Posted by Penny on October 9, 2003, at 10:17:54
In reply to Re: questionable information » Dr. Bob, posted by jay on October 9, 2003, at 3:10:45
>I am serious..I'll post the whole darn NASW, CASW, and International Federation of social worker's ethical guidelines.
Jay,
I have already posted a link to the ethical guidelines for the NASW and the APA - and, after having read both, I have *yet* to see where they recommend terminating a patient who is experiencing transference, even when the patient expresses those feelings to the therapist. Even in what you have posted, the only person I see saying that a therapist *will* terminate a patient based on the mere voicing of transference is YOU.
As I posted on psychological babble - I spoke with my therapist about this - she holds a Ph.D. from an esteemed university and has many years of experience - and her answer was that a therapist DOES NOT terminate a therapy relationship based on the voicing of transference!!!! Not to mention that I spoke with my former therapist - a clinical social worker who is quite involved at the regional level with the NASW - extensively on the topic of MY transference toward her, and NEVER ONCE did she EVER mention that she had even CONSIDERED terminating me!!! EVEN when I researched her online and then told her what I knew about her, ashamed as I was and afraid as I was, and EVEN when she admitted being upset by my doing that - her response was that she would get over it, and she used the experience to help me work through many of my feelings regarding her and her pregnancy/maternity leave. It was never a question of her terminating me - which would have been paramount to abandonment in my eyes - and which would have made things that much worse regarding my trust issues. In fact, her comment to me was that this was a good opportunity for me to learn that someone could be angry with me WITHOUT LEAVING ME.
On the other hand, my current therapist did say that if the countertransference feelings the therapist was experiencing became too much for the therapist to handle, where it was interfering with the therapy and the best interest of the client, then it was the therapist's obligation to refer the client to another practitioner. That's IF the feelings became too much for the therapist to handle, and that's the THERAPIST'S feelings, NOT the client's feelings.
I think what has upset me, and others, is that you are actually saying something that would cause a therapy client to withhold information from his or her therapist, and I cannot see how that would ever be a good thing. Most of the people I know who are in therapy experience some form of transference, and for those people to keep those feelings, especially when they can be painful, to themselves and to not process them with the therapist, well, I fail to see how that benefits either the patient or the therapist.
Here's what the code of ethics for the APA says about terminating therapy:
10.10 Terminating Therapy
(a) Psychologists terminate therapy when it becomes reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service.(b) Psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship.
(c) Except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide pretermination counseling and suggest alternative service providers as appropriate.
In this case, I would think that termination due to transference would have to fall under (a), and that would be limited to situations where the transference was causing HARM. Or, in (b), if the transference led to unacceptible behaviors, such as stalking. But general transference - as I would imagine occurs in most cases of therapy - wouldn't fall under either of these. A client feeling love, whether mother-child or romantic love, for a therapist doesn't automatically constitute harm, especially if the therapist uses those feelings to help the client.The NASW code of ethics says the following:
1.16 Termination of Services
(a) Social workers should terminate services to clients and professional relationships with them when such services and relationships are no longer required or no longer serve the clients' needs or interests.(b) Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.
(c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client.
(d) Social workers should not terminate services to pursue a social, financial, or sexual relationship with a client.
(e) Social workers who anticipate the termination or interruption of services to clients should notify clients promptly and seek the transfer, referral, or continuation of services in relation to the clients' needs and preferences.
(f) Social workers who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options.
Again - no mention of terminating therapy based solely on transference. In fact, except in unusual circumstances (which, of course, is subjective), it appears to be considered unethical for a social worker to withdraw services when the client is still paying, can still benefit from therapy, and there are no other extenuating circumstances preventing therapy from continuing.I suppose one could consider any transference-related situation as being of potential harm to the client, but having been in therapy myself and having experienced transference first-hand, I can certainly say that that is not the case in my experience. So ALL transference is not bad, and transference in the hands of a skilled practitioner gives much to work with in a therapy setting.
Again, for those who would like to read the codes of ethics in entirety for themselves:
American Psychological Association (APA): http://www.apa.org/ethics/code2002.htmlNational Association of Social Workers (U.S.):
http://www.socialworkers.org/pubs/code/code.aspAlso, the APA has a video available on its website that addresses the issue of patient sexual interest in the practitioner, and how the therapist can deal with it:
http://www.apa.org/videos/4310570.html?CFID=2493388&CFTOKEN=89863392I found this page interesting b/c in the video description, there is a statement about client fears regarding expressing such feelings for the therapist:
Moreover, patients and potential patients frequently misunderstand the probable consequences of their expression of sexual interest in the therapist. In one study of 265 potential patients (Bram, 1997), nearly one-quarter indicated that their therapist would have pursued the sexual interest and another 16% indicated that the therapist would have likely referred him or her to another therapist.
The point, of course, being that therapists most likely will NOT either pursue a sexual interest regarding a patient OR refer that patient to another therapist. The description does address the lack of training in this area for practitioners - hence the video. But the idea behind the video is not to tell therapists to terminate therapy with a client who expresses a sexual interest, but rather to instruct the therapist on the best ways of working with such feelings/information.What I have seen frequently is encouragement for the therapist to take care of him or herself, recognize when transference is becoming a problem, be aware of his or her own feelings and how they are affecting the therapy, and find ways of dealing with those situations should they become difficult - therapy for the therapist, supervision, consultation with another therapist, etc. I feel sure that a competent professional who found him or herself unable to deal with transference issues after attempting to (through the afore mentioned methods, if not others) would THEN, and only then, consider terminating the client.
P
poster:Penny
thread:266500
URL: http://www.dr-bob.org/babble/admin/20031008/msgs/267266.html