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Setting Clear and Ethical Boundaries with Clients

Section 3
Boundaries in Psychotherapy

Question 3 | Test | Table of Contents

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Now let's look at increasing your self-awareness concerning the impact of your gender culture. As you know, culture dictates patterns or ways of behaving in response to a specific situation, and these patterns are given to you as a child through your family, school, church, other social institutions, and your peer group.

In this process, the reasons for selecting a particular way of behaving may be lost. Your behavior becomes invested with an emotional significance, which is the accepted way for your particular culture. Culture also defines significant roles and sets up expectations of the behaviors that accompany them. When these role definitions become rigid, they tend to be counterproductive.

We can see much rigidity operating in the gender-role definitions that have been so inhibiting to women's use of their potential for achievement. We see these gender-roles operating in families where the accepted expectations for wife and parent roles may be so engrained that individuals cannot adapt to people whose expectations differ from their own.

So, with this in mind, let's look at increasing self-awareness of your culture as it dictates ways of behaving regarding gender-role expectations. In general, women are raised to be submissive to men. Men are raised with a culture of entitlement.

♦ A Client of the Opposite Gender
Ask yourself, when you have a client of the opposite gender, do you sometimes have a hard time setting boundaries because of these inferior versus superior roles? As a male, do you feel at a certain level that you should have all the answers for your client, especially your female clients?

Think a minute, as a male, do you have more of a tendency to feel you should be able to "fix" your female clients? Or, as a female, do you feel intimidated by some of your more domineering, assertive male clients? In setting a boundary with a client, in order to stay focused on the issues that they present in the session, a brief recall of the gender-role expectation in the culture in which you were raised may be of assistance. In light of the preceding examples, pause and recall a client of the opposite gender for which you may feel you have a gender-biased boundary issue.

♦ "White Knight" Complex - 5 Questions
The impact of your gender culture may come into play regarding crossing the boundary of providing favors for clients. I have found this creates more of a problem for my male colleagues than their female counterparts. Many males laughingly refer to this as their "white knight" complex. Here's a question for you...
-- If you see a client stranded on the roadside do you give him or her a ride?
-- Do you have clients for which you feel this would be appropriate?
-- Or do you feel there are no clients you are currently treating for which you would violate this boundary, by giving a ride?
-- If you work with children, how about giving a ride to their stranded the pouring rain?
-- How about this for complications of boundaries?
They are also your neighbors...and you live in a very small town. The situation creates more of a gray area in this case, than for the therapist that works in a big city probation department and the client stated in her last session she was starting to use drugs again.

♦ 3 Step Method for Deciding what is an Ethical Boundary
So how do you decide what is ethical boundary setting and what isn't? A three step method to help you decide, proposed by Robinson in his Ethical Decision Making book, is as follows:

#1. What is the context of the situation? I.e. big town versus small town or substance abuse history versus none.
What are the client's goals? Is this a ploy or manipulation for attention to reinforce dependence or perhaps a sexual fantasy? And finally,
#3. What is the potential harm resulting from a various course of action that may damage your future therapy relationship? I will be referring to Robinson's three step ethics assessment techniques several times throughout this course to give you practice in applying it. Hopefully by the end of the course you will have a working knowledge of his three step assessment method.

- Gartrell, N. (2002). Boundaries in Lesbian Therapy Relationships. Women and Therapy, 29-50.
- Robison, W. (2000). Ethical Decision Making. Boston: Allyn & Bacon.
Reviewed 2023

Peer-Reviewed Journal Article References:
Conlin, W. E., & Boness, C. L. (2019). Ethical considerations for addressing distorted beliefs in psychotherapy. Psychotherapy, 56(4), 449–458.

Contrastano, C. M. (2020). Trainee’s perspective of reciprocal vulnerability and boundaries in supervision. Journal of Psychotherapy Integration, 30(1), 44–51.

Dugbartey, A. T., & Miller, M. (2009). Review of Boundaries in psychotherapy: Ethical and clinical explorations [Review of the book Boundaries in psychotherapy: Ethical and clinical explorations, by O. Zur]. Canadian Psychology/Psychologie canadienne, 50(1), 42–43.

Pinner, D. H., & Kivlighan, D. M. III. (2018). The ethical implications and utility of routine outcome monitoring in determining boundaries of competence in practice. Professional Psychology: Research and Practice, 49(4), 247–254.

Tylim, I. (2004). Ethical notes on disrupted frames and violated boundaries. Psychoanalytic Psychology, 21(4), 609–613.

What are the three steps in ethics assessment technique? To select and enter your answer go to Test.

Section 4
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