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Can You Keep a Secret?

A Story of How One Therapist Changed Her Mind About Keeping Secrets

Evan Imber-Black

By Evan Imber-Black - Decades ago, a family walked into one therapist's office and utterly destroyed her beliefs about keeping secrets.

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May Quandary: Is It Ever Okay to Break Confidentially If I Know My Client Is Dating an Abuser?

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Diedre was widowed about three years ago, but was excited to tell her therapist about a man she's started dating. She's very happy. As her therapist heard more, he realized this is the same man another client used to date, who slowly became controlling and abusive. Should Diedre's therapist share this info? Five therapists weigh in.

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Managing Confidentiality

Three Things I Learned from My Small-Town Practice

Daniela Gitlin

By Daniela Gitlin - When you practice in a rural town, sometimes it can feel like everyone is connected to each other. Instead of worrying about boundary and confidentiality violations, I've learned a strategy that embraces the dilemma instead of avoiding it.

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January Quandary: Should I Keep One Partner’s Secret in Couples Therapy?

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Mark and his wife, Nicole, have been in couples therapy for almost six months. But Mark recently requested an individual session, where he revealed he recently shared a kiss with an old girlfriend and has plans to rekindle their friendship. He's asked his therapist to keep the whole thing a secret. Here's how five clinicians say they'd tackle the situation.

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July Quandary: My Client Uses Me in Inappropriate Hypothetical Examples!

Six Clinicians Give Their Take on This Tricky Clinical Scenario

Chris Lyford

By Chris Lyford - A male client uses his therapist in hypothetical examples, which the therapist finds inappropriate. Recently, when they were discussing healthy dating habits, he said, “So if you and I went to a movie, would it be okay to hold your hand afterwards?” The therapist wants to bring it up in their next session but is unsure how to do so. Here's how six clinicians say they'd tackle the situation.

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Keeping Secrets When Everyone Already Knows Them

A Therapist in Small-Town America Struggles with New Ethical Dilemmas

Jan Michael Sherman

By Jan Michael Sherman - When my wife and I moved to a place in the Yukon so small that when someone sneezed at one end of town, someone at the other end reached for the Kleenex, I quickly found that practicing therapy could get pretty tricky. Not only did everyone know everyone else's business, everyone was in everyone else's business.

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Why Torture Doesn't Work

What Neuroscience is Showing Us

Diane Cole

By Diane Cole - Using a broad swath of scientific, psychological, and medical evidence about brain function, Shane O'Mara, a professor of experimental brain research, delves into—and disproves—popular misconceptions about the brain under stress, memory, and the psychological state of torturers.

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Confronting Therapy's Ultimate Ethical Violation

A Therapist's Cautionary Tale on Breaching Sexual Boundaries

Susan Rowan

I doubt that I would fit many people's image of a therapist who would violate sexual boundaries with a client. On the day I first met Cara, I was a well-respected social worker at a venerable psychiatric hospital in the Midwest. I viewed myself as a caring and conscientious professional. Yet, over the course of two years, I progressed from sympathizing with Cara, to over-sympathizing with her, buying her groceries, paying her rent and, finally, sleeping with her. At first, I did not think I was doing anything harmful. But my previous dedication to all my clients became an obsession with one.

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Clarifying Boundary Issues to Strengthen Therapy

Why the Therapy Process Needs to be Free of Boundary Issues to be Successful

Mary Jo Barrett

We all know that the collaboration between therapist and client is the keystone of therapy. What many therapists may not realize is how much clarifying boundary issues contributes to establishing and strengthening that collaboration.

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The Ethics Gray Zone: Is it an Ethical Violation or Not?

When Unique Issues Arise, Therapist Need to Determine Whether or Not it’s a Potential Ethical Violation

Mary Jo Barrett

Sometimes ethical violations we face with our clients become so subtle and complex that we risk alienating clients when we’re trying our best to protect them.

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