has buried in his or her unconscious and rightfully should address to some other significant person in his or her life. The ability to be sensitive to the possibility of transference is essential to effective, ethical helping. While the loss of objectivity as a result of distorting the client’s reality, as in the case with simple identification and transference, may be infrequent, any helpers are at the risk of losing emotional objectivity if engaged in direct Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . Chapter 10. Boundaries and the Ethical Use of Power –●–251 personal involvement with clients. The possibility of engaging with the cli- ent in a relationship outside of the boundaries of helping is a topic that has received a lot of attention within the professional literature. The ethics of such dual relationships with clients has been and continues to be debated. It is clear, however, whichever side of the debate one finds himself or herself on, dual relationships may serve as a condition in which one’s professional objectivity can be compromised. Dual Relationships: Crossing and/or Mixing Boundaries A dual relationship is one in which the helper has two (or more) overlap- ping roles with the client. It is important to consider dual relationships and to reflect on the possible impact they may have on the counseling relation- ship (Exercise 10.3). Loss of professional objectivity and boundary violations are possible any- time a professional is engaged in multiple relationships with his or her cli- ent. This may also occur when professional helpers are engaged in personal friendships, family or business relationships, or social activities with their clients (see Case Illustration 10.3). Case Illustration 10.3 Tom and Elaine: Direct Personal Involvement Tom is a master’s level counselor working in a college career center. Elaine asked Tom to help her with a decision about joining the Peace Corps. Elaine, who is also Tom’s girlfriend, explained that she really is unsure if she should move away from their hometown to spend four years in the Peace Corps or stay at home and continue in graduate school. Tom suggested that Elaine employ an actuarial technique in which she would generate all of the costs and benefits to be accrued to both Elaine AND the significant people in her life if she stays or goes into the Peace Corps. This was a technique Tom had found successful with other clients. Typically, he would provide an initial example and then ask clients to complete the process on their own as a “homework.” He would then review their matrixes at the next session. With Elaine, however, Tom suggested that they do it together. He felt that he could help identify the possible benefits and costs to both Elaine AND, certainly, to the others in her life. Parsons, R. D., & Dickinson, K. L. (2016). Ethical practice in the human services : From knowing to being. ProQuest Ebook Central <a onclick=window.open(http://ebookcentral.proquest.com,_blank) href=http://ebookcentral.proquest.com target=_blank style=cursor: pointer;>http://ebookcentral.proquest.com</a> Created from capella on 2021-08-22 15:56:56. C o p yr ig h t © 2 0 1 6 . S A G E P u b lic a tio n s. A ll ri g h ts r e se rv e d . 252–●–ETHICAL PRACTICE IN THE HUMAN SERVICES While Tom (Case Illustration 10.3) may truly want to assist Elaine in making the best decision (for her), he may have difficulty keeping his own strong desire to keep her close to him and at home out of the equation. Thus, his suggestions may be …