Discussion 1: Professional Boundaries and Ethical Standards
The purpose of ethical standards is to help guide the helping professional in practice. However, making ethical decisions is not always easy or clear. Consider the following scenario using the ethical standards for sexual boundaries within your profession. Choose the answer that best fits your professional obligation regarding sexual matters and explain your rationale for your choice.
Susan has a private practice as a psychotherapist. Her client, John, has sought counseling services because he is going through a divorce. After seeing John for about 2 months, Susan realizes that she is growing sexually attracted to John. At the end of each session, John gives Susan a hug. What should Susan do first?
- Terminate with John and wait 1 year before beginning a sexual relationship.
- Terminate with John and refer him to another therapist.
- Seek supervision regarding countertransference.
- Discuss the attraction with John before deciding whether or no to terminate.
Post by Day 3 a brief summary of your preferred choice for Susan according to the boundaries of professional obligations of your current or future position. Explain your rationale, using relevant and supportive ethical standards.
Be sure to support your postings and responses with specific references to the resources.
Read a selection of your colleagues’ postings.
Respond by Day 5 to at least two of your colleagues’ postings that differ from your preferred choice for Susan. Discuss the difference in professional regulations and why you agree or disagree with your colleague’s choice. Use your professional standards to support your view.
COLLEAGUE 1: Kelly Henley
Brief summary of preferred choice
Counselors must employ ethical decision-making and consider professional values and ethical principles and standards in their counseling relationships (American Counseling Association [ACA], 2014). The actions that a therapist can and cannot engage in are guided by the law, professional ethics, and institutional policies and procedures (Risen, 2016). In this scenario, the first thing Susan should do is seek supervision.
Explanation of rationale
According to Risen (2016), John’s hugs at the end of each session are boundary-crossing. Research indicates that seemingly small boundary-crossing activities can lead to boundary violations (Risen, 2016). Whether boundary crossings help or harm in a therapeutic setting varies, but one factor is absolute, therapy should not include the possibility of a patient/therapist sexual relationship (Risen, 2016). Self-awareness is critical to ensure that a therapist’s needs are adequately met to effectively meet their clients’ needs (Risen, 2016). A therapist must be aware of their vulnerabilities to make sure their feelings do not impact the therapist/client relationship (Risen, 2016).
In Canada, the standards of practice for counselors are outlined by the Canadian Counselling and Psychotherapy Association. The standards stipulate that if a counselor is sexually attracted to a client, they must seek out consultation or supervision to determine if the attraction is likely to interfere with maintaining professional conduct (Canadian Counselling and Psychotherapy Association [CCPA], 2012). The National Association of Social Workers (2017) includes a discussion on conflict of interest in their code of ethics that states that social workers should be aware of and avoid conflicts that can impede professional discretion and impartiality. The code states that social workers should take reasonable steps to address the issue using methods that protect the client’s interests (National Association of Social Workers [NASW], 2017).
A therapist may become tempted to cross boundaries, and if these feelings are examined intellectually, they can provide information that is a valuable part of the professional maturation process (Risen, 2016). It is crucial to have a professional network to discuss these issues and use their guidance to provide professional, ethical care for clients (Risen, 2016). If a counselor can no longer uphold professional standards, they must provide appropriate referral options and alternatives and terminate the counseling relationship (ACA, 2014).
American Counselling Association. (2014). ACA code of ethics, https://www.counseling.org/Resources/aca-code-of-ethics.pdf
Canadian Counselling and Psychotherapy Association. (2012). Standards of practice for counsellors, https://www.ccpa-accp.ca/wp-content/uploads/2014/10/StandardsOfPractice_en.pdf
National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers, https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Risen, C. B. (2016). Boundary crossing in clinical practice. In S. B. Levine, C. B. Risen & S. E. Althof (Eds.), Handbook of clinical sexuality for mental health professionals (3rd ed). Routledge.
COLLEAGUE 2: Maureen Epps
Brief summary of preferred choice
As a practicing social worker, we have an obligation to serve clients using a professional code of conduct. According to the National Association of Social Workers (2017) code of ethics 1.06 conflict of interest states that social workers should be alert to avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgement. Social workers are held to high standards which is to suppose to enhance the well-being of all clients. Section 1.10 of the social workers code of ethics states that social workers should not engage in physical contact with clients when there is a possibility of psychological harm to the client as a result of the contact (such as cradling or caressing clients) (National Association of Social Workers,2017). Termination of services and referral should take place following the proper protocols to ensure a smooth transition of services with no interruption.
The American Association of Sexuality Educators, Counselors, and Therapist (2008) state that under Principle Two: Moral, Ethical, and Legal Standards certified members shall be aware of and monitor the fact that his/her personal needs may influence judgments and actions in the therapeutic relationship and shall, regardless of experience or training, have a qualified review source such as a supervisor available to assist in safeguarding against unwise or inappropriate judgments and acts. This code demonstrates that Susan sexual attraction to John could interfere with his treatment and affect her ability to provide therapy in a professional manner. In an instance like this it is recommended that Susan seek supervision for her countertransference. Levine et.al (2016) states that boundary crossing occurs when the therapist or the patient says or does something that falls outside of the structure of the prototypic therapeutic relationship. An example used in the text is the patient reaches out to hug the therapist, invites the therapist to a celebration, or calls the therapist at home (p23). John reaching out to give Susan a hug clearly demonstrates the crossing of boundaries.
American Association of Sexuality Educators, Counselors, and Therapists. (2008). Code of ethics. Retrieved from http://www.aasect.org/code-ethics
Levine, S. B., Risen, C. B., & Althof, S. E. (Eds.). (2016). Handbook of clinical sexuality for mental health professionals (3rd ed.). New York, NY: Routledge.
National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English