Ethical Boundaries in Balancing the Power Dynamic in the Therapeutic Relationship- 10 Credit Hrs.

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Questions:
1. What is one rationalization some have about abuse of the personal contact boundary with clients?
2. What are some biases against the validity of the topic of the Sexual abuse of Power between client and therapists?
3. What is one key factor that adds to the power imbalance between client and therapists?
4. What are two hurdles that remain after the client leaves the abusive relationship?
5. What are the four characteristics of a boundary violation?
6.What are four warning signs that a client may be vulnerable to an abusive balance of power?
7. What are the six categories listed in Schoener's typology of abuse?
8. What is one reason females are more vulnerable to therapeutic sexual abuse according to Penford?
9. What are some factors exploitative therapy relationships can contain?
10. What is "robotization?"
11. What are the three phases a victim may experience once she realizes the truth about her abuse?
12. What is a key in working with a client who has been abused by a therapist?
13. What are three phases of healing for the survivor of abuse?
14. What are some feelings an abuse survivor experiences to detour him or her from informing others?

Answers:
A. Many females are still programmed to believe that they will be happy and fulfilled by serving others.
B. Indulgence of professional privilege, role reversal, secrecy, and a double bind.
C. 1. focuses on her partner without any regard for her own needs, 2. remains subservient and self-effacing, and 3. starts to regain some control over her life.
D. The Bad Apple bias; Victim Blaming; Sexism; the Eunuch idea; and Codes of Ethics.
E. Naive and uninformed, healthy or mildly neurotic, severely neurotic, character disorders, sociopath or narcissistic, and psychotic or borderline personality disorders.
F. Experiencing a shutdown of thoughts, feelings, judgment and initiative.
G. It is key to show I understand, accept, and support their feelings of betrayal and anger.
H. Faith placed in the therapists as having special status.
I. Idealization of the professional; wishes for a rescuer; intense feelings bound up in the relationship; and traumatic transfer.
J. Diversion, erotic, exhibitionistic, dependency, power seeking, greed, and enabling.
K. Sexual abuse of clients mainly happened in the 90’s, and before. Today therapist are too lawsuit conscious for this to be an issue.
L. Seeking and finding support from friends and seeking professional help.
M. Shame, self-doubt, and fear.
N. Three phases of healing for abuse: 1. Remembering the trauma; 2. getting in touch with the feelings; and 3. developing a survivor rather than a victim mentality.

Course Content Manual Questions The Answer to Question 15 is found in Section 15 of the Course Content... and so on. Select correct answer from below. Place letter on the blank line before the corresponding question.
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Questions
15. What are primary hallmarks of boundary failures in the borderline client?
16. What are two definitions of manipulation?
17. The AAMFT, NBCC, and APA prohibit sexual relationship with former client’s for a period of two years. However, what does the NASW Code state?
18. What are potential clients warned about concerning boundaries and the power dynamic in consumer information?
19. What is Otto Fenichel’s definition of transference?
20. What are some interventions to counteract the power dynamic with clients who exhibit exaggerated silence?
21. What two types of therapist/patient relationships need to be balanced regarding supportive versus excessive therapeutic relationships?
22. According to the EEOC, who else can be included in a sexual harassment lawsuit besides the person harassed?
23. What is an example of a forceful cognitive intervention to use with a client’s self-defeating patterns, if used correctly, will not violate the balance of power?
24. What behavior on the part of clients put therapists in a position of power and yet impedes the therapist in his or her task of assisting clients to transcend their limited notions of themselves?
25. When a client enters your office and demands that you accommodate every one of his or her detailed requests before he or she will agree to work with you, what are they probably expecting and why?

Answers
A. “The act of changing others by unfair means to serve one’s own purpose” and “the act of improving one’s life situation through the skillful management of another person or system without consent from the effected party”.
B. 1. The real, uninterpreted relationship, which is like any other relationship 2. The transferential relationship, which is dominated by fantasies and expectations on the part of the patient.
C. Misunderstanding the present in terms of the past.
D. You have the capacity to stop making things difficult for yourself and others when you decide to think differently about your situation and your life.
E. The professional should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client.
F. Anyone affected by the offensive conduct.
G. Relabel behavior, schedule a silent session, prescribe the silence, provide structure, provide freedom, create a game, and use nonverbal sources.
H. Acting out behavior, chaotic relationships, and inability to control effect.
I. Nonevaluative trust or distrust.
J. The relationship feels uncomfortable, ambiguous, or confusing to the patient.
K. He or she is expecting you to turn them down so he or she has an excuse to terminate therapy.

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