Introduction

One would think, after all these years of having it pounded into our heads, that sexual misconduct-- entering into a sexual relationship with our clients or patients--would be a thing of the past.  After all, the codes of ethics of all the professional organizations for social work, psychology, psychiatry, and counseling state unequivocally that sexual contact with current and former clients is unethical.

However, next to suicide, boundary problems and sexual misconduct rank highest as causes of malpractice actions against mental health providers.  Repercussions to the therapist are stringent, ranging from loss of license to criminal and civil prosecutions, resulting in monetary fines and even prison.  You would think that it would not be worth the risk.

Yet despite this fact, studies have shown that this misconduct does occur and that clients are harmed.  Each person that we work with can test our capacity for ethical decisions and conduct in ways that are unpredictable, complex and frustrating.

Obviously, knowing THE RULES is not always enough to override the risk factors that can occur in our own lives that make us vulnerable, and which when combined with a variety of factors in our clients and patients can have disastrous sequelae.

Understanding and managing intense feeling states in treatment relationships ultimately central to the management of therapeutic boundaries.

So this ethics program is not the typical ethics programs which focus specifically on the rules.  Rather, we are aiming at something that Aristotle might have referred to as "developing virtuous character" through a more in-depth look at how these situations can develop.  We will be focusing on the self--on the ethical decision maker versus the decision making process.  Our premise is that who one is, morally and psychologically, is fundamental to one's decision-making.

LEARNING OBJECTIVES:

1.  Become aware of situations that may make a practitioner vulnerable to boundary violations.

2.  Be able to recognize signs that a therapist is improperly crossing the patient-therapist boundary.

3.  Understand the reasons why sexual violations are prohibited.

4.  Be able to identify the sexual and eroticized feelings that practitioners commonly encounter within the transference and countertransference relationship.


CURRICULUM SUMMARIES:

Interview #1:  Hugh Johnston, MD    "Overview"

We will hear an overview discussion about boundary violations, what causes them, what new findings in neurology show, how evolution has played a part, and how we can change a toxic work environment.

Interview #2:   Martin Williams, Ph.D.  "Risk Management Mania"

In this interview, we will hear how the topic of boundary violations is being used and misused in lawsuits against therapists.

Interview #3:  Judith Newman, LCSW  "Psychodynamic Understandings"

We will hear a psychodynamic explanation about what the clinician in this situation is experiencing when his (or her) "who-ness" -- that is his personal identity, needs, and vulnerabilities -- interfere -- with his (or her) "what-ness" -- that is professional role and the trust implicit in that.