Preventing Boundary Violations in Clinical Practice

Author:   Thomas G. Gutheil (Beth Israel Deaconess Medical Center and Harvard Medical School, United States) ,  Archie Brodsky (Beth Israel Deaconess Medical Center and Harvard Medical School, United States) ,  Kenneth Pope ,  Frank M. Dattilio
Publisher:   Guilford Publications
ISBN:  

9781593856915


Pages:   340
Publication Date:   01 June 2008
Format:   Hardback
Availability:   In Print   Availability explained
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Preventing Boundary Violations in Clinical Practice


Overview

What do you do when you run into a patient in a public place? How do you respond when a patient suddenly hugs you at the end of a session? Do you accept a gift that a patient brings to make up for causing you some inconvenience? Questions like these -- which virtually all clinicians face at one time or another -- have serious clinical, ethical, and legal implications. This authoritative, practical book uses compelling case vignettes to show how a wide range of boundary questions arise and can be responsibly resolved as part of the process of therapy. Coverage includes role reversal, gifts, self-disclosure, out-of-office encounters, physical contact, and sexual misconduct. Strategies for preventing boundary violations and managing associated legal risks are highlighted.

Full Product Details

Author:   Thomas G. Gutheil (Beth Israel Deaconess Medical Center and Harvard Medical School, United States) ,  Archie Brodsky (Beth Israel Deaconess Medical Center and Harvard Medical School, United States) ,  Kenneth Pope ,  Frank M. Dattilio
Publisher:   Guilford Publications
Imprint:   Guilford Publications
Dimensions:   Width: 15.20cm , Height: 2.70cm , Length: 22.90cm
Weight:   0.604kg
ISBN:  

9781593856915


ISBN 10:   1593856911
Pages:   340
Publication Date:   01 June 2008
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Hardback
Publisher's Status:   Out of Print
Availability:   In Print   Availability explained
Limited stock is available. It will be ordered for you and shipped pending supplier's limited stock.

Table of Contents

Introduction I. Foundations 1. Definitions and Dilemmas 2. Therapy and Its Limits II. Explorations 3. Role, Time, Place 4. Money, Services, Gifts 5. Self-Disclosure 6. Communication and Out-of-Office Contacts 7. Clothing and Physical Contact 8. Sexual Misconduct III. Implications 9. What Harms Are Caused? 10. Vulnerabilities 11. Understandings and Misunderstandings 12. Liabilities 13. Prevention Afterword

Reviews

At last, therapists have a clear, comprehensive, practical guide to the boundary decisions facing each of us throughout every course of therapy. Two foremost authorities discuss the full range of boundary issues -- time, place, fee, gifts, self-disclosure, touch, documentation, causes and responses to false complaints, avoiding problems and misunderstandings, and so on -- in light of the patient's condition and needs, benefits and risks, research, legal standards and liabilities, and varying theoretical orientations. No practicing therapist, training program, or expert witness should be without this essential resource. - Kenneth S. Pope, coauthor of Ethics in Psychotherapy and Counseling: A Practical Guide, Third Edition This is an excellent volume. I'm pleased to see that it immediately addresses 'transference atheists,' psychotherapists whose theoretical models allow them to pretend that a therapist holds no special power or responsibility in the relationship. The authors' willingness to make clear that clinical practice of mental health occurs within boundaries -- whether one practices CBT, prescribes medication, is covering for the treating provider, or does in-depth, transference-based work -- is wonderful to encounter. The clarity of the writing makes this book accessible both for beginning therapists and for those of us who are more experienced and think we know better -- but often don't. - Laura S. Brown, Fremont Community Therapy Project, Washington, USA


At last, therapists have a clear, comprehensive, practical guide to the boundary decisions facing each of us throughout every course of therapy. Two foremost authorities discuss the full range of boundary issues-time, place, fee, gifts, self-disclosure, touch, documentation, causes and responses to false complaints, avoiding problems and misunderstandings, and so on-in light of the patient's condition and needs, benefits and risks, research, legal standards and liabilities, and varying theoretical orientations. No practicing therapist, training program, or expert witness should be without this essential resource. - Kenneth S. Pope, coauthor of Ethics in Psychotherapy and Counseling: A Practical Guide, Third Edition Gutheil and Brodsky have done an outstanding job. Reading this text is like taking a course with the authors, who demonstrate great wisdom and perspicacity as they build the reader's awareness, elucidate what constitutes a boundary violation, and provide strategies for prevention. In today's litigious climate, in which clinical practitioners need to remain so mindful of their professional role, this book is a welcome contribution. - Frank M. Dattilio, Department of Psychiatry, Harvard Medical School and University of Pennsylvania School of Medicine, USA This is an excellent volume. I'm pleased to see that it immediately addresses 'transference atheists,' psychotherapists whose theoretical models allow them to pretend that a therapist holds no special power or responsibility in the relationship. The authors' willingness to make clear that clinical practice of mental health occurs within boundaries-whether one practices CBT, prescribes medication, is covering for the treating provider, or does in-depth, transference-based work-is wonderful to encounter. The clarity of the writing makes this book accessible both for beginning therapists and for those of us who are more experienced and think we know better-but often don't. - Laura S. Brown, Director, Fremont Community Therapy Project, Seattle, USA What is refreshing and exemplary about this superb book is that the authors appreciate the pervasive ambiguity and uncertainty that are inherent in clinical decisions involving boundaries. A gesture that saves the therapy in one context can destroy the therapy in another context. Each chapter of this rich volume is filled with clinical wisdom and thoughtful risk management strategies that will be of great assistance to both mental health trainees and experienced psychotherapists. - Glen O. Gabbard, Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry, Baylor College of Medicine, USA


Author Information

Thomas G. Gutheil, MD, is Professor of Psychiatry at Beth Israel Deaconess Medical Center, Harvard Medical School, Massachusetts, USA, where he is Assistant Director of Medical Student Training and Co-Founder of the Program in Psychiatry and the Law. A leading forensic psychiatrist, Dr. Gutheil lectures worldwide and is regularly consulted on boundary questions, risk management, and malpractice prevention by attorneys, licensing boards, and institutions. His over 250 publications include the coauthored Clinical Handbook of Psychiatry and the Law, winner of the American Psychiatric Association's Manfred S. Guttmacher Award. Among Dr. Gutheil's many other honors and awards are the American Psychiatric Association's Isaac Ray Award for outstanding contributions to forensic psychiatry. He is currently President of the International Academy of Law and Mental Health. Archie Brodsky is a Research Associate in the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Massachusetts, USA, and Co-Founder of the Program in Psychiatry and the Law. He has coauthored 15 books in the mental health field, including Sexual Dilemmas for the Helping Professional, a pioneering work on clinical and ethical boundaries in mental health treatment.

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