Avoiding Slippery Slopes

 

This is an ethics workshop, not a risk-management workshop:
in other words, the focus is on the risks to patients, not to ourselves.
We know that sometimes making exceptions to our usual ethical and clinical practices
can start us on a path  from which it can be very hard to recover,
and which can ultimately affect clinical outcome and patient welfare.
How can we recognize when we are about to take a step we will later regret?
Where are we each most vulnerable?
What support and reminders would be most helpful?

I. Establishing Clear Policies

A. Administrative, Scheduling, & Financial Policies

B. Clinical Policies (e.g., Session Frequency, Time, & Timing)

C. Boundaries

Within the Session (Physical Boundaries; Therapist Self-Disclosure, etc.)

Outside the Session (In Person or Electronically)

D. Confidentiality & Disclosure

E. Informed Consent

II. Living Up to Our Informed Consent Promises

III. Avoiding the Predictable Pitfalls

A. Resisting Temptations to Breach Confidentiality Unethically

Voluntary Disclosures

“Involuntary” Disclosures

B. Avoiding the Creation of “Avoidable” Conflicts of Interest

C. Resisting Pulls Toward Problematic Dual Relationships

D. Remaining Alert to Avoid Real or Perceived Boundary Violations

 IV. Monitoring Our Current State

A. Personal Stressors Leading to Therapist Over-Disclosure

B. Unmet Need for Support

C. Inadequate Self-Care Leading to Tired/Sleepy/Burned-Out

D. Unmet Need for Therapy

V. Acknowledging Our Clinical Limitations

VI. Acknowledging Our Personal Vulnerabilities

VII.  Understanding the Consequences for Patients

Workshop History:
Friday, March 9, 2012 - Fairfax VA
Monday, June 4, 2012 - Charlottesville VA
Monday, June 18, 2012 - Richmond VA
Saturday, April 20, 2013 - Falls Church VA
Saturday, June 28, 2014 - Williamsburg VA