Monthly Archives: September 2011

Dual Relationships as a Therapist*

(*Disclaimer: just a vent; nothing for S to freak out about)

So apparently the laws of ethics demand that therapists can never be friends with or sleep with clients. That makes perfect sense in the short term—sleeping with someone you’re currently treating as a client has all sorts of terrible repercussions (not to mention what it says about the therapist as a person). However, say for example a single female therapist sees a single male client in 2011 for a specific phobia. The client is otherwise a mentally healthy individual except he’s terrified of heights or injections (or dogs, whatever) and treatment takes about three months. After those three months, the client has overcome his fear and appreciates the help he was given. Three years later at a 2014-2015 New Years’ Eve party, the therapist’s best friend invites her roommates’ friends, one of whom happens to be this former client. They start talking about absolutely nothing related to the fear he experienced in his past (or even if they do) and they find out that they have a lot in common and share similar opinions and senses of humor.

They are absolutely forbidden to have sex or become friends based on the APA ethics code. As a matter of fact, they probably shouldn’t even have spoken. Because it’s “unethical” to establish any other form of a relationship outside of the therapeutic one with someone who has ever been a client.

I personally don’t agree with this. It was brought up in class that it’s just a simple black-and-white rule that having sex with a client is strictly forbidden. It’s not black-and-white. Nothing is ever black-and-white. Maybe that’s just the difference between myself and certain other people, but I always see myself interpersonally as having the potential to develop friendships with others in almost every new social interaction. If I were in that situation described above (and I wasn’t in the theoretical last relationship I’ll ever be in), I don’t know that the situation would really warrant that restriction via the ethics code. I’m sure this opinion will screw me in the future somehow, but I just want to know where the harm is in such a situation. Or why it’s so unfathomable that a situation such as that could easily arise.


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Group Choice/Self-Reflection

We were assigned to pick an activity from a list and write a 2-3 paged paper on it. I chose this one, and here is my response (because I find it easier to write freely like this when I think it’s just a blog post, especially when the assignment is my forte–self-reflection). 🙂

At this stage in my training, my interests in facilitating group work are higher than I imagined they would be at this time. When I always thought about psychology, I considered it only in the one-on-one fashion, and not as something often done in groups (save for maybe something like Alcoholics Anonymous and the like). My first exposure to group therapy was in my senior year of undergrad. I was working as an intern at an in-patient facility in New York for an art therapist. On Saturday of every week, I participated in four groups-one adolescent female, one adult, one adolescent co-ed and one child group. Due to the fact that I was an undergraduate intern as opposed to a Master’s student intern, I was never asked to co-lead a group. I simply provided assistance and participated in the projects themselves. I was rather surprised at the level of processing of some groups (e.g. adult) and the utter lack of processing of others (e.g. co-ed and child). I left that experience feeling as though art therapy was a bust for certain populations (and more specifically with externalizing issues). Because of this, I chose not to involve myself in the adolescent groups being run at a local high school through the child research team. Despite the groups not being art-related, I didn’t have a lot of faith in working in groups with that particular population. Technically, I still don’t; however, I’m more receptive to the idea at this point, because I also believe that the method in which the facility I worked at practiced therapy was not a very efficient one. I don’t imagine it to be a relatively easy task, but I am certainly interested in getting involved with some of the group projects that are coming around again on the child research team. However, my preference is with the child population as opposed to the adolescent groups.

To be perfectly honest, my population of choice for group work would be adults. (My population of choice for individual therapy is children.) I had the opportunity to watch some amazing emotional processing and revelations while I was an intern and it brought a feeling of doing. It sincerely felt like these individuals were getting something out of treatment. They were usually receptive to the task and would work at something (even if it wasn’t the assigned task) which was always a step in the right direction. Not everyone chose to share what they created or what it meant to them, but that wasn’t always the goal. So long as they were understanding the object of the assignment and could reflect to any degree on their own, the group was successful. At some point in my career, I would prefer to conduct (or co-lead) some form of an adult group. However, at this stage in my training, my preference is a child group. I have limited exposure to therapy with children (and I discredit the experience I had previously) and I don’t believe that my anxiety towards the unknown should be a barrier to performing a task such as this one. I have been told on numerous occasions that I work well with children (and have been asked in public domains if I am a teacher). I try to imagine that my strength in that area is enough to overcome my weakness of not knowing how or having faith in my ability to handle clinical populations.

I also don’t often take culture into consideration when creating these pseudo/imaginary groups in my head. Everyone is always White, and I think that’s just a product of my own culture–the neighborhood in which I grew up, who I had as friends, and even the cultures of the populations I worked with before. There were always several African American children or adolescents, but the majority of the population were White kids. Moving to Philadelphia and working in community mental health has certainly changed my exposure, but I haven’t been acculturated long enough for that to feel like the prominent culture in my life (though I imagine that will change over time). I also believe it’s something that can be addressed in a group, especially with a child population. Culture, ethnicity, religion, etc. are not things that we readily talk about, despite them often making us uncomfortable, and I believe that may be a rather effective group if presented to a group of semi-receptive children (of any culture). It may also influence the way they develop in life, having some semblance of perspective.

If I had a professional development plan (which I don’t currently), I would list exposure atop the list. I find that I am most influenced when I experiencing something directly and what better way then to delve in. I think co-leading is an excellent first step, and I personally plan to get involved with the group run through the child research team as soon as it begins. Being receptive to feedback is also high on the list. Feedback is valuable regardless of who is providing it–be it a supervisor, co-leader, professor, or even group members. I never want to overstep my boundaries and I never want to make anyone uncomfortable. I will always want people to feel like they can speak freely with me, including when an issue pertains to me. I hope that I always make that clear and I also believe that to be a tool that will assist in making me an effective group leader.

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