Boundaries in Psychotherapy: Ethical and Clinical Explorations
For individuals in the U.S. & U.S. territories
A client wishes to pay for therapy services by bartering his original artwork. A therapist accepts a client's hug. A client asks his or her therapist if they can be friends after therapy ends. A prospective client requests therapy from a therapist who is also her neighbor. A client inquires about a therapist's spiritual orientation. What is the best course of action in these difficult situations?
This book is for the professional who feels unsure when entering the gray areas that inevitably arise in psychotherapy practice. The author carefully differentiates between what constitutes appropriate and helpful boundary crossing rather than inappropriate boundary violation and explores the ethical and clinical complexities involved in boundary issues such as the exchange of gifts, nonsexual touch, therapists' self-disclosure, dual relationships, bartering, home visits, home office practice, and telehealth.
This book does not offer simple answers but, rather, examines the nature of boundaries in psychotherapy and helps readers view boundaries through both an ethical and a clinical lens. Readers will learn a decision-making process to help them think through when to cross and when not to cross a boundary. Examples of real-world situations are provided to aid therapists as they think critically about what is most appropriate and most helpful to their clients' well-being. Clinicians, trainers, supervisors, instructors, students, ethicists, licensing boards, administrators, and attorneys will appreciate this thoughtful orientation to the many different boundaries that surround and protect psychotherapists and their clients.
I. Boundaries in Context
- Dual Relationships
- Reflections on Power, Exploitation and Transference in Therapy
- Contexts of Therapy
- A Decision-Making Process for Boundary Crossing and Dual Relationships
II. Boundaries Around the Therapeutic Encounter
- Time and Money: Managing Time, Fees, Billing and Bartering
- Space for Therapy
- The Home Office Practice
- Telehealth and the Technology for Delivering Care
III. Boundaries Within the Therapeutic Encounter
- Touch in Therapy
- Personal Space, Language, Silence, Clothing, Food, Lending, and Other Boundary Considerations
IV. Final Thoughts
- Toward a Better Understanding of Boundaries in Therapy
Appendix A: Examples of Boundary Crossings and Boundary Violations in Psychotherapy
Appendix B: Ethics Codes on Boundaries and Dual Relationships in Psychotherapy and Counseling
About the Author
Ofer Zur, PhD, is a licensed psychologist, instructor, forensic and ethics consultant, and expert witness in private psychotherapy practice in Sonoma, California. He is the director of the Zur Institute, which offers innovative and challenging continuing education online for psychologists, social workers, and counselors. His teaching in the United States and abroad as well as his writing focuses on ethics, critical thinking, boundaries, dual relationships, and the creation of managed-care-free private practices. For many years he taught at graduate schools, including the California School of Professional Psychology in Alameda and the California Institute of Integral Studies in San Francisco. His books include Dual Relationships and Psychotherapy (2002, coedited with Arnold Lazarus), HIPAA Compliance Kit (2005), and The Complete Fee-for-Service Private Practice Handbook (2005).
This is a book that should be read by all professional psychologists and would be useful as a resource in ethics courses. I recommend it highly.
—Cognitive Behavioral Therapy Book Reviews
In summary, this is a very well-organized, well-written, and thought-provoking book. It is a book to be read, thought about, and discussed with colleagues. I would enthusiastically recommend it to all clinicians, regardless of theoretical orientation or level of practice.
—The American Journal of Clinical Hypnosis