Boundary Issues and Dual Relationships in the Human Services

Boundary Issues and Dual Relationships in the Human Services

Frederic G. Reamer
Copyright Date: 2012
Pages: 264
  • Cite this Item
  • Book Info
    Boundary Issues and Dual Relationships in the Human Services
    Book Description:

    Should a therapist disclose personal information to a client, accept a client's gift, or provide a former client with a job? Is it appropriate to exchange email or text messages with clients or correspond with them on social networking websites? Some acts, such as initiating a sexual relationship with a client, are clearly prohibited, yet what about more subtle interactions, such as hugging or accepting invitations to a social event? Is maintaining a friendship with a former client or client's relative a conflict of interest that ultimately subverts the client-practitioner relationship?

    Frederic G. Reamer, a certified authority on professional ethics, offers a frank analysis of a range of boundary issues and their complex formulations. He confronts the ethics of intimate and sexual relationships with clients and former clients, the healthy parameters of practitioners' self-disclosure, electronic relationships with clients, the giving and receiving of gifts and favors, the bartering of services, and the unavoidable and unanticipated circumstances of social encounters and geographical proximity. With case studies addressing challenges in the mental health field, school contexts, child welfare, addiction programs, home-healthcare, elder services, and prison, rural, and military settings, Reamer offers effective, practical risk-management models that prevent problems and help balance dual relationships.

    eISBN: 978-0-231-52768-2
    Subjects: Sociology

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
    (pp. vii-xii)
    (pp. 1-42)

    CONSIDER THE FOLLOWING case scenarios and imagine yourself as the human service professional. How would you handle the boundary issues in these circumstances?

    Tanya M., a counselor employed in a community mental health center, provides services to clients with chronic mental illness. One of her clients, who is being treated for bipolar disorder, has been abusing alcohol and cocaine. Tanya encouraged the client to begin attending twelve-step meetings. The client decides to attend a local meeting that she chose from a list of area meetings. At the meeting the client encountered Tanya, who has been in recovery for nearly nine...

    (pp. 43-95)

    MANY BOUNDARY ISSUES involve some form of intimate relationship. Some issues are glaring, such as those involving sexual contact between a therapist and a current client. Other issues, however, are more subtle, such as those involving seemingly innocent affectionate gestures.

    I will examine a wide range of boundary issues involving intimacy. They include sexual relationships between professionals and their current or former clients; sexual relationships between professionals and clients’ relatives or acquaintances; sexual relationships between professionals who are supervisors or educators and their supervisees, students, trainees, or other colleagues over whom they exercise professional authority; providing professional services to a...

    (pp. 96-123)

    BOUNDARY PROBLEMS arising from a practitioner’s personal issues can take many forms other than inappropriate intimate relationships. Some manifestations amount to boundary violations that lead to harm or exploitation of clients and others. Other boundary problems constitute boundary crossings, introducing complex issues that do not rise to the level of actual violations but must be managed carefully nonetheless.

    What many of these phenomena have in common is that they are rooted in the practitioner’s emotional and dependency needs, such as those stemming from childhood experiences, marital issues, aging, career frustrations, or financial or legal problems. Research on impaired professionals provides...

    (pp. 124-154)

    SOME BOUNDARY AND DUAL RELATIONSHIP issues emerge because of pragmatic concerns, specifically, the possibility that the practitioner’s relationship with the client could produce tangible, material benefits or favors for the practitioner beyond simple monetary payment for services rendered. Some such dual relationships arise from relatively benign motives—for example, when a client with specialized knowledge or expertise offers to help a practitioner with a personal need or challenge—and some arise from more sinister motives—for example, when a practitioner attempts to exploit a client for material gain.

    This chapter explores this wide range of circumstances, focusing on issues related...

    (pp. 155-183)

    A NUMBER OF BOUNDARY issues arise because of practitioners’ genuinely altruistic instincts and gestures. The vast majority of human service professionals are caring, dedicated, and honorable people who would never knowingly take advantage of clients. Ironically, practitioners who are remarkably generous and giving may unwittingly foster dual and multiple relationships that are counterproductive and harmful to the parties involved.

    Boundary issues related to altruism fall into several conceptual categories: giving gifts to clients; meetings clients in social or community settings; offering clients and other parties favors; accommodating clients’ unique needs and circumstances; and disclosing personal information to clients.

    At first...

    (pp. 184-205)

    ANOTHER TYPE OF DUAL RELATIONSHIP involves circumstances that practitioners cannot easily anticipate or prevent—circumstances that, in most respects, are difficult to avoid or unavoidable. In these situations practitioners encounter boundary crossings and dual relationships unexpectedly and need to manage the circumstances in a way that protects clients, colleagues, and practitioners to the greatest extent possible.

    Boundary issues involving unavoidable and unanticipated circumstances fall into four major categories, including those that involve geographic proximity, conflicts of interest, professional encounters, and social encounters.

    The likelihood of unanticipated boundary issues increases in geographically small communities, such as rural areas and military bases....

  10. 7 RISK MANAGEMENT: Guidelines and Strategies
    (pp. 206-212)

    I HAVE EXAMINED a diverse array of dual relationship and boundary issues, both those that are relatively uncomplicated and some that are complex. Some involve practitioners who are motivated primarily by altruism, and some involve practitioners who violate clients’ boundaries because of their own deep-seated pathology, emotional needs, or greed. Some boundary crossings serve a constructive purpose, whereas boundary violations are uniformly destructive.

    Despite the remarkable variety, dual relationship and boundary issues share several key features. First, they contain the seeds of potential harm to others. Although serious harm is not inevitable—except in the most egregious violations, such as...

    (pp. 213-228)
    (pp. 229-244)
  13. INDEX
    (pp. 245-250)