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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by gardenergirl on April 20, 2006, at 13:00:15
Posted with author's permission from a listserv message.
Begin message:
This *American Psychologist* study's findings led the authors to call
for changes in the APA ethics code.Here's some background. The original ethics code of the American Psychological Association was empirically based, the result of a membership survey, asking what ethical dilemmas psychologists encountered in their "real world" work.
Almost half a century later, Pope and Vetter replicated that study. They found that the second most frequently reported ethical dilemmas
were in the area of "blurred, dual, or conflictual relationships."On the basis of their findings, Pope and Vetter called for changes in the APA ethical principles in the areas of dual relationships, multiple
relationships, and boundary issues so that the ethics code would, for example:(1) define dual relationships more carefully and specify clearly conditions under which they might be therapeutically indicated or acceptable;
(2) address clearly and realistically the situations of those who practice in small towns, rural communities, remote locales, and similar
contexts (emphasizing that neither the current code in place at the time nor the draft revision under consideration at that time fully acknowledged or adequately addressed such contexts); and(3) distinguish between dual relationships and accidental or incidental extratherapeutic contacts (e.g., running into a patient at the grocery market or unexpectedly seeing a client at a party) and to address realistically the awkward entanglements into which even the most
careful therapist can fall.The new web page provides the relevant section from this article ("Ethical Dilemmas Encountered by Members of the American Psychological
Association: A National Survey" by Kenneth S. Pope & Valerie A. Vetter (published in the March, 1992 issue of *American Psychologist*). It also provides a link to the complete article.This new web page ("A Study Calling for Changes in the APA Ethics Code regarding Dual Relationships, Multiple Relationships, & Boundary
Decisions") is at http://kspope.com/dual/multiple-relationships.php<snip>
"Ethics codes cannot do our questioning, thinking, feeling, and responding for us. Such codes can never be a substitute for the active
process by which the individual therapist or counselor struggles with the sometimes bewildering, always unique constellation of questions, responsibilities, contexts, and competing demands of helping another
person. . . . Ethics must be practical. Clinicians confront an almost unimaginable diversity of situations, each with its own shifting questions, demands, and responsibilities. Every clinician is unique in
important ways. Every client is unique in important ways. Ethics that are out of touch with the practical realities of clinical work, with the diversity and constantly changing nature of the therapeutic venture, are useless." (Pope & Vasquez, *Ethics in Psychotherapy & Counseling, 2nd Edition*) End message.Sounds like great recommendations to clarify and adapt the Ethics Code to the realities faced in therapist/client relationships.
gg
Posted by happyflower on April 20, 2006, at 13:15:17
In reply to multiple relationships APA ethics code: study, posted by gardenergirl on April 20, 2006, at 13:00:15
I clicked on the link and read the whole thing, it makes a lot of sense to me.
One thing that is happening with me and my T attending the same gym. Is that I am making friends with people there, friends who I didn't know where friends with my T . My T doesn't socailize with anyone really at the gym. He just worksout and leaves so I don't know he is friends with anyone there.
Now that he has told me that I am talking to his really good friends, I feel like I am doing something wrong. My T and I are crossing paths a lot in a lot of different ways. It is weird. Now what happens if I get invited to a party by some of these people who I now know are friends with my T ? They don't know the connection between us or that we even know each other. Should I be the one who reclines the offer because they were his friends first? I know it is my T's responsibilty, but should I avoid this?
Posted by happyflower on April 20, 2006, at 13:26:49
In reply to Re: multiple relationships APA ethics code: study » gardenergirl, posted by happyflower on April 20, 2006, at 13:15:17
Maybe this is why my T is giving me mixed messsages, not on purpose though. He wants me to socalize and exercise, both good things. But it must be confusing for him when I start to socialize with his friends and start working out at the same place. I didn't know who his friends are, but now I do know, and it does make me feel weird. Why did he tell me? He is also questioning me on others too, that I know he knows, because he knows their names, but why?
Maybe he didn't expect me to become a socail butterfly at his workout place? I didn't know he worked out there and I didn't know I was talking to his friends. What a coincedense, don't ya think? How would you handle this GG, if this happens to you as a T?
Posted by happyflower on April 20, 2006, at 13:27:51
In reply to Re: multiple relationships APA ethics code: study, posted by happyflower on April 20, 2006, at 13:26:49
Posted by LadyBug on April 20, 2006, at 15:05:05
In reply to multiple relationships APA ethics code: study, posted by gardenergirl on April 20, 2006, at 13:00:15
This website is awesome! At least what I've read so far. Thanks for sharing it with us.
LadyBug
Posted by gardenergirl on April 22, 2006, at 21:54:26
In reply to Re: multiple relationships APA ethics code: study » gardenergirl, posted by happyflower on April 20, 2006, at 13:15:17
> Should I be the one who reclines the offer because they were his friends first? I know it is my T's responsibilty, but should I avoid this?
That sounds like a really uncomfortable situation, which came about through no fault of your own. It's interesting to me that your T said these were his friends. I just know that if it were my T, he would never ever say that to me. But then, he's psychoanalytically oriented, so I get almost no self-disclosure, even after nearly 3 years. Which I prefer, actually.
But anyway, (enough about me) given that he's disclosed this, I think I'd talk to him a bit more about why he did. Was he trying to help you avoid an awkward situation by giving you a "heads-up?" And if so, does he have a preference about what you would do? Does he plan to do anything different? Could this be another example of his boundaries loosening up, whether he's aware or not? I don't know the answer.
As far as what should you do, well...that's tough too. My gut says that you seem to be someone with a number of friends in your social circle (although I don't know if that's true or not). And given that, although it's not fair and doesn't feel good to sort of "pass" on a new friend, maybe it would be less confusing and potentially stressful for you to sort of back off from them. Maybe just keep your acquaintance with them limited to at the gym? If you do choose to pursue friendships with them, and I'm not saying you shouldn't, I think you need to be very clear with yourself why you are. Just a teeny bit of soul-searching or observing your ego to see if there's anything about wanting to be friends with them that is related to your feelings about your T. If so, then I think you're headed down a slippery slope. If not, then I guess you have to weigh the potential "benefits" of their friendship against the potential "costs" related to the awkwardness and confusion that could come with it.
deep breath (I feel like I was talking without taking a breath).
Okay. I hope that helps.
Take care,
gg
Posted by gardenergirl on April 22, 2006, at 22:08:14
In reply to Re: multiple relationships APA ethics code: study, posted by happyflower on April 20, 2006, at 13:26:49
> How would you handle this GG, if this happens to you as a T?
Well, this is also something my T doesn't address, unless if it comes up, I guess. However, I've been trained to tell my clients in the first session about how I would handle incidental contact outside of therapy. I tell them that I will not acknowledge them unless they acknowledge me first. That way, it protects their privacy if they are with anyone and don't want to feel that social "pressure" to introduce me to the other. I also tell them this so that if they see me and I don't acknowledge them, they know why versus worrying about why I didn't say anything.
My T thinks this is not necessary to talk about in the beginning, and he probably thinks it "muddies up the therapeutic space", so to speak if you do. But I have run into clients outside of therapy a few times. I've always asked them the next time if they want to talk about it at all. It's usually fine. I admit, though, that once or twice I ran into clients while out with my husband, and that felt a bit weird for me. It felt a bit intrusive, although the client's behavior was fine. It was just my stuff, ya know? Eek, now they have a mental image of me with my loved one. What do they think? This is my own stuff, though, so I have to keep it in check unless it comes up with the client. I'm not sure I'd want one of my T with his wife. In fact, I know I don't.
Again, I'm rambling. Must be the lack of enough sleep last night and the long day today.
Take care,
gg
Posted by gardenergirl on April 22, 2006, at 22:08:48
In reply to Re: multiple relationships APA ethics code: study » gardenergirl, posted by LadyBug on April 20, 2006, at 15:05:05
Posted by happyflower on April 24, 2006, at 9:31:09
In reply to Re: multiple relationships APA ethics code: study » happyflower, posted by gardenergirl on April 22, 2006, at 22:08:14
Thank GG,
You advice is really helping me deceide what to do. I really don't have a circle of friends because after my kids were born, I became somewhat of a hermit due to the stress of motherhood. So it is hard to meet people and we like each other, but yet now I feel weird because I find out that they are my T's friends.The fact that me and my T have so much in common, I guess it isn't all that odd that we would like the same kind of people. Maybe I will ask him why he told me that he is friends with these people.
I saw him today at the gym and I felt a little strange. We just looked at each other, and then he said something to me first. So much for the I can't be socail with you comment. But then again he did say we could make small talk at the gym but nothing that would lead to a "coffee date". I guess I am kinda like well if we can't be friends, then why should I even say anything to him at all at the gym. But I guess that is me being a stuborn butt. LOL
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