What do you do when you run into a patient in a public place? How do you respond when a patient suddenly hugs you at the end of a session? Do you accept a gift that a patient brings to make up for causing you some inconvenience? Questions like thesewhich virtually all clinicians face at one time or anotherhave serious clinical, ethical, and legal implications. This authoritative, practical book uses compelling case vignettes to show how a wide range of boundary questions arise and can be responsibly resolved as part of the process of therapy. Coverage includes role reversal, gifts, self-disclosure, out-of-office encounters, physical contact, and sexual misconduct. Strategies for preventing boundary violations and managing associated legal risks are highlighted.
"At last, therapists have a clear, comprehensive, practical guide to the boundary decisions facing each of us throughout every course of therapy. Two foremost authorities discuss the full range of boundary issues--time, place, fee, gifts, self-disclosure, touch, documentation, causes and responses to false complaints, avoiding problems and misunderstandings, and so on--in light of the patient's condition and needs, benefits and risks, research, legal standards and liabilities, and varying theoretical orientations. No practicing therapist, training program, or expert witness should be without this essential resource."--Kenneth S. Pope, PhD, ABPP, coauthor of Ethics in Psychotherapy and Counseling: A Practical Guide, Third Edition
"Gutheil and Brodsky have provided mental health professionals of all persuasions with a marvelous guide to navigating the minefield of professional boundaries. What is refreshing and exemplary about this superb book is that the authors appreciate the pervasive ambiguity and uncertainty that are inherent in clinical decisions involving boundaries. A gesture that saves the therapy in one context can destroy the therapy in another context. Each chapter of this rich volume is filled with clinical wisdom and thoughtful risk management strategies that will be of great assistance to both mental health trainees and experienced psychotherapists."--Glen O. Gabbard, MD, Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry, Baylor College of Medicine
"Gutheil and Brodsky have done an outstanding job. Reading this book is like taking a course with the authors, who demonstrate great wisdom and perspicacity as they build the reader's awareness, elucidate what constitutes a boundary violation, and provide strategies for prevention. In today's litigious climate, in which clinical practitioners need to remain so mindful of their professional role, this book is a welcome contribution. I highly recommend this resource to everyone from students to seasoned professionals."--Frank M. Dattilio, PhD, ABPP, Department of Psychiatry, Harvard Medical School and University of Pennsylvania School of Medicine
"This is an excellent volume. I'm pleased to see that it immediately addresses 'transference atheists,' psychotherapists whose theoretical models allow them to pretend that a therapist holds no special power or responsibility in the relationship. The authors' willingness to make clear that clinical practice of mental health occurs within boundaries--whether one practices CBT, prescribes medication, is covering for the treating provider, or does in-depth, transference-based work--is wonderful to encounter. The clarity of the writing makes this book accessible both for beginning therapists and for those of us who are more experienced and think we know better--but often don't."--Laura S. Brown, PhD, ABPP, past president, Division of Trauma Psychology, American Psychological Association; private practice, Seattle, Washington
"Excellent....The authors take the reader carefully through the morass of understanding and analyzing boundary issues in the therapeutic encounter, whether one is a psychiatrist or any other mental health."--Journal of Clinical Psychiatry