Module 5 Flashcards
What are 4 types of multiple relationships?
- Non-professional relationship with client (friend, family member)
- Different professional relationship with the client (work colleague, tenant)
- Non-professional relationship with associated party (client’s best friend, sibling)
- Recipient of service provided by client (client is also your GP, psychologist, or masseuse etc.)
What are 3 problems associated with MRs?
- Unequal power relationship
- Conflict of interest
- Objectivity may be compromised
What’s the difference between boundary crossing and entering a MR with a client?
Boundary crossings become behaviours in a MR when the professional assumes another role in another relationship with the client
What are 3 examples of boundary crossing?
- Crying in front of a client
- Attending a client’s special event
- Disclosing a personal stressor to a client
If you were to enter into another relationship with a client, what are 3 things you should do before-hand?
- Be aware of client vulnerability and the potential for exploitation
- Conflict of interest - develop a plan to minimise harm
- Ensure your objectivity is not compromised
Give on example of how a boundary crossing can quickly turn into a boundary violation
Doing a home visit for an elderly person (acceptable boundary crossing), but then staying for dinner (boundary violation)
(Gottlieb and Younggren): What are the 4 strategies of ethical acculturation? Which is most likely to lead one down the slippery slope of boundary crossing?
- Integration (high maintenance of personal values, high contact/participation with new culture of psychology)
- Separation (high maintenance, low contact, more likely to make decisions based on personal values
- Assimilation (low maintenance, high contact)
- Marginalisation (low maintenance, low contact, most likely to go down slippery slope)
What were some of Gottlieb and Younggren’s recommendations for avoiding the slippery slope?
- Comprehensive informed consent document
- Peer consultation groups
- Document consultants’ suggestions
- Develop your own set of practice ethics policies
- More research
- Professional competence in multicultural context
What are the 9 steps Pope and Kieth-Spiegel (2008) recommend for considering whether a boundary crossing is helpful or harmful?
- Imagine the best and worst possible outcomes
- Look at the research
- Look at guidelines, ethics codes, laws
- Pay attention to your own feelings
- Inform the client about the exact kind of work you do. Refer on if client appears uncomfortable
- Refer on if you feel incompetent
- Put any planned boundary crossings in informed consent
- Keep notes
What are the 7 cognitive errors identified by Pope and Kieth-Spiegel (2008)
- What happens outside the session has nothing to do with therapy
- Crossing a boundary with a client is the same as doing that with a non-client (eg: helping them take off their coat)
- Our understanding of a boundary crossing is also the client’s understanding of a boundary crossing
- A boundary crossing that is therapeutic for one client will also be therapeutic for another
- A boundary crossing is a static, isolated event
- If we don’t see any downsides to crossing a boundary, then there aren’t any
- Self-disclosure is always therapeutic, because it shows authenticity, transparency, and trust
What are the 4 factors of Sonne’s model?
- Therapist factors
- Client factors
- Therapy relationship factors
- Other relationship factors
What are some therapist factors that may contribute to boundary crossings?
- Ethical sensitivity
- Willingness to expend cognitive effort
- Guiding ethical principles
- Gender - men tend to take more risks
- Culture
- Religion/spirituality
- Theoretical orientation (eg: humanists have more MRs)
- Character traits (eg: need to please)
What are some client factors that may contribute to boundary crossings?
- Gender
- Culture
- Religion/spirituality
- Psychosocial strengths/vulnerabilities (eg: not crossing boundaries with BPD clients)
- History of boundary crossings (eg: sexual assault victims)
What are some therapy-relationship factors that may contribute to boundary crossings?
- Nature of therapeutic relationship (eg: informed consent, transference)
- Power differential (greater = more risk to client)
- Duration of therapy
- Practice setting
- Practice locale (small/specialised communities at higher risk of MRs)
What are some other relationship factors that may contribute to boundary crossings?
- Change in nature of relationship
- Who’s needs are being met?
- Potential for role conflict/incompatibility
- Potential for harm to client/third parties
- Potential for client benefit
