Experiential Exercise 7
Write 8 mini-summaries/reflections.
Introduction to Boundaries: Part A of Boundaries Series
In this video Dr. Zur gives an overview of therapeutic boundaries. He discussed boundary violations vs. boundary crossings. A boundary violation is when a therapist crosses the line of decency, violate or explicate their clients. Some examples include sex exploitation and abuse of power. Boundary crossings are neutral appropriate, ethical benign or clinically effective interventions. These can include home visits, non sexual comforting, clinically appropriate self disclosure, ethical bartering, appropriate emails and googling clients for safety reasons.
Dr. Zur states that it is VERY IMPORTANT that ethical boundary crossing by therapists has a clear clinical rationale and has the client’s welfare at heart. Some other boundaries include around the therapeutic relationships vs. between therapists and clients. There is also therapists initiated boundary vs. client initiated boundary. I found it very interesting that Dr. Zur referenced the movie What About Bob? because that is one of my favorite movies and displays the client initiated boundary being crossed excessively.
Historical shifts in attitudes about boundaries are also addressed in this video. There use to be very loose boundaries but things have changed over time and it also has to be addressed that some dual relationships are going to happen and we have become more understanding. In conclusion, Dr. Zur makes the important point that boundaries can only be understood within the context of therapy. Each situation will be different and depends on the client, setting, and the therapist.
Self-Disclosure in Therapy: Part B of Boundaries Series
This video gives us an overview of self-disclosure. Transparency self disclosure is a revelation of personal rather than professional information about the therapist to the client. Types of self-disclosure are verbal vs. non verbal, deliberate-intentional, accidental and unavoidable.
In small communities self disclosure is unavoidable. People know each other so it becomes unavoidable and clients are more likely to know about their therapist. Self disclosure is very important because it can help build the trust between client and therapist. If a social worker is cold and distant then therapy is less likely to be effective or helpful.
Self disclosure is more likely in cognitive behavioral therapy, feminists, and group and family therapy. There are certain populations where self-disclosure is very important. They include adolescents, veterans, addicts, parents, and abused women.
One important piece of information that was addressed is how things have changed so much in the digital age. The internet has changed everything and clients can Google therapists, evaluate them online and there are social networking sites and sites where patients can leave complaints. There is not much privacy for therapists and clients have control over what is said on the internet about them. Dr. Zur points out that therapists should Google themselves regularly. They can do that by signing up for Google alerts and do not react impulsively regarding negativity that is on the internet about you, because it will be there forever.
I think it is very important for self-disclosure to play a role in therapy. Many clients want to feel a connection with their worker. If they trust them then therapy will be more successful.
Gifts in Therapy: Part C of Boundaries Series
In this video Dr. Zur discusses gifts in therapy. There are 3 types of gifts in therapy: from therapists to client, from client to therapist and from 3rd party to therapist. There are appropriate and inappropriate gifts that can be given. Sometimes it can be customary or symbolic. Dr. Zur points out that “ethical gift giving by therapists has a clear clinical rational and has the clients welfare at heart.”
Some examples that were given that are appropriate gifts are cards, flowers, food, children’s drawings, books, gift certificates and symbolic gifts. These can be given at certain times such as the end of therapy, a holiday, special occasion special challenge was met or a special occasion in a clients life.
The setting matters when giving a gift and can make a huge difference. The meaning of a gift can only be understood within the context of therapy. While watching this video I found it hard to think of a reason I would give a therapist a gift or why I would give a client a gift, but Dr. Zur makes the comment that he has brought back rocks and water from other countries and given them as gifts to his patients. I think that is an excellent and appropriate gift between the client and therapist.
Bartering in Therapy: Part D of Boundaries Series
In this video we learn about bartering in therapy. Bartering in psychotherapy is the acceptance of services, goods or other non-monetary payments from clients or patients in return for psychological services.
I think the biggest concern about bartering is the outcome if one of the parties is not satisfied. It can become complicated and if the therapists is unhappy with the job that the client did, how will therapy be affected? This could cause tension between the client and therapist and therefore the client won’t receive the service that they deserve. The APA code of ethics states that psychologists may barter only if it is not clinically contradicted and the resulting arrangement is not exploitative. However it can work in some situations and Dr. Zur gives us an example of his client giving the fee to a charity instead of the therapist. So it can work but there have to be rigid guidelines that are followed so treatment won’t be affected.
Dual & Multiple Relationships in Therapy: Part E of Boundaries Series
In this part of the video we learn about dual and multiple relationships. Dr. Zur defines dual and multiple relationships as any situation where multiple roles exist between a therapist and client. This can be social, professional, business, communal, forensic, sexual, and online and others. These can be intense/casual, ethical/unethical, legal/illegal, avoidable/unavoidable and predictable/unpredictable. In large cities dual relationships can be avoidable but in smaller communities they can become unavoidable. Sometimes it is mandated in agencies such as CPS, military, police, prisons and jails.
Sexual relationships are of course unethical, but not all dual relationships are unethical. In fact, they can be a healthy part of interconnected communities. There are different levels of relationships: low, medium and intense. Low levels consist of shopping at the same store of having you kids go to the same school. Medium levels consist of seeing each other on a regular basis such as church every Sunday. Intense levels is when you see one another a lot, an example would be playing on a recreational league together or being on a committee together.
Dual relationships can and will happen. There will be times when you may see one another outside of your session together. So it is important to talk about it and make boundaries with each other.
Touch in Therapy: Part F of Boundaries Series (2 of 2)
This section of the video we learn about touch in therapy. We learn about appropriate touch and the benefits that it can have. Types of appropriate touch include soothing touch, ritualistic touch, a handshake, conversational marker, consultation touch, reassuring touch, playful touch, grounding touch, task oriented touch, connective experience, instructional modeling touch and celebratory or congratulatory touch.
Touch should be used to help. Considerations for touch in therapy include gender, age, history and setting of the therapy. Also the client’s mental state, nature of the therapist/client relationship, therapist’s attitude toward touch and the therapist’s gender, age and culture. These can all make a difference in whether or not a touch is appropriate.
Some people are more comfortable with touch than others. For me personally, I am not a touchy person and have don’t enjoy hugging or touching others to convey my feelings or emotions. I really only feel comfortable using touch with those close to me including my husband and kids. If I were the client I would not be comfortable with the therapist using touch and as a social worker I would not feel comfortable using touch because that is hard for me and I don’t enjoy it and it would make me feel very uncomfortable. As the video states, touch in therapy is based on many factors and will not work in all situations.
Out of Office Experiences: Part G (final) of Boundaries Series
We learn about out of office experiences in this segment. Out of office can include home visits, hospital visits, treating homeless on the streets, adventure therapy, anorexic lunch, equine therapy and desensitization. Types of out of office experiences can be part of the treatment plan or can be unavoidable. It can also be used for enhancing therapeutic effectiveness and these can be accidental encounters. In home therapy can take place with clients that are bed ridden, elderly, have no transportation, child abuse cases or to conduct family therapy in its natural setting.
There are boundary considerations in our out of office experiences and home visits. First and foremost is the workers safety. They have no control over the environment so their safety could be jeopardy and also there will be increased self disclosure in these types of situations. Another consideration is that confidentiality may be compromised because others may overhear what the therapist and client are talking about. The therapist also has less control of the time, space, those in attendance, noise and if alcohol is served.
Home visits can be very useful for certain clients. There are benefits from it but there are also disadvantages of it. The therapist must be very careful to review the situation before they make a decision whether or not to have an out of office experience.
When I worked with homeless and at risk teenagers we went to a camp and did many exercises and group activities. This outdoor/adventure therapy was very beneficial to the group of teens who attended. They did team building exercises that would have never been possible inside an office. I was able to witness the positive effect it had on everyone, including the staff. Since I was able to experience this type of therapy I think it is a wonderful option for certain clients.
My Review
I enjoyed the movies and think they can be very beneficial to those who are entering the social work profession. Dr. Zur breaks down the boundaries and standards that are needed to be a successful social worker. He goes in depth in each video and it is very easy to follow. I think anyone that watches these videos would find them helpful, even the most experienced social workers or therapists. There are always learning opportunities for everyone and these videos display a great learning opportunity for those in this profession.
I can apply what I learned in these videos to my professional practice by implanting the boundaries and standards that are addressed. Dr. Zur is very knowledgeable and with his years of experience, he gives great advice to other social workers to help us improve our treatment and empowerment of our clients. Great videos!
Write 8 mini-summaries/reflections.
Introduction to Boundaries: Part A of Boundaries Series
In this video Dr. Zur gives an overview of therapeutic boundaries. He discussed boundary violations vs. boundary crossings. A boundary violation is when a therapist crosses the line of decency, violate or explicate their clients. Some examples include sex exploitation and abuse of power. Boundary crossings are neutral appropriate, ethical benign or clinically effective interventions. These can include home visits, non sexual comforting, clinically appropriate self disclosure, ethical bartering, appropriate emails and googling clients for safety reasons.
Dr. Zur states that it is VERY IMPORTANT that ethical boundary crossing by therapists has a clear clinical rationale and has the client’s welfare at heart. Some other boundaries include around the therapeutic relationships vs. between therapists and clients. There is also therapists initiated boundary vs. client initiated boundary. I found it very interesting that Dr. Zur referenced the movie What About Bob? because that is one of my favorite movies and displays the client initiated boundary being crossed excessively.
Historical shifts in attitudes about boundaries are also addressed in this video. There use to be very loose boundaries but things have changed over time and it also has to be addressed that some dual relationships are going to happen and we have become more understanding. In conclusion, Dr. Zur makes the important point that boundaries can only be understood within the context of therapy. Each situation will be different and depends on the client, setting, and the therapist.
Self-Disclosure in Therapy: Part B of Boundaries Series
This video gives us an overview of self-disclosure. Transparency self disclosure is a revelation of personal rather than professional information about the therapist to the client. Types of self-disclosure are verbal vs. non verbal, deliberate-intentional, accidental and unavoidable.
In small communities self disclosure is unavoidable. People know each other so it becomes unavoidable and clients are more likely to know about their therapist. Self disclosure is very important because it can help build the trust between client and therapist. If a social worker is cold and distant then therapy is less likely to be effective or helpful.
Self disclosure is more likely in cognitive behavioral therapy, feminists, and group and family therapy. There are certain populations where self-disclosure is very important. They include adolescents, veterans, addicts, parents, and abused women.
One important piece of information that was addressed is how things have changed so much in the digital age. The internet has changed everything and clients can Google therapists, evaluate them online and there are social networking sites and sites where patients can leave complaints. There is not much privacy for therapists and clients have control over what is said on the internet about them. Dr. Zur points out that therapists should Google themselves regularly. They can do that by signing up for Google alerts and do not react impulsively regarding negativity that is on the internet about you, because it will be there forever.
I think it is very important for self-disclosure to play a role in therapy. Many clients want to feel a connection with their worker. If they trust them then therapy will be more successful.
Gifts in Therapy: Part C of Boundaries Series
In this video Dr. Zur discusses gifts in therapy. There are 3 types of gifts in therapy: from therapists to client, from client to therapist and from 3rd party to therapist. There are appropriate and inappropriate gifts that can be given. Sometimes it can be customary or symbolic. Dr. Zur points out that “ethical gift giving by therapists has a clear clinical rational and has the clients welfare at heart.”
Some examples that were given that are appropriate gifts are cards, flowers, food, children’s drawings, books, gift certificates and symbolic gifts. These can be given at certain times such as the end of therapy, a holiday, special occasion special challenge was met or a special occasion in a clients life.
The setting matters when giving a gift and can make a huge difference. The meaning of a gift can only be understood within the context of therapy. While watching this video I found it hard to think of a reason I would give a therapist a gift or why I would give a client a gift, but Dr. Zur makes the comment that he has brought back rocks and water from other countries and given them as gifts to his patients. I think that is an excellent and appropriate gift between the client and therapist.
Bartering in Therapy: Part D of Boundaries Series
In this video we learn about bartering in therapy. Bartering in psychotherapy is the acceptance of services, goods or other non-monetary payments from clients or patients in return for psychological services.
I think the biggest concern about bartering is the outcome if one of the parties is not satisfied. It can become complicated and if the therapists is unhappy with the job that the client did, how will therapy be affected? This could cause tension between the client and therapist and therefore the client won’t receive the service that they deserve. The APA code of ethics states that psychologists may barter only if it is not clinically contradicted and the resulting arrangement is not exploitative. However it can work in some situations and Dr. Zur gives us an example of his client giving the fee to a charity instead of the therapist. So it can work but there have to be rigid guidelines that are followed so treatment won’t be affected.
Dual & Multiple Relationships in Therapy: Part E of Boundaries Series
In this part of the video we learn about dual and multiple relationships. Dr. Zur defines dual and multiple relationships as any situation where multiple roles exist between a therapist and client. This can be social, professional, business, communal, forensic, sexual, and online and others. These can be intense/casual, ethical/unethical, legal/illegal, avoidable/unavoidable and predictable/unpredictable. In large cities dual relationships can be avoidable but in smaller communities they can become unavoidable. Sometimes it is mandated in agencies such as CPS, military, police, prisons and jails.
Sexual relationships are of course unethical, but not all dual relationships are unethical. In fact, they can be a healthy part of interconnected communities. There are different levels of relationships: low, medium and intense. Low levels consist of shopping at the same store of having you kids go to the same school. Medium levels consist of seeing each other on a regular basis such as church every Sunday. Intense levels is when you see one another a lot, an example would be playing on a recreational league together or being on a committee together.
Dual relationships can and will happen. There will be times when you may see one another outside of your session together. So it is important to talk about it and make boundaries with each other.
Touch in Therapy: Part F of Boundaries Series (2 of 2)
This section of the video we learn about touch in therapy. We learn about appropriate touch and the benefits that it can have. Types of appropriate touch include soothing touch, ritualistic touch, a handshake, conversational marker, consultation touch, reassuring touch, playful touch, grounding touch, task oriented touch, connective experience, instructional modeling touch and celebratory or congratulatory touch.
Touch should be used to help. Considerations for touch in therapy include gender, age, history and setting of the therapy. Also the client’s mental state, nature of the therapist/client relationship, therapist’s attitude toward touch and the therapist’s gender, age and culture. These can all make a difference in whether or not a touch is appropriate.
Some people are more comfortable with touch than others. For me personally, I am not a touchy person and have don’t enjoy hugging or touching others to convey my feelings or emotions. I really only feel comfortable using touch with those close to me including my husband and kids. If I were the client I would not be comfortable with the therapist using touch and as a social worker I would not feel comfortable using touch because that is hard for me and I don’t enjoy it and it would make me feel very uncomfortable. As the video states, touch in therapy is based on many factors and will not work in all situations.
Out of Office Experiences: Part G (final) of Boundaries Series
We learn about out of office experiences in this segment. Out of office can include home visits, hospital visits, treating homeless on the streets, adventure therapy, anorexic lunch, equine therapy and desensitization. Types of out of office experiences can be part of the treatment plan or can be unavoidable. It can also be used for enhancing therapeutic effectiveness and these can be accidental encounters. In home therapy can take place with clients that are bed ridden, elderly, have no transportation, child abuse cases or to conduct family therapy in its natural setting.
There are boundary considerations in our out of office experiences and home visits. First and foremost is the workers safety. They have no control over the environment so their safety could be jeopardy and also there will be increased self disclosure in these types of situations. Another consideration is that confidentiality may be compromised because others may overhear what the therapist and client are talking about. The therapist also has less control of the time, space, those in attendance, noise and if alcohol is served.
Home visits can be very useful for certain clients. There are benefits from it but there are also disadvantages of it. The therapist must be very careful to review the situation before they make a decision whether or not to have an out of office experience.
When I worked with homeless and at risk teenagers we went to a camp and did many exercises and group activities. This outdoor/adventure therapy was very beneficial to the group of teens who attended. They did team building exercises that would have never been possible inside an office. I was able to witness the positive effect it had on everyone, including the staff. Since I was able to experience this type of therapy I think it is a wonderful option for certain clients.
My Review
I enjoyed the movies and think they can be very beneficial to those who are entering the social work profession. Dr. Zur breaks down the boundaries and standards that are needed to be a successful social worker. He goes in depth in each video and it is very easy to follow. I think anyone that watches these videos would find them helpful, even the most experienced social workers or therapists. There are always learning opportunities for everyone and these videos display a great learning opportunity for those in this profession.
I can apply what I learned in these videos to my professional practice by implanting the boundaries and standards that are addressed. Dr. Zur is very knowledgeable and with his years of experience, he gives great advice to other social workers to help us improve our treatment and empowerment of our clients. Great videos!