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Facing therapist indiscretions, transgressions, and misconduct (pp. 45-65). American Psychological Association. https://doi.org.10.1037/0000247-003 Ling, T. J., & Hauck, J. M. (2017). The ETHICS model: Comprehensive, ethical decision- making. American Counseling Association VISTAS Online, 18. https://www.counseling.org/ docs/default-source/vistas/the-ethics-model.pdf Magiste, E. J. (2020). Prevalence rates of unsubstantiated and adjudicated ethics violations. Journal of Social Work, 20(6), 751-774. https://journals.sagepub.com/doi/ abs/10.1177/1468017319837521 Mosher, D. K., Hook, J. N., Captari, L. E., Davis, D. E., DeBlaere C., & Owen, J. (2017) Cultural humility: A therapeutic framework for engaging diverse clients. Practice Innovations, 2(4), 221-233. http://dx.doi.org/10.1037/pri0000055 National Association of Social Work. (2021). Highlighted revisions to the code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Highlighted-Revisions-to-the- Code-of-Ethics National Board for Certified Counselors. (2023). Code of ethics. https://www.nbcc.org/ assets/ethics/nbcccodeofethics.pdf New York State Education Department Office of the Professions. (2023). Professional practice: Supervision. https://www.op.nysed.gov/professions/psychology/professional- practice/supervision PEW Research Center (2021). Social media fact sheet. https://www.pewresearch.org/ internet/fact-sheet/social-media/ Pope, K. S., & Keith-Spiegel, P. (2008). A practical approach to boundaries in psychotherapy: Making decisions, bypassing blunders, and mending fences. Journal of Clinical Psychology, 64(5), 638-652. https://pubmed.ncbi.nlm.nih.gov/18386835/ Riggin, B. M., & Lack, C. W. (2018). Ethical decision-making models across mental health treatment: A review and expansion. Current Psychiatry Reviews, 14, 1-17. https://doi.org/10. 2174/1573400514666180816112109 Roberts, L. W., & Termuehlen, G. (2021). Special report: Ethical decision-making in contemporary psychiatric practice—An evolving challenge. American Psychiatric Association Psychiatric News. https://doi.org/10.1176/appi.pn.2022.1.22 Schoener, G. (2021). Supervision and consultation with therapists who have engaged in sexual misconduct. In A. L. Steinberg, J. L. Alpert, & C. A. Courtois (Eds.), Sexual boundary violations in psychotherapy: Facing therapist indiscretions, transgressions, and misconduct (pp. 45-65). American Psychological Association. https://doi.org/10.1037/0000247-019 Steinberg A., Alpert J.L., & Courtois, C.A. (2021). Sexual boundary violations in the psychotherapy setting. In A. L. Steinberg, J. L. Alpert, & C. A. Courtois (Eds.), Sexual boundary violations in psychotherapy: Facing therapist indiscretions, transgressions, and misconduct (pp. 45-65). American Psychological Association. https://doi. org/10.1037/0000247-001 Stoll, J., Muller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 1-16. https://doi.org/10.3389/fpsyt2019.00993 Szumer, R .T., & Arnold, M. (2023). The ethics of overlapping relationships in rural and remote healthcare. Bioethical Inquiry, 20, 181-190. https://doi.org/10.1007/s11673-023- 10243w Unhjem, L., Hoss, L., Roberts, B., & VanderTuin, S. (2021). Swipe right…My therapist? Ethical considerations for therapists using dating apps. Contemporary Family Therapy, 43, 177-188. https://doi.org/10.1007/s10591-020-09561-7 Vesentini, L., Van Overmeire, R., Mattys, F., DeWachter, D., Van Puyenbroeck, H. & Bilsen, J. (2022). Intimacy in psychotherapy: An exploratory survey among therapist. Archives of Sexual Behavior, 51, 453-463. https://doi.org/10.1007/s/10508-021-02190-7 Witts, B. N., Brodhead, M. T., Adlington, L. C., & Barron, D. K. (2020). Behavior analysts accept gifts during practice: So now what? Behavior Analysis: Research and Practice, 20(3), 196-202. http://dx.doi.org/10.1037/bar0000117 Wu, K. S., & Sonne, J. L. (2021). Therapist boundary crossings in the digital age: Psychologists’ practice frequencies and perceptions of ethicality. Professional Psychology: Research and Practices, 52(5), 419-428. https://doi.org/10.1037/pro0000406 Zur, Ofer (n.d.). Gifts in psychotherapy; Ethical and clinical considerations. Ethics, cultural, and standard of care considerations. https://drzur.com/gifts-in-therapy/
MANAGING PROFESSIONAL BOUNDARIES Self-Assessment Answers and Rationales
1. The correct answer is d. Rationale: The principle of autonomy/justice states that clinicians treat clients equitably and without discrimination. Beneficence relates to promoting well-being, nonmaleficence relates to doing no harm, and integrity/fidelity relates to honesty and truthfulness. 2. The correct answer is: b. Rationale: Sexually provocative conversations are a boundary violation with potential for harm to the client. The other options are nonexploitative boundary crossings. 3. The correct answer is d. Rationale: All of these factors should be considered when determining if a gift is an acceptable boundary crossing and can be accepted . 4. The correct answer is c. Rationale: Connecting with a current client by “friending” or “following” may lead to inappropriate therapist self-disclosure. It creates a privacy concern, has the potential for harm, and is specifically addressed in most codes of ethics.
5. The correct answer is c. Rationale: Sexual relationships with clients are clear unethical boundary violations, have the potential for harm and exploitation of the client, and are illegal in all states. 6. The correct answer is b. Rationale: The model chosen for use should help the clinician identify the problem, analyze alternatives, choose and implement an action, and evaluate the consequences of the decision, all of which provide sound justification for the chosen course of action. 7. The correct answer is d. Rationale: There is rarely only one right answer or action when faced with ethical decisions, and different clinicians may choose different alternatives. Use of a decision-making model provides structure and organization to help guide the clinician in evaluating all aspects and consequences so that they can arrive at the best possible option for the client.
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