I recently came across the attached article on therapeutic ethics. This article was particularly compelling to me because it talks about how to provide a safe and contained environment for therapy to take place. Providing a safe environment is vitally important to helping our clients develop the trust necessary to succeed in therapy. Yet how many of us have operationalized safety and really gone out of our way to ensure that we have really clear boundaries and rules in place to ensure that clients can feel safe.

As the clients and therapists I work with know, I search through Therapist Directory profiles as a first step in bringing therapists into my network. I look for profiles in which the therapist describes what they do with clients and how they do it. If they can describe their work I know that this is probably someone who is well trained and has theory behind their practice. About 80% of the profiles that I read, however, talk exclusively about safety, and maintain that the reason people should come to see them is that they provide a safe and trusting environment. Most of these profiles say little else, and I can honestly say I bypass every one of them. To me, providing safety is so fundamental and obvious that if that’s all that a therapist has to say about what they do, I figure they’re not doing much with their clients beyond sitting and listening to them. And I think it’s also likely that if I called most of these therapists and asked them what they do to provide safety and a trusting environment they wouldn’t be able to tell me.

I’m pleased to see this article in which the author describes in great detail all of the ways that she ensures safety and clear boundaries with clients. This includes a pointed dialogue with every client about what the boundaries are, how a therapeutic relationship is different from a social one, how the therapist might behave in session, when and how physical touch can or won’t occur, what silences mean, and a discussion about how the therapist and client should behave if they meet outside of the therapy session. And while I don’t share the same therapeutic stance as this therapist on whether it is ever appropriate to share personal information, I appreciate so much that her position is consistent and well thought out from a consideration of what is ethical and in the best interests of her clients. This is what matters the most.

So in the end, yes, safety and trust are the most important elements in a therapeutic relationship. The big lesson for me in this article is once again, that therapists need to be able to talk about what they do to help clients, and if what they do most of is provide safety and a trusting environment then every client coming in to see them should know how that safety and trust will be there and what it looks like. http://www.psychotherapynetworker.org/daily/freereports/ethics-in-therapy-defining-professional-boundaries/


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