All psychotherapists engage in self-disclosure with their clients. At times it may be deliberate or nondeliberate, verbal or nonverbal, and avoidable or unavoidable. Yet, modern-day Internet technologies have redefined the meaning and applications of self-disclosure and transparency in psychotherapy. Consumers of mental health services can easily access large amounts of information about their psychologists. Clients' online searches about their psychotherapists may range from normal curiosity to criminal stalking. Following an examination of these issues, three invited experts share their commentaries on the issues raised. A historical review of self-disclosure in the mental health professions and the opposition of many theorists and practitioners to its use are provided. Further, the roles of Internet social networking and online communities for psychotherapists and their clients and prospective clients are explored, along with the clinical meaning of the ever-increasing digital transparencies of psychologists, trainees, and clients. Advice is provided for how to view, understand, and consider web postings by psychotherapists, clients, and others. Implications for clinical practice and training are provided along with recommendations for how to effectively address issues of digital transparency.
Hugging, dining with, self-disclosing to, or making house calls to patients are among behaviors which have been termed "boundary violations" in psychotherapy. Although authors have asserted that boundary violations are both harmful and beneath the standard of care, some of the activities in question are consistent with the ethical practice of humanistic and behavioral psychotherapies, as well as with eclectic approaches deriving from those schools. Theoretical statements, survey research, and case examples are used to elucidate concerns about maintaining metaphorical boundaries in psychotherapy and to demonstrate that psychotherapy is diverse with respect to the behaviors at issue. It is concluded that even scrupulous humanistic, behavioral, and eclectic practitioners might appear to practice negligently by virtue of engaging in behaviors which some consider to be boundary violations and that innovative practice might be stifled by riskmanagement concerns.
The Logic of Boundary ConcernsSeveral authors have contributed arguments which emphasize the importance of maintaining boundaries in psychotherapy (
Widespread sympathy for patients who have been victims of abuse perpetrated by predatory psychologists may obscure the possibility that some purported victims fabricate or distort their claims. Civil courts or licensing boards might be used by purported victims to further a variety of personal agendas that involve false claims against psychologists. Anecdotal reports of 6 antecedents of such claims are presented. It is hoped that this discussion will increase awareness by peers and by those involved with relevant litigation that false, but credible, claims of negligence, predation, and malpractice not only are possible but may serve a number of emotional and practical needs on the part of the accuser.Psychologists and those who adjudicate such claims are urged to be wary that the purported victim may be himself or herself the predator.
A growing body of evidence documents a clinical pattern of harmful effects of therapist-patient sexual involvement. In addition, surveys suggest that 1 to 12% of all therapists may have engaged in this behavior at least once in their careers. In order to develop a more comprehensive research agenda, several of these studies are reviewed in terms of inferences that may or may not be drawn. Case studies and surveys may provide for inference of clinical harm and syndrome, but they are limited in terms of generalizations about incidence in the overall population. A population approach coupled with case sampling may provide a useful tool by which to approximate a minimum level of incidence and of effects.
The state and provincial boards that regulate the practice of psychology may regularly engage in a variety of investigative and enforcement practices that fail to provide due-process protection for accused psychologists. Because psychology regulatory boards operate under administrative law, rather than under civil or criminal law, familiar due-process protections may be considered unnecessary, or they may be perceived to be antithetical to the mandate of these boards to protect the public. Examples of board practices that bypass due-process protection are provided. An agenda is offered to state psychological associations to monitor the actions of their state psychology boards, to independently investigate complaints by members of unfair board practices, to offer support to members facing licensing complaints, and to propose appropriate legislative remedies for unfair board practices in their respective states and provinces.
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