Help when therapy boundaries are violated

Dear Reader,

If something that is happening with a mental health professional upsets you or someone you care about, it may be a good idea to explore the situation and even talk about it with a trusted family member, friend, or mentor. Within a healthy mental health professional-client relationship, it's normal, and even appropriate at times, for some of the work in therapy to be unsettling. For many, doing work in therapy can mean that issues often arise that can be confusing, anxiety-producing, sad, or even scary, and some of these feelings may even be directed at the therapist. It's also common for there to be instances when the mental health professional and client disagree or the client feels unsatisfied with the way the sessions are going. These can be constructive issues to discuss with the mental health professional — assuming that overall the relationship feels safe and supportive. However, there is a difference between feeling challenged by the emotions that therapy brings up and feeling as though the professional and ethical boundaries of a patient-provider relationship have been crossed. If the relationship isn't one that is safe and supportive, and the therapist has crossed professional boundaries, there are actions that clients can take.

In general, therapists with credentialed professional training are responsible for adhering to the Code of Ethics developed by their professional association(s). Each of these organizations has a set of guidelines that are designed to protect clients while ensuring thorough, respectful, and safe care. These guidelines can include rules such as not entering into any outside relationship with a client (such as a friendship, romance, or business deal), respecting a client's self-determination and privacy, clearly communicating fees, availability, changes in treatment and many additional standards of conduct. However, something to keep in mind is that not all people claiming to be counselors or therapists have professional training or affiliations. When choosing a mental health professional, considering the training (graduate and post-professional, as well as training certificates) of the person you're checking out can ensure that they're qualified to provide the type of care you're seeking. You can do this by asking the person directly about their credentials and experience. You can also contact the various professional organizations for a list of providers in your area or check on the validity of a professional's stated affiliations. This is not to say, however, that all credentialed professionals always behave in ethical ways or that those without specific professional training exploit their clients.

Each of the recognized professional organizations for therapists have procedures for filing complaints about members. Some suggest consumers direct their concerns to their local chapters, and the contact information for each is on their national websites. Some associations accept complaints by telephone or e-mail, while others require the client to submit their complaints in writing. For example, the American Psychiatric Association suggests that written complaints include a letter with a brief explanation of the situation, as well as the time of the treatment. Additionally, including your name and contact information will allow the committee looking into your complaint to gather further details from you if necessary. For more information on filing complaints, you can check out the websites of the following professional organizations for therapists:

• National Association of Social Workers
• American Psychological Association
• The Association of State and Provincial Psychology Boards
• American Psychiatric Association
• American Association for Marriage and Family Therapy

If you're a student engaged in therapy at school, your first step can be to voice or file a complaint with the director of the counseling service. Keep in mind that the receipt and investigation of an ethical complaint against a mental health professional doesn't necessarily result in the removal of an individual's professional license, arrest, or any other sanctions.

Hope this information helps,