Getting the Most Out of Psychotherapy
Standards of Ethical Practice
Licensed psychologists and other licensed therapists work under legal and ethical standards that have been carefully thought out to promote clinical safety and safeguard consumer interests. (Please note that I am not an attorney, and that the information given here does not constitute legal advice but is for educational purposes only.) These standards include the conditions under which confidentiality applies and where that confidentiality may or must yield to protect people when clients are a danger to themselves or others. The ethical and legal standards also cover therapist reporting of suspected abuse of children, elderly or disabled adults.
There are also federal laws that govern the administration of medical records. These can be exceedingly complex. For example, any psychologist who exchanges information electronically (not including facsimile) with clients is probably bound by the Health Insurance Portability and Accountability Act.
Therapists Should Not Take Advantage of Clients
A key element of the ethics code and legal regulations is the principle that therapists not take advantage of their clients. For example, the material above about sexual feelings emerging in therapy introduces one of the ways that therapy can go very wrong.
One of the principal ways that psychotherapy heals is by teaching the client that any emotion can be experienced without being acted upon. When one learns this through experience, one builds what is called “affect tolerance” and can have a cooperative relationship with one’s emotions that then become another way of sensing the world. It follows that when a therapist acts on sexual feelings that emerge in therapy, this is a betrayal of the client’s healing process where vulnerable thoughts and feelings are explored, not acted out. There is no professional psychotherapy situation in which sexual contact is appropriate between therapist and client  unless the client is specifically working with a surrogate partner supervised by a sex therapist. Otherwise, the therapist has stopped providing a safe container in which vulnerable feelings can be experienced and understood.
Avoiding Dual Roles
Similarly, therapists usually seek to avoid dual relationships with the client, such as having the client provide a business service for the therapist. This is because dual relationships have the potential for the therapist’s personal needs to compete with those of the client. The only reason that such relationships are “usually” avoided is that sometimes exceptions are made when therapist and client live in a small community where both, for instance, may be members of the same church or neighborhood association. Even in such cases, therapists take care to avoid having their personal needs impinge on those of the client. The client’s paying the therapist a fee does not constitute a dual relationship but is a paradox of therapy that arises out of the therapist’s need to make a living. This is not unlike other business relationships where a proprietor may have a collaborative and caring relationship with a client.
Therapists also take care to avoid providing duplicate services to clients. For instance, if a client is seeing another therapist for individual cognitive therapy, a therapist may not simultaneously provide the same kind of service. Avoiding duplicate services helps motivate the client to work out any differences or perceived deficiencies with the one therapist she or he is working with rather than avoid that necessary confrontation by seeing two therapists for similar work.
Seeman, G. (2013). Getting the Most Out of Psychotherapy. Psych Central. Retrieved on April 25, 2015, from http://psychcentral.com/lib/getting-the-most-out-of-psychotherapy/0001771