Tuesday, June 10, 2014

Dr. Kim is an experienced therapist with more than 15 years of practice. He is a quiet and reserved man. A new client, Susan, asks Dr. Kim for a hug at the end of a session. Though feeling uncomfortable, he allows it. This happens at the end of the next 3 sessions, and he becomes increasingly uncomfortable. He seeks supervision from a more experienced therapist. In reading the case study for Unit 6, how do you assess Dr. Kim's behavior? Do you see any potential ethical issues?

Based on the information provided in the post, in which the case study referenced is not provided, several actual and potential ethical issues arise. Issues of physical contact are frequently discussed in regard to therapist-patient interactions. Non-sexual touch is not prohibited in professional associations’ ethical guidelines but is recommended only as part of the treatment process. Regarding “hugs” specifically, one idea that has arisen is “virtual hugs,” in which therapists help the patient understand the meaning of such touching.
The description of Dr. Kim indicates that he is “experienced” and has been in practice for “more than 15 years.” If he were described as a beginner, then it might be understandable that he would allow and implicitly encourage physical contact with his patient, but an experienced doctor should be thoroughly familiar with professional ethical guidelines and refrain from such ambiguous contact. The description of the multiple repetitions of the physical contact emphasize his “feelings,” which are “increasingly uncomfortable.” The emphasis placed here on the doctor’s emotional reaction also serves to indicate that he has not been applying a rational approach to the situation. In addition, the post mentions that the physical contact occurs on four separate occasions, although it does not specify the period of time between the sessions, before he contacts a more experienced colleague; this might be four weeks or even four months.
The initial description of the doctor’s personality as “quiet and reserved” is not an adequate explanation for his behavior. This does not account for him not telling the patient on the first occasion that there should be no “hugs” or similar physical contact between doctor and patient, or allowing that contact to continue on even one more occasion. The information provided raises numerous questions about his approach to boundary issues. The more experienced therapist whose opinion he sought will almost certainly ask those questions. Dr. Kim seems incapable of controlling professional interactions with this patient, so he should probably recommend that she work with a different therapist. It is not unlikely that she could file a complaint, for she may be under the impression that he initiated the contacts.
https://ct.counseling.org/2017/03/healing-language-appropriate-touch/

https://www.psychologytoday.com/us/blog/talking-about-trauma/201707/hands-approach-psychotherapy

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