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305 Boundaries and Ethics – 2 seminars

Seminar Leaders: M. J. Esplen and J. Kohl

Course Description

In these two seminars, we explore aspects of sexual boundaries and their modes of violation in treatment situations. Typologies of boundary violators are considered, to increase awareness of both the situations therapists can fall into, and the work that they can do to prevent these from occurring. Some analysts do not well understand the nature of transference in the area of ongoing boundary concerns. Therefore, a section considers post-termination boundaries, both between colleague-therapists (boundaries in supervision are also considered), as well as for non-therapists, who terminate their treatment. Finally, a section of the first evening is devoted to the area of confidentiality that affects clinical reporting and dossier access. Discussion centers on ethical concerns, as well as possible impact on clinical outcome.

Course Objectives

  1. To consider the role of sexual boundaries in treatment, to allow the safe and effective use of the therapeutic relationship, and to protect the patient from the imposition of the therapist’s inappropriate personal needs (4.3); Recognize ethical issues encountered in practice. (3.2)
  2. Typologies of sexual boundary violators are studied, which establishes the critical roles of the therapist’s subjective context and of better understanding the power dynamics, in this area (4.3).
  3. Different ways of protecting the therapeutic space (4.2) and the physical and emotional safety of the patient from such violations are considered. These include consultation, supervision, and the therapist’s re-entry into treatment.
  4. The ongoing nature of transference (and a power dynamic, (4.3) is considered, in terms of issues such as post-termination boundaries, boundaries in supervision, and amongst colleagues where a treatment relationship once existed.
  5. To study and discuss further the aspects of confidentiality that relate to the potential use of clinical material for scientific presentation or for publication. Requests for dossier access will also be considered in this area. (4.2, boundary needs and 4.4, legal requirements).

Seminar 1

In this session we explore aspects of sexual boundaries and their modes of violation in treatment situations. Typologies of boundary violators are considered to increase awareness of both the situations therapists can fall into, and the work that they can do to prevent these from occurring. Also, a section of the evening is devoted to the area of confidentiality that affects clinical reporting and dossier access. Discussion centers on ethical concerns, as well as possible impact on clinical outcome.

Required Readings

Gabbard, G.O. & Lester, E.  (1995). Chapter 6: Boundaries and boundary violations in psychoanalysis. In Sexual Boundary Violations. New York, NY: Basic Books.

Levine, H.B. (2010). Sexual boundary violations: A psychoanalytic perspective. British Journal of Psychotherapy, 26, 50-63.

Gabbard, G.O. (2000). Disguise or consent: problems and recommendations concerning the publication and presentation of clinical material. International Journal of Psychoanalysis, 81,1071.

Furlong, A.  (1998). Should we or shouldn’t we? Some aspects of confidentiality of clinical reporting and dossier access. International Journal of Psychoanalysis, 79, 727-739.

Seminar 2

Required Readings

Some analysts do not well understand the nature of transference in the area of ongoing, continuous boundary concerns. Therefore, a section considers post-termination boundaries, both between colleague-therapists, as well as for non-therapists, who terminate their treatment. Boundaries in supervision are also considered.

Gabbard G.O. & Lester E. (1995). Chapter 8: The fate of the transference post termination boundaries. In Boundaries and Boundary Violations in Psychoanalysis.  New York, NY: Basic Books.

Gabbard G.O. & Lester E.  (1995). Chapter 9: Boundaries in psychoanalytic supervision. In Boundaries and Boundary Violations in Psychoanalysis. New York, NY: Basic Books.

Goren, E. (2013). Ethics, boundaries and supervision. Commentary on trauma triangles and parallel processes: geometry and the supervisor/trainee/patient triad.  Psychoanalytic Dialogues, 23, 737-743.

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