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Setting Clear and Ethical Boundaries with Clients

Section 2
Attitude Formation

Question 2 | Test | Table of Contents

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Let's explore in more detail your attitudes and culture since they are the cornerstones of objective decision making and setting ethic boundaries.

♦ 4 Questions for a Self-Awareness Check
Do a self-awareness check regarding an attitude. Let's take the emotionally-charged topic of substance abuse.
1. What is your earliest memory of having a negative reaction to seeing someone drunk?
2. Was it in your childhood?
3. Was it a relative, family friend, or neighbor?
4. Secondly, what was your response to this situation?

I recall I was about 8, and my aunt had had too much to drink. She was very sick the next morning. I observed everyone being very supportive the next morning, and she seemed almost to have "hero" status with my mother, father, her husband, and other family members who provided her with various home-remedy hangover-cures.

My learned response and what felt right then was, "we care for those who have consumed too much alcohol." This felt like the "right" response. This "right" response was reinforced by significant others and the media, as alcohol consumption was an accepted sophisticated activity. The American way of the 50's and early 60's movies was that dad and mom would have an after-dinner nightcap.

The resulting "boundaries therapy challenge" is that whenever a client mentions drinking, then internally for me, a red light goes off. I need to do a perspective check and remind myself that not everyone who drinks is a problem drinker.

♦ How Do You Learn to Know Yourself?
How do you learn to know yourself and to use yourself to effectively set ethical boundaries with your clients? Let's look at how your attitudes and behaviors are learned.

As you know, attitudes and behaviors are learned in response to a need to react to particular circumstances, as in the case of my aunt and the hangover. Attitudes tend to become internalized and invested with an emotional component that may have little relationship to their true significance. In my preceding example about my aunt who drank too much, the progression of how my attitudes and behaviors were linked and learned moved through the following six stages:

6 Stages in Progression of Attitudes & Behaviors
1. A situation that demands a reaction from me, i.e. my aunt's hangover;
2. Response on a trial-and-error basis or on the basis of perception, of showing sympathy and not scorn or reproach;
3. Learning that a particular response is effective...at the time, selection of another response, besides those mirrored by adults in my life, was not even considered;
4. Development of feeling that this is the "right" response because it worked in that situation;
5. Reinforcement of this "right" response by support of significant others; and
6. Development of feeling that people who respond differently are "wrong."

How do these six stages apply to setting ethical boundaries with your clients?

To increase your self-awareness of how your attitudes are linked to your past behaviors and your current setting of client boundaries, I would like for you to pause a minute and think back to an emotionally-charged situation from your childhood. Secondly, what was the response of others and what was your resulting learned-response as being the "right" reaction? Thirdly, think where you are regarding this response at present. Recall the most recent time that this issue came up in a session with a client. What was your response? What was the client's attitude towards the issue?

- Schoener, GR. (1997). Boundaries in Group Therapy: Ethical and Practice Issues. In Women and Group Psychotherapy. New York: Builford Press.
Reviewed 2023

Peer-Reviewed Journal Article References:
Contrastano, C. M. (2020). Trainee’s perspective of reciprocal vulnerability and boundaries in supervision. Journal of Psychotherapy Integration, 30(1), 44–51. 

Fishel, A., Coleman, J., Rubin, D., Giulino, P., & Abel, M. R. (2020). Comparing couples’ and clinicians’ experiences of spoken and written reflections during and after a reflecting team consultation. Couple and Family Psychology: Research and Practice, 9(4), 191–205.

Pinner, D. H., & Kivlighan, D. M. III. (2018). The ethical implications and utility of routine outcome monitoring in determining boundaries of competence in practice. Professional Psychology: Research and Practice, 49(4), 247–254.

Van Kleef, G. A., van den Berg, H., & Heerdink, M. W. (2015). The persuasive power of emotions: Effects of emotional expressions on attitude formation and change. Journal of Applied Psychology, 100(4), 1124–1142. 

QUESTION 2
What are six stages in attitude formation from past experiences? To select and enter your answer go to Test.

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