A Preliminary Look at How Psychologists Identify, Evaluate, and Proceed When Faced With Possible Multiple Relationship Dilemmas.

Psychologists identified which nonsexual multiple relationships (MRs) they most frequently had to negotiate with current and former clients, supervisees, and students. Information was also gathered on how potential sexual MRs develop and why such relationships do not ultimately occur. Nonsexual MRs were discussed or addressed most frequently with supervisees, and social interactions and events were the types of relationships that were most frequently discussed. Actions cuing a potential sexual MR are also described, and rationales that deterred psychologists from actually engaging in sexual relationships are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual and nonsexual boundary violations involving psychologists, clients, supervisees, and students: Implications for professional practice.

What is available to psychologists to assist them in identifying or minimizing the damage that can result from inappropriate professional boundary crossings? Frequency data of both sexual and nonsexual boundary violations by psychologists are provided as they occurred with clients, supervisees, and students. The impact of engaging in such relationships on subsequent professional practice is also reported. Data on 18 nonsexual boundary crossings are described, and guidelines for making decisions about crossing accepted professional boundaries are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple relationships encountered by lesbian and bisexual psychotherapists: How close is too close?

There is consensus that sexual relationships with clients are unethical; however, there is ongoing debate regarding nonsexual multiple relationships. Rural psychologists report especially high incidences of multiple relationships, and several authors have suggested that lesbian and bisexual psychologists may be faced with similarly frequent and complicated multiple relationships due to the small size of those communities. Fifty-two lesbian and bisexual psychotherapists (45 of them psychologists) described 109 critical incidents involving either multiple relationships or decisions involving potential relationships. From these responses, we documented multiple relationships encountered by lesbian and bisexual women psychotherapists, considerations these clinicians used in deciding whether to take on multiple roles, and strategies they used to either prevent or cope with nonsexual multiple relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy and the recovery of memories of childhood sexual abuse: U.S. and British practitioners' opinions, practices, and experiences.

Psychotherapists were surveyed regarding clients' memories of childhood sexual abuse (CSA). The 3 samples were highly similar on the vast majority of measures. Respondents listed a wide variety of behavioral symptoms as potential indicators of CSA, and 71% indicated that they had used various techniques (e.g., hypnosis, interpretation of dreams) to help clients recover suspected memories of CSA . Across samples, 25% of the respondents reported a constellation of beliefs and practices suggestive of a focus on memory recovery, and these psychologists reported relatively high rates of memory recovery in their clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy, professional relationships, and ethical considerations in the myspace generation.

The pervasive use of Internet technologies has created new ethical dilemmas for psychology trainees and professionals. In particular, Web sites that allow users to post personal information have sparked controversy regarding the amount of freedom psychologists should have in placing personal information online and how discovering such information may impact professional relationships, including the therapeutic relationship. Results from a graduate student survey (N = 302) address the prevalence of the use of online social networking sites, security measure efforts that limit public access, incidents of client access to psychotherapists’ personal Web sites and Internet use by psychotherapists to obtain client information, and their subsequent effect on the therapeutic relationship. Using applicable ethical principles and standards, we provide recommendations for the field in an effort to decrease potential harm and maximize areas of opportunity for psychologists and constructive professional relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual relationships between therapist and client: A national study of psychologists, psychiatrists, and social workers.

4,800 psychologists, psychiatrists, and social workers were surveyed (return rate?=?49%) to examine attitudes and practices regarding dual professional roles, social involvements, financial involvements, and incidental involvements. Half of the Ss rated the degree to which each behavior was ethical; the other half reported how often they engaged in each behavior. A majority believed dual role behaviors to be unethical under most conditions; most reported that they had rarely or never engaged in the behaviors. 10 factors (therapist gender, profession, age, experience, marital status, region of residence, client gender, practice setting, theoretical orientation, and practice locale) were examined for their relation to the beliefs and behaviors. A higher proportion of male than of female therapists were perpetrators of sexual and nonsexual dual relationships. The professions did not differ among themselves in terms of (a) sexual intimacies with clients before or after termination, (b) nonsexual dual professional roles, (c) social involvements, or (d) financial involvements with patients. 10 specific training implications are discussed in light of the exploitive and clinically harmful nature of dual relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary survey of counseling psychologists' personal experiences with depression and treatment.

The fact that psychologists may not realize how much their own diagnosable emotional problems can impact their practices led to the undertaking of an exploratory survey of practicing psychologists in order to assess that notion. The results of a random sample of 1,000 psychologists indicate that women were more frequent respondents than men by a ratio of 3 to 2 and that depression (dysthymia) was the most frequently acknowledged diagnosis. Respondents felt that their emotional issues gave them more empathy for their clients; however, they also experienced an increased sense of isolation from their colleagues and lessened energy and ability to concentrate in their relationships with their clients. Recommendations are offered for self-care practices for psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonromantic, nonsexual posttherapy relationships between psychologists and former clients: An exploratory study of critical incidents.

The authors asked 320 psychologists to participate in a nonrandom, exploratory study by providing incidents of nonromantic, nonsexual relationships with former clients. In addition, these psychologists were asked to discuss whether they saw these relationships as ethically problematic. A total of 91 useable incidents (from a final sample size of 63 respondents) were sorted into eight relationships categories. The results of this study highlight several issues: (a) Psychologists are dealing with a variety of nonromantic, nonsexual relationships with former clients, (b) there is little consensus about the ethicality of these contracts, and (c) future revisions of the Ethics Code (American Psychological Association, 1992) may need to consider nonsexual and nonromantic relationships with former clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients Who Stalk Psychologists: Prevalence, Methods, and Motives.

There is emerging recognition that psychologists are susceptible to various forms of intrusiveness by clients, including stalking. Information regarding the contexts in which stalking emerges and the behaviors to which clinicians are subjected is limited. A random sample of Australian psychologists (N = 1,750) was surveyed to ascertain the prevalence, nature, and occupational impact of stalking by clients. Of the 830 respondents, 19.5% had been stalked for 2 weeks or more. Psychologists typically perceived the stalking to be motivated by resentment (42%) or infatuation (19%). Most practitioners altered their professional practice as a consequence of the harassment and 29% considered leaving the profession. Stalking by clients is a salient professional issue that requires greater attention to better manage conduct that is potentially damaging to both therapists and clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Remembering childhood sexual abuse: A national survey of psychologists' clinical practices, beliefs, and personal experiences.

A national survey of 1,000 psychologists, to which 223 responded, assessed professionals' clinical practices and beliefs about the treatment of adult survivors of childhood sexual abuse (CSA), personal CSA history, and the phenomenon of clients remembering CSA in therapy. Results indicated that over 25% of therapists reported using guided imagery, dream interpretation, bibliotherapy regarding sexual abuse, referral to sexual abuse survivors' group, and free association of childhood memories as memory retrieval techniques with clients who had no specific memory of CSA. However, the majority of therapists reported that they had not seen any cases of adult clients entering therapy with no memory of CSA and subsequently recalling abuse in the course of therapy. A personal history of CSA was not associated with most clinical practices related to treating sexual abuse survivors. The implications for training and establishing scientific standards of psychological practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual-relationship dilemmas of rural and small-community psychologists.

Sixteen licensed psychologists who lived and practiced in rural areas and small communities participated in interviews about ethical dilemmas they faced in daily practice. Dilemmas involving professional boundaries were identified as significant concerns for all of the psychologists. Major themes were the reality of overlapping business relationships, the effects of overlapping relationships on members of the psychologist's own family, and the dilemmas of working with more than 1 family member as clients or with others who have friendships with individual clients. The psychologists knew the content of ethical codes but often struggled in choosing how to apply those codes in the best interest of clients. Ongoing discussions regarding these choices can contribute to the evolution of practice codes applicable to rural areas and other small communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

African American and European American therapists' experiences of addressing race in cross-racial psychotherapy dyads.

Using Consensual Qualitative Research, 12 licensed psychologists' overall experiences addressing race in psychotherapy were investigated, as were their experiences addressing race in a specific cross-racial therapy dyad. Results indicated that only African American psychologists reported routinely addressing race with clients of color or when race was part of a client's presenting concern. European American psychologists indicated that they would address race if clients raised the topic, and some reported that they did not normally address race with racially different clients. When discussing a specific cross-racial dyad, African American therapists more often than European American therapists addressed race because they perceived client discomfort. Only European American therapists reported feeling uncomfortable addressing race, but therapists of both races perceived that such discussions had positive effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guidelines for psychotherapy with lesbian, gay, and bisexual clients.

Provides guidelines intended to assist psychologists in seeking and using appropriate education and training in their treatment of lesbian, gay, and bisexual clients. The specific goals of these guidelines are to provide practitioners with (1) a frame of reference for the treatment of lesbian, gay, and bisexual clients and (2) basic information and further references in the areas of assessment, intervention, identity, relationships, and the education and training of psychologists. These guidelines are organized into 4 sections: (1) attitudes toward homosexuality and bisexuality, (2) relationships and families, (3) issues of diversity, and (4) education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologist suicide: Incidence, impact, and suggestions for prevention, intervention, and postvention.

Psychologist practitioners are not immune to certain mental health problems, including suicidality, for which they provide services. In the aftermath of two recent psychologist suicides, the American Psychological Association's Advisory Committee on Colleague Assistance (ACCA) initiated the formation of a conjoint ad hoc committee consisting of members from ACCA, the American Psychological Association (APA) Practice Directorate, and the Section on Clinical Emergencies and Crises (Section VII of APA's Division 12) to investigate the incidence of psychologist suicide and its impact on colleagues, students or interns, patients or clients, and the profession. The committee reviewed the extant empirical literature on suicide rates for psychologists, evaluated unpublished data on psychologist suicide provided by the National Institute of Occupational Safety and Health (NIOSH), interviewed colleague survivors, reviewed published case reports of the impact of therapist suicides, and linked their findings to the literature on professional distress, impairment, and self-care. The committee concluded that there is evidence suggestive of an elevated risk of suicide for psychologists in past decades. It further concluded that there is a need for further research to confirm if there is a heightened risk of suicide for psychologists in the present day and to determine factors that might contribute to such risk. Accounts from colleague-survivors suggest that the impact of a psychologist's suicide can affect many people including family, colleagues, students, and patients or clients. This article offers suggestions for possible preventive approaches, for intervention with potentially at-risk colleagues, and for postvention efforts in the wake of a colleague suicide. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sexual intimacy in psychology training: Results and implications of a national survey.

In a nationwide survey of members of American Psychological Association Division 29 (Psychotherapy), which had a 48% return rate (N=481), 10% of the respondents reported sexual contact as students with their educators; 13% reported entering sexual relationships as educators with their students. However, only 2% believed that such relationships could be beneficial to trainees and educators. Gender differences were significant: 16.5% of the women, compared with 3% of the men, reported sexual contact as students; however, 19% of the men, compared with 8% of the women, reported such contact as psychology educators; and 12% of the males, compared with 3% of the females, reported sexual contact as psychotherapists with their clients. Sexual contact in psychology training programs seems to be increasing: 25% of the recent female graduates had had sexual contact, compared with only 5% of those with degrees for more than 21 yrs. The literature on ethics, standards, research, theory, and practice leaves both psychology graduate students and those psychologists responsible for their education without clear expectations, information, or guidelines concerning sexual intimacy in psychology training. This article represents an attempt to raise the issue and to present some initial information. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National survey of ethical practices across rural and urban communities.

This study examines ethical dilemmas and problems that are encountered by psychologists across rural and urban communities. A survey instrument was created on the basis of previous surveys of ethical practices. A national sample of 1,000 psychologists stratified into urban and nonurban practitioners was surveyed; 447 usable surveys were returned. Data analysis revealed significant differences between small town/rural and urban/suburban groups for several ethical categories. Notably, small town/rural psychologists are more likely to encounter several types of multiple relationships than their urban counterparts. Small town/rural practitioners are also more likely to be highly visible, or well-known, in their communities. Qualitatively, respondents described their struggles with dual relationships, and several offered suggestions to cope with boundary issues. These findings suggest the need to study the practice of psychology in rural communities in more depth, to study the impact of rural characteristics on clients and practitioners, and to create a conceptual model of best practices for rural practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do therapists address ethnic and racial differences in cross-cultural psychotherapy?

Ethnic and racial differences between client and therapist affect therapy processes and outcomes, but little is known about the extent to which therapists have dialogues about their differences in therapy. A survey on this topic was completed by 689 APA-licensed psychologists with experience conducting cross-cultural therapy. Most psychologists reported having such discussions, but with less than half of their cross-ethnic/racial clients. Therapists and clients were equally likely to initiate discussions. Reasons for discussing differences varied greatly. Therapists consistently described themselves as comfortable with and skilled at these discussions, and reported that discussions facilitated therapy. Therapists who were female, older, nonminority, less experienced with diverse clients, and viewed training as an important factor were more likely to have discussions about differences. Results point to the need to better understand if, when, and how ethnic and racial differences should be addressed in therapy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Complementary/alternative medicine: Ethical, professional, and practical challenges for psychologists.

Do your clients talk about using various complementary/alternative medicine (CAM) approaches to deal with their problems? Are you aware of the research on these approaches and their possible effect on health? Many popular CAM approaches are described, and the background and efficacy literature on several of them is reviewed and discussed. Ethical, legal, and practical issues for psychologists are discussed. Data from a preliminary survey of members of the American Psychological Association (N=202) on their knowledge and use of CAM are reported. A majority held favorable opinions of the potential legitimacy of alternative modalities, but many correctly assumed that state laws are ambiguous on this matter. This information may help the practicing psychologist respond more effectively when clients talk about their CAM interests and practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of self-help materials for anxiety and depression in mental health services: A national survey of psychologists in Norway.

[Correction Notice: An erratum for this article was reported in Vol 42(3) of Professional Psychology: Research and Practice (see record 2011-11548-002). The author's affiliations were listed incorrectly. The correct affiliations are in the correction.] How do psychologists in clinical practice perceive and use self-help materials for clients with anxiety and depression? The use of self-help materials with guidance from a therapist has been suggested as a way of meeting the increasing need for mental health services. The present study investigated factors relevant to the use of self-help materials for the treatment of anxiety and depression among psychologists employed in mental health services. Among 1863 eligible clinical psychologists in Norway, 815 (43.7%) participated in a national survey. A total of 93.5% of the participants had recommended self-help materials to clients, and approximately half (55.1%) had received requests from their clients regarding self-help materials. Self-help materials were recommended as an adjunct and not as an alternative to therapist contact by 73.0% of respondents, by 16.6% for relapse prevention, and by 1.2% to clients on a waiting list. Internet/computer-based programs were recommended by 2.2% of the participants. The practitioner's previous use of self-help materials to enhance his or her therapy skills and knowledge of self-help materials was related to use of self-help materials with clients. Psychologists working in child mental health services recommended self-help less often than those working in adult services. These results have implications for future efforts to disseminate effective self-help materials through increased attention toward self-help interventions in training and clinical practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Harmful effects of posttermination sexual and romantic relationships between therapists and their former clients.

[Correction Notice: An erratum for this article was reported in Vol 25(4) of Psychotherapy: Theory, Research, Practice, Training (see record 2007-12032-001). Reference was made to the Minnesota law regarding reporting of "any sexual or romantic relationship in which the parties were once therapist and client" (p. 250). Upon further review by the author, it was determined that the law is more complicated than conveyed in the article. A detailed explanation of the law is provided in the erratum, although legal counsel is suggested for further interpretation.] Examines anecdotal evidence regarding the harmful effects of posttermination sexual or romantic relationships between therapists and clients, focusing on relationships between female therapists and former clients who are also women. The question of equality of power between therapists and former clients is addressed. The impact of these relationships on the community in which they occur is considered. It is concluded that posttermination relationships between therapists and clients have the potential to do as much harm as relationships initiated during therapy and that such relationships should be defined as unethical. (PsycINFO Database Record (c) 2010 APA, all rights reserved)