Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 5
Track #5 - The "Normal" Imbalance of Power
(revised 12/19/03)

Question 5 found at the bottom of this page
Answer Booklet | Table of Contents
Get Audio Track: Open a new window with Ctrl N,
Left click audio track to Listen, Right click to "Save..." mp3
Get PRINTABLE format of this page

Information in the following track is based on Peterson (1992). In a professional client relationship, the professional has the expertise and the client has the need. This arrangement creates a natural asymmetry usually referred to as a power differential. There is nothing wrong with the fact that the professional has more power in the relationship as long as that power is used to help clients. Indeed, the professional's use of his or her power is based on the unspoken understanding that the client's needs will come first and ahead of the professional's needs.

When professionals, however, put their needs first, they change the rules and the priorities in the relationship which increases the client's vulnerability. For example, when a male therapist is sexual with a female client, he puts his own needs for self gratification ahead of what is best for the client. Moreover, he uses his power to take from her what he wants for his own ends. Because the client is emotionally dependent on the therapist for help, the client cannot disengage and proceed on a self- directed course at will. Therefore, his use of her places her at risk for psychological injury.

Peterson contends that transgressions occur when professionals deny their greater power in the professional client relationship because then they relieve themselves of the responsibility for how they use it. She has delineated four characteristics that collectively comprise a boundary violation. As integral parts of the whole, these four characteristics are interconnected and become a dynamic system that has a wayward life of its own.

The first characteristic is the reversal of roles. In a professional client relationship, the professional has the power and the client has the need. When a boundary violation occurs, the professional and client change places. The professional gives priority to his or her own need and uses the client to meet it. The client, in effect, then becomes the caretaker. Since the professional looks to the client for what is needed, the client is assigned a new power. The client experiences this change as a shift in status. "I never felt so special". Unfortunately, the client never realizes that the feeling of importance happened because the professional sees the client as someone who can meet his or her need. It has little to do with who the client really is.

The second characteristic is a secret or secrets. When the professional places his or her need first, another agenda is created which functions illicitly to the legitimate purpose of the professional client relationship which is to meet the client's need. These two agendas co-occur which confuses the client because the client cannot tell which agenda is operating when and which agenda has the priority. For example, if a male therapist is abusing a female client, the client cannot tell if the therapist's concern for her is because he is her therapist or because he is trying to seduce her. Consequently, she cannot count on the accuracy of her perceptions to protect herself which magnifies her vulnerability in the relationship.

The third characteristic is a double bind. A client feels dependent on the professional for what the client needs and fears being without the relationship. Since the client is being used by the professional for the professional's own needs, remaining in the relationship endangers the client. The client feels a sense of double jeopardy. If the client leaves the relationship, the client loses his or her source of help. If the client stays in the relationship, the client could get hurt more. Any direction the client moves is a loss. Moreover, the client blames himself or herself for having the need that made the client dependent and for having participated in the relationship at all.

The fourth characteristic is a presumption of professional privilege. In a boundary violation, the professional presumes his or her right to take from the client for personal ends. As such, the professional indulges his or her professional privilege. Since a professional is supposed to put the client's need first, the professional who transgresses has to justify behavior that runs counter to what is prescribed by professional standards and codes of ethics. The professional rationalizes his or her choice by believing it is being done "for" the client, maintaining that "it was no big deal", or insisting that he or she can keep professional and personal worlds separate. These explanations diminish the incongruence that exists between giving to professionals when the professional is supposed to be giving to the client. Distortion of this inherent conflict makes it easier to disguise from the client what the professional is doing. If the client believes that the professional's behavior is in the client's best interests, the client will likely cooperate which sanctions the continuation of the professional's misconduct.

The four characteristics include reversal of roles, the presence of one or more secrets, a double bind, and the presumption of professional privilege. All four must be present before there is a boundary violation because they work together as a circular system. Professionals presume their (1) privilege by introducing their own needs into the professional-client relationship. The decisions of professionals to act on those needs creates (2) secrets because they co-exist alongside the real or legitimate purpose of the relationship. Since professionals look to clients to meet their needs, they (3) reverse roles and clients now become caretakers for what professionals need. Unsuspecting clients are (4) double bound by their real or perceived need for help and the reality that getting that help endangers their welfare. Justifications by professionals bar clients from seeing the incongruence in the relationship and handling it effectively. Cooperation from clients sanction the (1) privilege of professionals to continue to indulge themselves by placing their own needs first. The four characteristics function together as a closed system that continues until negative consequences emerge to break through the distortions that maintain the system.

QUESTION 5
What are the four characteristics of a boundary violation? To select and enter your answer go to Answer Booklet.

Peterson, M. R. (1992). At Personal Risk: Boundary Violations in Professional Client Relationships. New York: W.W. Norton.