50/50:How close is too close ? Casey Harvilla & Sarah McElroy
introduction• We explored the boundaries and appropriateness in a working therapeutic relationship• The film 50/50 demonstrates a client-therapist relationship with blurred boundaries
Dual Relationship• Dual relationships in psychotherapy refers to any situation where multiple roles exist between a therapist and a client. Examples of dual relationships are when the client is also a student, friend, family member, employee or business associate of the therapist.
media history• Psychology Today’s 2008 article: – “The Narcissus in All of Us” by Joshua D. Foster• “Dr. Evil” – Hannibal Lecter in Silence of the Lambs• “Dr. Dippy” – Frasier and Niles Crane from the sitcom Frasier• “Dr. Wonderful” – Dr. Susan Lowenstein from Prince of Tides
recent case studies• In Trenton, NJ: Psychologist Natalie Barone was fired after having an affair with convicted sex offender Michael Bordo, a former patient. – Barone used her powerful position as Director of Psychology to keep Bardo quiet about their relationship – Barone has surrendered her license in NJ, but is also licensed in PA• In Clifton, NJ: Behavioral therapist Samuelle Klein- Von Reiche had her license suspended after an inappropriate relationship with a former patient – Klein-Von Reiche accompanied him to the Bahamas on a business trip
ethical considerations• A.1.a. Primary Responsibility• A.5.a. Current Clients• A.5.b. Former Clients• A.11.c. Appropriate Termination• B.6.a. Confidentiality of Records• C.4.d. Implying Doctoral Level Competence• F.8.a. Standards for Students
film clip: early sessions• During the first session, the therapist appears unprepared at first and the client questions her experience level – Identifies herself as Dr. McKay, although she is not yet a doctor – Informs the client of his inclusion in her dissertation• During the second session, she employs touch as a therapeutic means – Client is uncomfortable with this, but she continues to try – Personal boundaries
clip #1 discussion• Do you think it was unprofessional for the therapist to not be prepared? – How could she have handled this differently?• Could the therapist have explored using touch in a different way?• What are your thoughts?
film clip: Ride home• The therapist offers to give her client a ride home from the hospital• Discloses personal information• Gives her client her personal cellphone number after dropping him off
clip #2 discussion• Was it okay for the therapist to give her client a ride home?• How could this become an ethical issue?• How else could she have handled providing her phone number?• What are your thoughts?
film clip: late night phone call• The therapist willingly provided her client with her personal phone number• Engaged in conversation about dating/personal relationship
clip #3 discussion• Was it okay for the therapist to give her client her personal cellphone number?• Should the therapist use this time on the phone to set boundaries with her client?• Why could it be considered unethical to have a dual relationship with a client?