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CE Credits: 6
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In these litigious times, therapists often avoid genuinely healing and perfectly ethical practices involving self-disclosure, touch, gifts, bartering, home visits, dual relationships, and other issues that they fear might get them censured or sued for “boundary violations.” But in recent years, there have been a number of important changes in professional standards, codes of ethics, and peer attitudes about boundary issues that can have a profound impact on clinical practice. This Telecourse will give you an up-to-date review of current thinking about ethics and standards of practice, focusing particularly on the emerging understanding that some boundary crossings and dual relationships are unavoidable and even therapeutically beneficial. Referring to more than 50 essential clinical resources on the instructor’s website, we’ll discuss good practices for making ethical decisions that aren’t based on fear and anxiety, but draw on solid information, critical thinking, and clinical integrity. Note: This course fulfills many state board requirements for training in ethics and risk management.
Ofer Zur, Ph.D. is a clinical and forensic psychologist and a consultant for therapists and attorneys. A prominent voice in the movement to make the fields of psychotherapy and counseling more flexible and realistic about boundary issues, he’s written dozens of articles and four books, including Dual Relationships in Psychotherapy (2002) and Boundaries in Psychotherapy (2007). He’s the director of the Zur Institute (www.zurinstitute.com), which offers more than 90 online CE courses for psychologists, social workers, and counselors.
Session 1: Review boundary crossings, boundary violations, and the difference between them • Define dual relationships • Discern the differences between boundary crossing and boundary violations • Discuss historical changes in attitudes toward therapeutic boundaries • Review the evolution of the standard of care in therapy and counseling • Discuss the ethics of boundaries • EACH boundary will be discussed in the following sessions in terms of: Descriptions and definitions • Examples and case studies • The ethical, clinical, legal, and standard-of-care considerations of each boundary
Session 2: Self-Disclosure: avoidable, unavoidable, helpful, unhelpful, accidental • Clients as informed consumers; Internet self-disclosure • To give gifts or not to give gifts; the timing, value, and meaning of gifts from clients and therapists
Session 3: The touchy issue of touch in therapy • Bartering for goods and services: when it works, when it doesn’t
Session 4: Out-of-office therapy: home visits, desensitization/exposure therapy, adventure therapy • Home office: issues and potential problems when working from your own home • E-therapy: telephone and e-mail based therapy • Additional boundary issues: length of sessions, language, clothing, physical proximity
Session 5: Dual relationships: unavoidable and avoidable, concurrent vs. sequential, professional, social, financial.
Session 6: Power dynamics in therapy: therapist’s vs. client’s power • Clinical-ethical decision-making about psychotherapeutic boundaries • Beyond “risk-management” and fear of boards and attorneys • Ethical risk-management
1. Review and grasp the changing history and different perceptions of ethics and professionalism in psychotherapy.
2. Recognize the specific issues and situations in clinical practice that are likely to have boundary implications
3. Learn an approach to ethical decision-making that ensures high ethical standards, without sacrificing clinical effectiveness.