Abstract
Five experienced clinical psychologists were interviewed about their strategies for maintaining boundaries in psychotherapy. The interviews were subjected to qualitative analysis using grounded theory techniques to develop a preliminary model of boundary maintenance. The central principle exhibited by the interviewees was maintaining a therapeutic relationship to facilitate client self care. Overall, the central principle was comprised of three main working strategies: (1) maintaining client boundaries to ensure a clear focus on client needs; (2) maintaining psychotherapist boundaries to protect effective practice; and (3) maintaining psychotherapy boundaries to facilitate client reflection, awareness, and assumption of responsibility. Each strategy included two or three distinct meaning categories, explicated in the paper. Implications for clinical work and future research are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ægisdóttir, S., White, M. J., Spengler, P. M., Maugherman, A. S., Anderson, L. A., Cook, R. S., et al. (2006). The meta-analysis of clinical judgment project: Fifty-six years of accumulated research on clinical versus statistical prediction. The Counseling Psychologist, 34, 341–382.
American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association.
Barnett, J. E. (2005). Must some boundaries be crossed? Division 42 Online. http://www.division42.org/MembersArea/Nws_Views/articles/Ethics/boundaries.html.
Barnett, J. E., & Scheetz, K. (2003). Technological advances and telehealth: Ethics, law, and the practice of psychotherapy. Psychotherapy, 40, 86–93.
Barrett, M. S., & Berman, J. S. (2001). Is psychotherapy more effective when therapists disclose information about themselves? Journal of Consulting and Clinical Psychology, 69, 597–603.
Bernard, J., & Jara, C. (1986). The failure of clinical psychology graduate students to apply understood ethical principles. Professional Psychology: Research and Practice, 17, 313–315.
Bernard, J., Murphy, M., & Little, M. (1987). The failure of clinical psychologists to apply understood ethical principles. Professional Psychology: Research and Practice, 18, 489–491.
Bickman, L. (1999). Practice makes perfect and other myths about mental health services. American Psychologist, 54, 965–978.
Chwalisz, K. (2003). Evidence-based practice: A framework for twenty-first century scientistpractitioner training. The Counseling Psychologist, 31, 497–528.
Corey, G., Corey, M. S., & Callanan, P. (1993). Issues and ethics in the helping professions. Pacific Grove, CA: Brooks/Cole Publishing Company.
Elliot, R. (1986). Interpersonal Process Recall (IPR) as a process method. In L. Greenberg & W. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp. 503–528). New York: Guilford Press.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter.
Goldberg, A. (1999). Boundaries as pre-conditions. Psychoanalytic Quarterly, 68, 248–263.
Grove, W. M., & Meehl, P. E. (1996). Comparative efficiency of informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: The clinical-statistical controversy. Psychology, Public Policy, and Law, 2, 293–323.
Gutheil, T. G., & Gabbard, G. (1993). The concept of boundaries in clinical practice: Theoretical and risk-management dimensions. American Journal of Psychiatry, 150, 188–196.
Haas, L. J., Malouf, J. L., & Mayerson, N. H. (1988). Personal and professional characteristics as factors in psychologists ethical decision making. Professional Psychology: Research and Practice, 19, 35–42.
Handelsman, M. M., Gottlieb, M. C., & Knapp, S. (2005). Training ethical psychologists: An acculturation model. Professional Psychology: Research and Practice, 36, 59–65.
Koocher, G. P., & Kieth-Spiegel, P. (1998). Multiple role relationships and conflicts of interest. In G. P. Koocher & P. Kieth-Spiegel (Eds.), Ethics in psychology: Professional standards and cases (pp. 171–200). New York: Oxford University Press.
Kopp, S. B. (1972). If you meet the Buddha on the road, kill him!: The pilgrimage of psychotherapy patients. New York: Bantam Books.
Lazarus, A. A. (1994). How certain boundaries and ethics diminish therapeutic effectiveness. Ethics and Behavior, 4, 255–261.
Levitt, H. M., Neimeyer, R., & Williams, D. (2005). Rules versus principles in psychotherapy: Implications of the quest for universal guidelines in the movement for empirically supported treatments. Journal of Contemporary Psychotherapy, 35(1), 117–129.
Negretti, M. A., & Wieling, E. (2001). The use of communication technology in private practice: Ethical implications and boundary dilemmas in therapy. Contemporary Family Therapy: An International Journal, 23, 275–293.
Patton, M. Q. (2002). Qualitative research and evaluation methods. Thousand Oaks, CA: Sage.
Pope, K. S. (1990). Therapist-patient sexual contact: Clinical, legal, and ethical implications. In E. A. Margenau (Ed.), The encyclopedia handbook of private practice. New York: Gardner Press, Inc.
Pope, K. S., & Vasquez, M. J. T. (1998). Ethics in psychotherapy and counseling: A practical guide (2nd ed.). San Francisco: Jossey-Bass.
Rennie, D. L. (2000). Grounded theory methodology as methodical hermeneutics: Reconciling realism and relativism. Theory and Psychology, 10(4), 481–502.
Renninger, S. M., Veach, P. M., & Bagdade, P. (2002). Psychologists’ knowledge, opinions, and decision-making processes regarding child abuse and neglect reporting laws. Professional Psychology: Research and Practice, 33, 19–23.
Smith, T. S., McGuire, J. M., Abbott, D. W., & Blau, B. I. (1991). Clinical ethical decision making: An investigation of the rationales used to justify doing less than one believes one should. Professional Psychology: Research and Practice, 22, 235–239.
Williams, M. H. (1997). Boundary violations: Do some contended standards of care fail to encompass commonplace procedures of humanistic, behavioral and eclectic psychotherapies? Psychotherapy, 34, 239–249.
Woody, R. H. (1988). Protecting your mental health practice: How to minimize legal and financial risk. San Francisco: Jossey-Bass.
Younggren, J. N., & Gottlieb, M. C. (2004). Managing risk when contemplating multiple relationships. Professional Psychology: Research and Practice, 35, 255–260.
Zur, O. (2000). In celebration of dual relationships: How prohibition of non-sexual dual relationships increases the chance of exploitation and harm. The Independent Practitioner, 20, 97–100.
Zur, O. (2005). The dumbing down of psychology: Faulty beliefs about boundary crossings and dual relationships. In R. H. Wright & N. A. Cummings (Eds.), Destructive trends in mental health: The well-intentioned path to harm (pp. 253–282). New York: Routledge.
Zur, O., & Lazarus, A. (2005). Guidelines for non-sexual dual relationships and boundaries in psychotherapy. http://www.drzur.com/dualrelationships.html.
Acknowledgments
We would like to acknowledge and express our gratitude to Dr. Robert Neimeyer for his help with this project. Financial support for this project was provided by Israel’s Center for Absorption in Science.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Frankel, Z., Holland, J.M. & Currier, J.M. Encounters with Boundary Challenges: A Preliminary Model of Experienced Psychotherapists’ Working Strategies. J Contemp Psychother 42, 101–112 (2012). https://doi.org/10.1007/s10879-011-9189-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10879-011-9189-x