Essay Example on John and Emma: Benefits and Harms of Counselling Relationship

Introduction

Therapists may offer services to patients at home or the hospitals. This is a fully professional setting and only matters concerning the client should be discussed. However, the therapists many times find themselves in difficulty when they try to go outside the needs of the client and talk about their needs. This results in some unethical challenges. They need to observe boundaries and be cautious.

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Ethics can be described as the accepted moral behavior that regulates the behavior of a person when he or she is acting (Knapp & Slattery, 2004). In other words, it defines what is acceptable and what is not. On the other hand, a law is a set of principles or rules that have been written and enforced through bodies.

Boundaries can be defined as the rules of any professional relationship that makes the relationship be set apart from any other relationship (Knapp & Slattery, 2004). In essence, the make the actions that are acceptable or unacceptable for that professional setting in contrast to those which are not appropriate in other settings. Considering that the boundaries create a structure for the therapy and also set the limits, they help in protecting patients. Moreover, the developed atmosphere as a result of the boundary will make the patients feel at easy reflecting on their issues instead of being concerned about what the psychologists need. Additionally, the boundaries make it clear that a patient receives therapy so that mainly his or she needs to take center-stage and not those of the therapist.

A therapist could have several relationships with just a single client. In such a situation where the therapist has at least one other relationship with the patient besides the primary one, a multiple boundary relationship is said to exist. There are different types of multiple relationships such as sexual, business and financial. It is not a requirement that all the secondary relationships with the patient be avoided. Only the most harmful ones to the client must be avoided (Wendel, 2014). It should be noted that it is almost impossible to not have even a single secondary relationship.

Several boundaries could be crossed and abused. This is termed as boundary violation or crossing. It occurs when the therapist goes beyond the accepted line of trust and uses both his power and integrity (Krishnaram, Aravind & Thasneem, 2012). Most of the boundary violations are unethical and illegal. Many of them are normally sexual or business relationships.

The case study that is being considered is one with a patient and a therapist. The therapist is John while the patient is Emma. He is to take Emma through grief counseling. However, he has interacted with Emma through other avenues. Firstly, he had bought a car from her husband immediately after the relocation. Secondly, John volunteers in an NGO where the husband to the patient is a well-known individual. Finally, one of the sons of Emma is the student of the therapist in one of his classes. The primary relationship, in this case, should be the doctor helping the patient to recover from grief. However, from the description given, there are other relationships that the therapist has with the patient. The relationships could be beneficial or harmful to the patient.

Benefits to Emma and the Counselling Relationship

All the multiple relationships that are non-sexual with Emma cannot be deduced to be harmful (Zur, 2016). This is because it can be practical and not many would want it. It should be considered that although the setting in this case study is in a rural area that mostly has a smaller population, even if the setting was in the big cities, a patient and his therapist could meet in a non-therapeutic setting (Harley et al., 2018). This could be by accident. The case here involved word-of-mouth invite the private practicing John. This implies that John had to deal with both the church pastor and Emma. This also constitutes multiple relationships.

The counseling relationship could prove to be beneficial to Emma. For instance, Emma and John were linked by the pastor. This will help in creating good trust and the development of a desirable working alliance (Johnson & Barnett, 2016). It should be noted that the pastor could be monitoring the progress of his church member, Emma, and if good, the relationship could be solid. It could reach a point whereby if the multiple relationships have more than therapeutic value. This means that if John tries to end the other relationships, Emma could be affected adversely. For instance, Emma's son could be graduating from the professional ethics class and she could invite John to attend. If John fails to go for the graduation, Emma would lose trust and thus the treatment and the healing would be disrupted (Zur, 2016).

Also, Emma could feel that the process has really helped and thus invite him for another personal event such as if the husband decides to run for the chairmanship of the NGO and he is to be inaugurated. If John is invited and refuses to attend the inauguration, Emma could feel that the interest of John in her life is disingenuous. This could harm the counseling relationship (Corey et al., 2019). Therefore, the counseling relationships, in this case, would be beneficial for the reasons described above.

Harms to Emma and the Counselling Relationship

The multiple relationships are addressed in the ethics code (Herlihy & Corey, 2015). One of the reasons for this is that most of the lawsuits against therapists involve cases concerning boundary crossings. In this case, Emma could get harm as a result of his multiple relationships with John. Firstly, since they already have several other relationships, both John and Emma and in particular, John could lose his professionalism. The main effect of this would be poor judgment and making of decisions to assist in the counseling of Emma's grief. Besides, what he may advise Emma to do at this point may not be useful to her.

Secondly, John could decide to exploit Emma (Herlihy & Corey, 2015). The most type of exploitation that John could give Emma is undue power and influence. For instance, he could tell her to ask his husband to give him favors at the NGO considering the husband is respected there. Besides, he could have asked Emma to tell the husband to reduce the price of the car. Worse exploitation could be a sexual transgression. This could happen that since Emma is emotional and griefing, John could trigger the emotions that can make her lose for engaging in sexual activities with her.

Ethical Concerns and Implications

All mental health association condemns sexual exploitation (Burgard, 2013). It is also forbidden by law. It should be mentioned that engaging in sexual activities be verbal, insinuations or even the act is self whether with former clients or current is completely unethical.

Many of the research agree that any form of sexual relationship with the client would be harmful to them in some way or another (Burgard, 2013). Sexual relationship is the only one which is elaborated condemned by all scholars and the law. Another ethical concern is that the setting in which John is operating in rural areas where there are normally small communities. Therefore, he might be the only therapist in that area. This means that he cannot refer Emma to a different therapist so that he avoids the issue of multiple boundaries. Hence, he has to find a way to deal with ethical issues. The main issue that the client could be harmed.

Management of the Case

The pastor should continuously monitor the progress of his church members. If she is doing he should let him continue.

Recommendations for John and Reasons

John should not take advantage of the grief of the patient and exploit the opportunity for his good (Fisher, 2017). He should refrain from engaging in any activity that may put the healing of the patient in danger. In general, his main aim should be the treatment of Emma.

Conclusion

The issue of multiple relationships and boundary-crossing is critical since it could lead to the disruption of the treatment. Only sexual relationships are strictly forbidden in all mental health associations. The others and especially when in rural settings such as the case of John, are left open. The boundaries must be clearly defined between what is professional and what is not so that harm can be avoided. Moreover, the relationships between the two should be given close monitoring and analysis so that Emma is not affected. In conclusion, the situation should be monitored to ensure that Emma's treatment is not disrupted and that she is not harmed.

References

Burgard, E. L. (2013). Ethical Concerns about Dual Relationships in Small and Rural Communities - A review. Journal of European Psychology Students, 4(1), 69. DOI:10.5334/jeps.az

Corey, G., Corey, M. S., & Corey, C. (2019). Issues & ethics in the helping professions. Australia: Cengage Learning.

Fisher, C. B. (2017). Decoding the ethics code: A practical guide for psychologists. Los Angeles; London; New Delhi; Singapore; Washington DC; Melbourne: SAGE.

Harley, D. A., Ysasi, N. A., Bishop, M. L., & Fleming, A. R. (2018). Disability and vocational rehabilitation in rural settings challenges to service delivery. Cham: Springer Nature.

Herlihy, B., & Corey, G. (2015). Boundary issues in counseling: Multiple roles and responsibilities. Alexandria, VA: American Counseling Association.

Johnson, B., & Barnett, J. (2016). Boundaries and Barriers Within Counseling Relationships. Relationships in Counseling and the Counselors Life, 121-144. DOI:10.1002/9781119375463.ch9

Knapp, S., & Slattery, J. M. (2004). Professional Boundaries in Nontraditional Settings. Professional Psychology: Research and Practice, 35(5), 553-558. DOI:10.1037/0735-7028.35.5.553

Krishnaram, V., Aravind, V., & Thasneem, Z. (2012). Boundary Crossings and Violations in Clinical Settings. Indian Journal of Psychological Medicine, 34(1), 21. DOI:10.4103/0253-7176.96151

Wendel, W. B. (2014). Ethics and law: An introduction. Cambridge: Cambridge University Press.

Zur, O. (2016). Multiple Relationships in Psychotherapy and Counseling. DOI:10.4324/9781315676135