Ethics Plus MP3

Boundaries in Clinical Practice - Barbara Herlihy, Ph.D.

Here is a mini-interview on the subject of Boundaries. Our speaker on ON GOOD AUTHORITY PLUS, #1 is Dr. Barbara Herlihy, and the topic is “Boundaries in Clinical Practice.” The curious thing about the topic of boundaries is that the more one gets into it, the less clear cut it becomes. While there is certainly a need for careful maintenance of the most obvious boundaries–the real no-no’s like sexual relations with patients–and sanctions for those who violate, there are many situations and traditions and practices in other forms of therapy in which certain boundaries are murky. There is a wide range of “boundary crossings” that are not violations and may be sensitive, sensible, and humane, and therefore justified and consistent with good care. For instance, the value of self disclosure is one arena around which theory is developing–and not only in individual therapy–group psychotherapists may–just as other members in the group–openly share their thoughts and feelings, respond to others authentically, and acknowledge or refute motives and feelings attributed to them. Other forms of therapy may dictate that some boundaries be crossed, or disregard boundaries altogether. Some behavioral therapists, for instance, have little concern about socializing with patients outside of therapy sessions because they view their work as applying a set of technical procedures, and therefore not requiring special rules about relationships. And of course there are the unavoidable boundary issues–you see your patients at the grocery store; or, you are the only marital counselor in an area and one of your patients is also the little league coach. The variety of situations is endless. When is it negligence, justifying licensing sanctions and financial settlements, and when is good care? Listen in.

Gifts and Adjudication/Sanctions - Ted Remley, Ph.D., LCC

In Ethics II, we presented speakers having radically different points of view of the topic of Confidentiality–one speaker admonishes us to document everything so as to protect ourselves from our patients, another says to document nothing in order to protect our patients from an ever more invasive and prying outside world. Now we will hear a true alternative to both these positions–but I won’t give it away–you’ll just have to listen on.