Therapeutic Boundaries In Relation To Transference Essay.

Therapists' Self-Disclosure

Discuss about the Therapeutic Boundaries in Relation To Transfrence.

Counseling within the mental health service requires maintenance of therapeutic boundaries between the client and the therapist. Therapeutic boundaries are the expected psychological and social distance between the therapist and the client(Gutheil & Gabbard, 2013). It involves issues such as the therapist’s self-disclosure, involvement with the client outside the office, the length of sessions, touch and exchanging gifts. Transference and countertransference are concepts that come up during therapy and it is necessary to maintain healthy boundaries when they arise.  Sigmund Freud described countertransference as an unconscious phenomenon whereby the therapists’ emotions are influenced by a client and causes the therapist to react in a certain way(Kring, et al., 2013). On the other hand, transference refers to a phenomenon whereby the client transfers their feelings about a significant person in theirlives to the therapist. These feelings are usually manifested in many forms such as hatred, mistrust, rage and extreme dependence on the therapist. This paper will focus on exploring the therapeutic boundaries needed when counselling within the mental health service in relation to the concepts of transference and countertransference.

One of therapeutic boundaries involves the therapist’s self-disclosure. Therapists have the choice to share their own feelings and experiences with their clients but with some moderation.Excessive self-disclosure may lead the therapist to spend a lot of time focusing on their feelings and experiences and deny the client the chance to have their issues handled(Derlaga & Berg, 2013). Excessive disclosure on the therapist’s side may also blur their ability to recognize the presence of countertransference and generally interfere with the therapeutic process since it will be based on the therapist’s feelings and not the client’s. However, when therapists establish healthy boundaries in regards to self-disclosure, they are able to share their own experiences with their clients and they may use countertransference consciously to understand the differences between their experiences and those of their clients in order to ensure the therapeutic process is objective(Henretty, et al., 2014). Moderate self-disclosure can enable the therapist to identify the countertransference and help the client in understanding their issues better and it also makes therapists more empathetic since they understand the client’s situation (Henretty, et al., 2014). The therapists are also able to recognize transference in the client when they give more time for the client to talk about their feelings and experiences (Brown 2017). It is important to recognize whenever any unconscious countertransference occurs by having healthy boundaries set when it comes to self-disclosure (Butcher, Minieka and Hooley  2013).

Involvement with The Client Outside The Office

Involvement with the client outside the office is another therapeutic boundary that is important within the mental health service. The relationship between a client and a therapist is supposed to be strictly within the counselling environment. One of the common ways in which transference and countertransference is usually manifested is through an erotic attraction between the therapist and the client(Fuertes & Cheng, 2013). The client may want to initiate dates and extra meetings outside the therapeutic timeline in order to fulfill the feelings that result from the transference. It is important for the therapists to recognize the transference in their patients so that they can be aware of the motives their clients might have and even how the clients might be eliciting a countertransference in them. By limiting the involvement with clients outside the office, the therapist is able to avoid other ethical problems such as dual relationships and romantic relationships with their clients. In addition, they avoid encouraging the clients to dwell on the feelings that result from transference such as erotic attractions and instead focus on issues that will promote the wellbeingof the client.

Extreme dependence of the client on the therapist can also be as a result of transference. For example, a client who experiences social isolation may make the therapist the central part of their social life, such a client might want to constantly interact with the therapist outside the office as a way to fulfill their social wellbeing. It is important for the therapist to establish their stand on maintaining a professional relationship within the counselling environment and avoid giving the client any indications contrary to this(Corey, 2015). Countertransference may also lead the therapist to be over involved in the client’s situation. Once the client has shared their problem with the therapist, the therapist might remember a similar occasion that occurred in their lives and it may trigger outrage in them. For example, when the client is a rape victim and the therapist also had a similar incident happen to them or someone close to them it brings back the negative feelings that resulted from that incident and it may provoke the therapist to be either under or overinvolved with the client.  Because of this, they may want to make an extra effort beyond the therapeutic counselling process to try and help their clients. This constitutes involvement with the client outside the counselling set up that may eventually compromise the outcome of the therapeutic process. In a case where the therapists considers it necessary to intervene in the patients situation, they have to clearly explain to the client their reasons for intervening to avoid misinterpretations that may arise (Pope & Vaquez, 2016).Maintaining a therapeutic boundary that prevents involvement outside the therapeutic relationship can help the therapist in dealing with issues arising from transference and countertransference henceensuring the credibility of the mental health service. However, there are some unique circumstances that may necessitate an interaction with the client outside the counselling session. For example, when the client suddenly falls ill and the therapist goes to visit him at the hospital to help him deal with the vulnerability of the situation. In such a situation, the therapist has to explain to the client the significance of the visit in the context of their therapeutic relationship to avoid misinterpretation (Brown 2017).

Extreme Dependence of The Client on The Therapist

Touch and exchange of gifts between the client and the therapist are also issues that come into consideration when discussing therapeutic boundaries. These two concepts are usuallyinvolved when individuals have a nonprofessional relationship and therefore, it becomes unethical when the relationship between the client and the therapists comprises of exchanging gifts and intimate touching(Zur, 2015). It may also trigger a romantic relationship which is against the code of ethics for counsellors. In reference to transference and counter transference, touch and exchange of gifts might elevate the feelings of attraction that occurs between the client and the therapist. It will affect the therapeutic relationship since the gestures might be misinterpreted by both parties as an initiation of a relationship or a response to their romantic feelings. For example, a client who once had a loved one who constantly showered them with gifts and reassured them with intimate touching might misinterpret a simple gesture of comfort as a show of affection because of transferring the feelings they got from their loved one to the therapist. A therapist may also experience countertransference when they receive a gift from aclient since it might trigger certain memories related to receiving gifts from someone else in their lives. Crossing this boundary interferes with the objectivity of the therapeutic process since it compromises the professional relationship between the client and the therapist (Beck, Freeman and Davis 2015).

Sexual relationship between the therapist and the client should be avoided. Sexual misconduct usually results from other subsequent boundary violations, such a s exchanging gifts and meeting outside the counseling set up (Butler, Chapman, Forman 2016). Due to transference, a client may develop intimate feelings for the therapists and make moves towards achieving a sexual relationship with them. They may do this by initiating dates and offering gifts and favors in exchange for the services offered by the therapist. It is important for the therapist to recognize the presence of any transference in the therapeutic relationship with the client and help the client in acknowledging and understanding those feelings(Paul, 2015). Failing to recognize and address these feelings may eventually result in a sexual relationship with the client which ruins the professional relationship. The therapists might also see a resemblance in physical appearance or mannerisms of a client that triggers memories of a former or current sexual partner (Henretty, et al., 2014). This may result in them thinking of the client in a sexual way. The therapists has to recognize that the feelings are not directly related to their clients but instead they are a representation of someone else. By doing this, they can be able to avoid getting into a sexual relationship with the client and disrupting the therapeutic relationship. It will also prevent further problems related to code of ethics (Henretty, et al., 2014).

Touch and Exchange of Gifts

Therapeutic boundaries also need to be established when it comes to the length of sessions between the client and the therapist. A therapist should give each client an equal session and avoid giving preference to particular clients (Henretty, et al., 2014). The length of the session will limit the therapist from going beyond the scope of their session and instead focusing on the important aspects of the session. For example, when countertransference occurs, a therapist is more likely to talk about their experiences and feelings. This gives the client less time to have their issues addressed. When there is an allocated length of time for a particular session, the therapists can organize themselves better to ensure the client is given more time to talk about their issues. Once the therapist recognizes the presence of countertransference when engaging with a particular client, they may then organize the time they have to ensure they focus on the relevant information and avoid deviating to less important information(Sharpless & Barber, 2015).Transference in counselling might occur when a client views the therapist as one of their close friend or a family member. Maybe the individual had a family member who never used to listen to them and they may take the therapist as being that close family member (Henretty, et al., 2014). They may want to talk with the therapists for longer periods and they may feel frustrated when the therapist allocates only a few minutes to them since they generalize that everyone does not like to listen to them. Before the first session begins it is important to clarify with the client the length of the sessions you will be having with them so that there is no misinterpretation on the length of time allocated to them (Henretty, et al., 2014).

In therapy Transference is the transferal of patients feelings from  a significant person to the therapist while counter transference is noted as the rerouting of the therapist emotional state towards the client (Henretty, et al., 2014). Therefore it is important that therapeutic boundaries are in place so that a beneficial relationship that takes place is not violated  and at  the same time the client is able to get the treatment he or she needs in the most professional way possible this article explores this boundaries within a mental service environment. Boundaries are important in any client patient relation, and can be violated within these different parameters which are Power, Trust, Respect and personal closeness (Brown 2017).

Sexual Misconduct

In this case, in reference to power the client sees the therapist as all powerful, and it is because of this that the client comes to the therapist for guidance or help (Beck, Freeman and Davis 2015). It is therefore very easy for the therapist to violate this power, and infringe on the patient’s rights for instance, the Therapist changing the time set for therapy without liaising with the patient or forcing the patient to attend therapy would show abuse of power. In reference to counter transference the therapist might want to use the power he has to ask a victim who was maybe sexually abused by a former therapist into not reporting the incidence or even go further into making the patient believe that incident never happened (Drum and Littleton 2014).

In addition, trust and respect between the patient and therapist come in handy, and are essential this is because the Clients have confidence that the therapist knows what he is doing and has the skills, and aptitudes to give the best care possible. The therapist should ensure that the client can trust him and thus confidently share whatever issues that the client might have help (Beck, Freeman and Davis 2015). In regards to Respect, Therapist is accountable in regards to a client this irrespective of color of the skin, faith, age, or health status (Khalikova 2016).

Last but not least Personal  closeness is also a boundary that needs to be addressed therapist that are inclined to psychoanalysis are probably not likely  to touch their patients this is because their hypothetical model expect that physical contact may satisfy transference unrealities that should be comprehended,  and not carried out. Some therapists affected by this school of thought are more disposed to embrace routinely toward the finish of sessions help (Beck, Freeman and Davis 2015). Personal space is important in mental health this is because some of these patients are violent and some may not want to be touched or any slight provocation would result in the client withdrawing from therapy (Khalikova 2016). Therefore, when boundaries in therapy are crossed and above parameters are upheld it is noted not to be harmful to the patient or the therapist, and is sometimes allowed in therapy but it is wise to note that in the mental health it is not advisable to cross any boundary as this might be detrimental, and when boundaries are violated the infringe on the patient’s rights, and this might also become harmful not only to the patient but also to the therapist (Geller and Srikameswaran 2015).

Conclusion

In conclusion, a mental healthcare provider should maintain high therapeutic relationship. Therapeutic boundaries are the probable social and physical distance between the therapist and the client; this involves issues such as the therapist’s self-disclosure, involvement with the client outside the office, the length of sessions, touch and exchanging gifts. In this case, transference refers to an occurrence whereby the client transfers their feelings about their personal their lives to the therapist. Such feelings are usually manifested in many forms such as h mistrust, hatred rage and high dependence on the therapist.  Therefore, it is important for the therapist to identify and deal with transference and countertransference that occurs during therapy by putting in place firm boundaries. The therapist should give the client a secure environment to express their feelings including the uncomfortable ones. By understanding the therapists own countertransference, he is able to manage the outcomes to ensure it does not jeopardize the wellbeing of the clients. It also provides an opportunity for the therapist to be more empathetic since they can relate to the client’s experiences. The therapist’s ability to understand the client’s transference can be a great tool in treatment since it indicates the source of the problem and the therapists can establish the proper way to help the client. The therapeutic boundaries enable us to deal with transference and countertransference in more appropriate ways to avoid harming clients.

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