Academic journal article Ife Psychologia

Boundary Transgressions: An Issue in Psychotherapeutic Encounter

Academic journal article Ife Psychologia

Boundary Transgressions: An Issue in Psychotherapeutic Encounter

Article excerpt

ABSTRACT

Boundary transgressions tend to be conceptualized on a continuum ranging from boundary crossings to boundary violations. Boundary crossings (e.g. accepting an inexpensive holiday gift from a client, unintentionally encountering a client in public, or attending a client's special event) are described in the literature as deviations from commonly accepted practice that may be harmful, helpful, or benign to the therapeutic process. On the other hand, boundary violations (e.g. drinking alcohol with a client, or engaging in sexual relations with a client) depart from accepted practice and place clients, and the therapeutic process, at serious risk (Gutheil & Gabbard, 1993; Simon, 1992).

According to empirical findings, sexual boundaiy transgressions between therapists and their clients are almost always harmful. When therapists become sexually involved with their clients, clients may experience feelings such as depression, betrayal, and low selfesteem. Thus, these relationships are commonly referred to as boundaiy violations. Nonsexual boundaiy transgressions tend to be regarded as boundaiy crossings.

However, these boundaiy transgressions may be just as harmful to clients as sexual boundaiy transgressions. Non-sexual boundary transgressions are problematic because of their pervasiveness, inevitability, and lack of consensus among mental health professionals regarding their appropriateness. For example, a couple from a small town may need therapy and there is only one therapist within a 300 mile radius. The problem is that this couple owns the only groceiy store in the area, and the therapist is a frequent customer. Would it be ethical for the therapist to deny needed services to this couple? Is it reasonable for the therapist to treat this couple and forego food consumption? These are the sorts of questions that mental health professionals debate. In addition, subtle boundary crossings are problematic because they tend to consistently lead to more adverse boundary transgressions.

Boundaiy transgressions have the potential of exploiting clients and impairing therapists' professional judgment (Corey, Corey, & Callanan, 1998). As a result, the therapeutic relationship between therapists and their clients is compromised. Research concerning this topic discusses how exploited clients experience depression, feelings of betrayal, loss of selfesteem, and suicidal ideation. Thus, therapists are advised to refrain from transgressing boundaries with their clients.

However, because they are inevitable, therapists should educate their clients about boundaiy transgressions during initial therapy sessions, and continuously address such actions when they arise. It is also helpful to let clients express their feelings pertaining to boundaiy transgressions (Chadda & Slonim, 1998; Corey et. al.; Plaut, 1997).

According to Butler and Gardner (2001), professional codes of ethics are "constitutional frameworks" that guide professionals in their work. Almost all the mental health professions' ethical codes stress the obligation of therapists to be cognizant of the potential harm that may result when boundaries are transgressed. The codes explicitly prohibit sexual boundaiy transgressions. Yet, ethical codes regarding non-sexual boundaries are general and subjective (Miller & Maier, 2002). This is because they are inevitable, pervasive, and there is a lack of consensus among mental health professionals regarding their appropriateness. For example, professionals are not in full agreement regarding the appropriateness of using first names with clients.

Most of what is known about boundary transgressions comes from the perspective of professionals. According to the literature, mental health professionals agree that therapists have an ethical obligation to ensure clients or potential clients (in other words, members of the general public) understand what constitutes appropriate behavior during the therapeutic relationship. …

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