Of course, therapists must be aware that some situations—for instance, cases involving custody, repressed memory, and complex PTSD issues or clients who are highly paranoid, aggressive, dissociative, antisocial, or litigious—may present higher levels of risk than others. Additionally, boundary issues should be handled with extra care with clients who have serious personality disorders, such as borderline or narcissistic personality disorder, or those who view themselves inherently as victims.
If we try to combine the role of lawyer and therapist, we'll inevitably make a hash of both. The best and truest kind of "risk management" isn't motivated by fear of taking a wrong step or making a wrong move: it's based on therapeutic competence; knowledge of the laws and codes of ethics; a deep commitment to our clients' welfare; our own maturity, professional development, and common sense; and our ability to think critically, work only within our scope of practice and competence, and carry out an ethical decision-making process. Then, of course, we must bear in mind the importance of informed consent, thorough documentation, and consultations. Without these qualities, we won't be good therapists, no matter how much case law we memorize.
Ofer Zur, Ph.D., is a forensic expert, consultant, author, and psychologist practicing in Sonoma, California. His recent publications include Dual Relationships and Psychotherapy, coedited with Arnold Lazarus, and the bestselling HIPAA Compliance Kit, now in its third edition. His most recent book is Boundaries in Psychotherapy. Dozens of free articles are posted at www.drzur.com. Contact: firstname.lastname@example.org.
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