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Setting Clear and Ethical Boundaries with Clients
Four Basic Premises
This is a two course series. The first course in this series will cover: basic premises; attitudes and behaviors; gender culture; use of defense mechanisms; security vs. growth; middle-class values; setting session tempo; nonverbal communication; touch; and acceptance that leads to expectations.
The second course will discuss the boundaries issues of: self-determination, transference and counter transference, friendship versus partnership; judgments; setting the session focus; partialization; advice giving; making promises; confrontation; manipulation; and referrals.
♦ #2. The right of self-determination is also a basic ethical premise that raises boundary issues. Later in this course we will explore the issue of suicide. However, with a suicidal client you treated, where did you set the boundary between freedom and commitment to an in-patient unit?
♦ #3. A third philosophical basis of the therapeutic relationship is the right to share the benefits of society, but at what point does your client with a substance-related disorder lose his rights to share the benefits of society? Let's explore this one further. Some substance-use treatment professionals have criticized the classification of substance-use disorders by the DSM, Diagnostic and Statistical Manual, as simplistic and too straightforward.
They have argued that substance use cannot be forced into the two arbitrary categories of abuse or dependence, but rather that substance use represents a continuum that ranges from non-use to dependency. With your last "substance-related disordered client," what criteria did you use to set a boundary in the gray area of the DSM classification system, which many view as inadequate, regarding court orders to a treatment facility and depriving the client of his or her right to benefit from societal freedom?
♦ #4. The mutual rights and responsibility between your client and society is a philosophical basis of the mental health professions. Now, regarding the boundary between rights of your client, versus the rights of society...ask yourself...the last time your client threatened to harm an identifiable other, where and how in your mind did you draw the limit regarding a need to warn or not warn the other party?
♦ Four Basic Premises Examples
By "awareness" I mean my ability to deal with my personality patterns and client issues, as they may relate to my life experience, which may cloud my ability to relate to the client.
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CEU Continuing Education for
Psychologist CEUs, Social Worker CEUs, Counselor CEUs, MFT CEUs