Deck 7: Managing Boundaries and Multiple Relationships

Question 1

Joe has a counseling practice and is also teaching psychology part-time at a university. He is well-liked and trusted by students and some have asked for private counseling. Joe has decided to wait until semester break before taking them on as clients. Joe would be:

A) exhibiting ethical behavior by telling his students that he will counsel them at the end of the semester.
B) in a dual relationship with his students, which may cause ethical problems.
C) playing favoritism by not counseling all of his students.
D) not qualified to counsel his students because he is a part-time instructor.

Answer 1

B

Question 2

Bonnie became sexually involved with her therapist soon after therapy began. This action was initiated by the______________________ therapist who saw Bonnie's provocative behavior as an invitation to become intimate. Which of the following is NOT______________________a possible on-going consequence for the client being sexually exploited?

A) Experiencing feelings of freedom and peacefulness
B) Experiencing feelings of shame and guilt and Post Traumatic Stress Disorder
C) Experiencing depression, fear, and anger
D) Experiencing isolation, a stronger distrust, and suicidal tendencies

Answer 2

A

Question 3

Ted is a counselor educator and also acts as therapeutic agent for his students' personal development, since personal awareness is considered to be an intrinsic part of developing counselor skills in the program at the university in which he teaches. Ted is:

A) totally unethical in attempting to guide his students towards self-awareness.
B) involved in a situation in which he will become so subjective that he will be unable to teach his students.
C) involved in role blending, which is inevitable in the process of educating and supervising counselor trainees.
D) in a situation that automatically leads to a conflict of interest.

Answer 3

C

Question 4

Therapists can deal with powerful attractions to clients by:

A) repressing their feelings of attraction.
B) asking the client if the feeling is mutual.
C) terminating the relationship immediately.
D) monitoring boundaries by setting clear limits on physical contact, self-disclosure, and client requests for personal information.

Question 5

According to the National Organization for Human Services, the following is TRUE concerning dual relationships:

A) There is a clear consensus among practitioners regarding nonsexual relationships in counseling.
B) Due to the fact that there are clinical, ethical, and legal risks, all blending of roles must be avoided.
C) Objectivity in counseling is enhanced with dual relationships.
D) Professionals support the trust implicit in the helping relationship by avoiding dual relationships that may impair professional judgment, increase the risk of harm to clients, or lead to exploitation.

Question 6

______________________is a serious breach that results in harm to clients and is therefore unethical.

A) A slippery slope
B) A dual relationship
C) A boundary violation
D) A malpractice suit

Question 7

Which one of the following is NOT considered a guideline to minimizing the likelihood of sexual transgressions by clinicians?

A) Seek professional support during times of personal loss or crisis.
B) Differentiate between having sexual attraction to clients and acting on this attraction.
C) Avoid terminating the therapeutic relationship, even when sexual feelings obscure objectivity.
D) Make it a practice to examine and monitor feelings and behaviors toward clients.

Question 8

Linda is considering developing a multiple or dual relationship with her client. It's important for Linda to remember:

A) that all multiple relationships should be avoided because they are usually harmful.
B) that absolute answers are available to resolve dual or multiple relationship dilemmas.
C) to be cautious in order to protect herself from censure.
D) to consider whether the potential benefit outweighs the potential for harm.

Question 9

A common reaction of therapists who realize that they have sexual feelings towards their clients is to:

A) feel angry at themselves.
B) speak openly about the matter to the client.
C) investigate to see if the client feels the same.
D) feel guilty, anxious, and confused.

Question 10

Boundary management is:

A) not an issue in sparsely populated areas.
B) less challenging in rural areas than in urban areas.
C) equally as challenging in rural and urban areas.
D) more challenging in rural areas than in urban areas.

Question 11

Departures from commonly accepted practices that could potentially benefit clients are referred to as:

A) unethical boundaries.
B) boundary crossings.
C) boundary violations.
D) interpersonal boundaries.

Question 12

Which of the following situations does NOT have the potential to harm or exploit a client?

A) Entering a business venture with a client
B) Developing a sexual relationship with a client
C) Establishing a social relationship with a client
D) Setting healthy boundaries during the initial visit

Question 13

When a client is unable to afford therapy, it is possible that he or she may:

A) offer a bartering arrangement or exchanging goods in lieu of a fee.
B) offer sexual favors in exchange for services.
C) force the therapist to continue treatment free of charge.
D) report the therapist to his or her license board if he or she refuses to continue treatment and receive payment when the client can afford it at a later date.

Question 14

Marty is counseling with an Asian client who recently returned from a trip to Japan to visit relatives. His client wants to give him an inexpensive souvenir. It is important for Marty to:

A) refuse the gift on ethical grounds.
B) explain that the gift would change their relationship and create a conflict of interest.
C) be aware that accepting the gift may be culturally appropriate with this client.
D) explain that he cannot accept the gift until the counseling relationship is over.

Question 15

A counselor is likely to adopt stricter social boundaries and will be concerned about polluting the transference relationship if he or she is:

A) psychoanalytically oriented.
B) a behavioral therapist.
C) working with culturally diverse clients.
D) already engaged in an active social life.

Question 16

Clients can file a legal complaint against a therapist for sexual misconduct by all of the following methods EXCEPT:

A) filing a malpractice suit.
B) filing an ethical complaint with the therapist's licensing board.
C) lodging a complaint with the AARP.
D) filing a criminal complaint or a civil suit.

Question 17

In the authors' view, non­erotic touching between counselor and client should be:

A) a spontaneous and honest expression of the therapist's feelings.
B) incongruent with what they feel.
C) a therapeutic technique used to extinguish catharsis.
D) considered unethical.

Question 18

Which of the following actions would maximize the risks inherent in dual or multiple relationships?

A) Setting healthy boundaries from the outset
B) Securing informed consent of clients and discuss with them both the potential risks and benefits of dual relationships
C) Documenting any dual relationships in clinical case notes
D) Becoming romantically involved with the client

Question 19

In regards to boundaries in the counseling relationship, Lazarus takes the position that:

A) certain ethics and boundaries actually diminish therapeutic effectiveness.
B) all boundaries should be eliminated because they destroy the counseling relationship.
C) strong boundaries must be maintained in order to avoid malpractice suits.
D) traits such as flexibility, spontaneity, and warmth tend to be characteristics of therapists who maintain strong boundaries.

Question 20

According to professional codes of ethics, sexual relationships between client and counselor are considered to be ethical under which of the following circumstances?

A) If the therapist is really in love with the client.
B) If there is consent by the client.
C) These relationships are not considered to be ethical under any circumstances.
D) If the sexual relationship begins within six months of termination.

Question 21

Mentors often balance a multiplicity of roles. Which of the following would NOT be considered one of these roles?

A) Teacher and counselor
B) Role model
C) Guide and friend
D) Partner

Question 22

Clinicians who oppose any form of physical contact with their clients (e.g., non-erotic touching) believe all of the following EXCEPT:

A) it can promote dependency.
B) it can interfere with the transference relationship.
C) it can be misread by clients.
D) it can become a healthy romantic relationship.

Question 23

Which of the following is NOT a code of ethics in regards to sexual contact and the therapeutic relationship from various professional organizations?

A) Sexual intimacy with current clients, or their spouses or partners, is prohibited. Engaging in sexual intimacy with individuals who are known to be close relatives, guardians or significant others of current clients is prohibited.
B) Psychologists do not engage in sexual intimacies with current clients/patients; however, if a client/patient has not been treated within two years a relationship may become ethically approved.
C) Sexual or romantic counselor-client interactions or relationships with current clients or their family members are prohibited.
D) Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this______________________standard.

Question 24

Which of the following is NOT a possible multiple relationship in a small community?

A) A therapist might attend the same church or community activities as the clients they serve.
B) A therapist who is a recovering alcoholic and attends Alcoholics Anonymous meetings may meet a client at one of these meetings.
C) A therapist isolates him or herself in order to limit the possibility of multiple relationships.
D) In an isolated area, a clergy person may seek counseling for a personal crisis from the only counselor in the town - someone who also happens to be a parishioner.

Question 25

Few professional codes of ethics specifically address the topic of giving or receiving gifts in the therapeutic relationship. The AAMFT does have such a guideline and it states that marriage and family therapists:

A) cannot give to or receive from clients gifts of substantial value or that impair the integrity or efficacy of the therapeutic relationship.
B) can give to or receive from clients small gifts of little monetary value.
C) can give to or receive from clients gifts when given during an appropriate and healthy therapeutic relationship.
D) cannot give or receive gifts under any circumstances.

Question 26

Miguel has been providing couples' counseling to Saundra and Steven for a couple of years and was recently invited to attend their 20^th wedding anniversary party. Attending this event is an example of:

A) a boundary violation.
B) a potentially beneficial non-professional interaction.
C) an unprofessional interaction.
D) a lapse of judgment.

Question 27

Neglecting to attend to family-of-origin issues can lead to such as being attracted to clients.

A) blind spots
B) bartering
C) the ethical deterioration phenomenon
D) the slippery slope phenomenon

Question 28

Which of the following statements about giving or receiving gifts is FALSE?

A) Lavish gifts certainly present an ethical problem; yet, we can go too far in the direction of trying to be ethical and actually damage the therapeutic relationship.
B) It is important to recognize when accepting a gift from a client is clinically contraindicated and that you be willing to explore this with your client.
C) In working with culturally diverse client populations, clinicians often discover that they need to engage in boundary crossing to enhance the counseling relationship.
D) It could be more problematic to accept a gift at a later stage of a counseling relationship.

Question 29

The notion that certain actions will inevitably lead to a progressive deterioration of ethical behavior is commonly referred to as:

A) the slippery slope phenomenon.
B) therapist decay.
C) the ethical deterioration phenomenon.
D) role erosion.

Question 30

All of the following are true about bartering EXCEPT:

A) bartering can be a dignified and honorable form of payment for those who are cash poor but talented in other ways.
B) bartering is a healthy norm in many cultures.
C) bartering is illegal and unethical.
D) bartering can be part of a clearly articulated treatment plan; like other interventions, bartering must be considered in light of the client's needs, desires, situation, and cultural background.

Question 31

Which of the following is NOT a controversy of boundary issues?

A) Age, diagnosis, life experiences such as abuse, and culture are key elements of the therapeutic relationship.
B) An unfortunate reality is that some practitioners have difficulty distinguishing where appropriate boundary lines should be drawn.
C) The goal of ethical decision making is to take a position where the potential for exploitation is minimized.
D) Failing to establish clear boundaries can be very dangerous to both the client and the therapist.

Question 32

When in conflict with clinical needs, context, competence, or consent, even the most well-intentioned nonsexual physical contact may be experienced as:

A) appropriate, gentle, and wanted contact.
B) aggressive, frightening, intimidating, demeaning, arrogant, unwanted, insensitive, threatening, or intrusive.
C) passive, soothing, calming, comforting, gentle, and peaceful.
D) completely indifferent for both therapist and client.

Question 33

Which of the following is NOT a reason for discouraging the practice of accepting friends as clients or of becoming socially involved with clients?

A) Therapists may not be as challenging as they need to be with clients they know socially because of a need to be liked and accepted by the client.
B) Therapists may be as effective with clients they know socially as they are with clients they have never met previously to the therapeutic relationship.
C) Counselors' own needs may be enmeshed with those of their clients to the point that objectivity is lost.
D) Counselors are at greater risk of exploiting clients because of the power differential in the therapeutic relationship.