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A Touchy Subject: The Ethics of Touching To touch or not to touch. That is the question. Presented by Frances Patterson, PhD, LADAC, MAC, BCPC, CCJAS, SAP, QCS December 21, 2016
A Touchy Subject: The Ethics of Touching
To touch or not to touch. That is the question.
Presented by
Frances Patterson, PhD, LADAC, MAC, BCPC, CCJAS, SAP, QCS
December 21, 2016
Thomas Durham, PhD
Director of Training
NAADAC, the Association for
Addiction Professionals
www.naadac.org
Produced By
NAADAC, the Association for Addiction Professionalswww.naadac.org/webinars
www.naadac.org/webinars
www.naadac.org/ethics-in-touching
Cost to
Watch:
Free
CE Hours
Available:
1 CEH
CE
Certificate
for
NAADAC
Members:
Free
CE
Certificate
for Non-
members:
$15
To obtain a CE Certificate for the time you
spent watching this webinar:
1. Watch and listen to this entire webinar.
2. Pass the online CE quiz, which is
posted at
www.naadac.org/ethic-in-touching
3. If applicable, submit payment for CE
certificate or join NAADAC.
4. A CE certificate will be emailed to you
within 21 days of submitting the quiz.
CE Certificate
Using GoToWebinar – (Live Participants Only)
Control Panel
Asking Questions
Audio (phone
preferred)
Polling Questions
Frances Patterson, PhD, MAC
Phone: 615-289-4905
Fax: 615-349-8862
Webinar Presenter
YourFootprints Consulting Services, LLC
Webinar Learning Objectives
LO #1
Discuss how touch may
be confusing for many
counselors
LO #2
Consider the role touch
may have in counseling
LO #3
Define guidelines for making
an ethical decision when
faced with touch in
counseling clients
1 32
A Controversial Topic!!
What is appropriate touch?
Nothing should be done in private that could not be done in
public
Research does NOT support the idea that non-sexual physical
contact leads to sexual involvement with clients
Physical Contact in Counseling
One of the most essential elements of human
development: a form of communication
critical for healthy development
one of the most significant healing forces
High degree of cultural relativity:Anglo-Saxons place low on a continuum of touch
Latin, Mediterranean and third world ancestry place on the high end
Touch
To Touch or Not to Touch
Clinical Update
By Zur Institute 2014
Polling Question #1
Do you believe it is acceptable to hug clients?
1. Yes
2. No
3. Sometimes
Questions:
Is it ever OK?
Who’s agenda?
Why are you touching?
Are there “Rules”?
To touch or not to touch?
Clients need boundaries
We model boundaries
Appropriate touch is often
misunderstood by clients
Our job is to teach
Empowering Clients by Establishing
Boundaries
What is appropriate touch?
Nothing should be done in private that could not be done in public.
Research does NOT support the idea that non-sexual physical contact leads to sexual involvement with clients
Physical contact
Ritualistic or socially accepted gestures
Conversational Marker
Consoling or reassuring
Playful touch?
Grounding or reorienting
Task-Oriented
Corrective experience
Instructional or modeling
Celebratory or congratulatory
Experiential
Referential
Inadvertent
Preventing someone from hurting self or others
Self-defense
Therapeutic intervention - A body therapy medical technique
Inappropriate, unethical and mostly illegal forms of touch include
sexual, hostile-violent and punishing touch.
Types Of Touch In PsychotherapyTo Touch or Not to Touch
Clinical Update
By Zur Institute 2014
Western culture: emphasis on autonomy, independence,
separateness and privacy
The cultural tendency in US to sexualize most types of touch
Separation of mind-body or mental-physical in Western culture
Homophobia
Some religious idioms have highly restrictive view of all forms of
touch.
The litigious culture and resulting risk management
Why Prohibition Of Touch In Therapy?
To Touch or Not to Touch
Clinical Update
By Zur Institute 2014
Traditional psychoanalytic emphasis on neutrality, distance, rigid
boundaries
Feminist scholars often state most touch by male therapists of
female clients is disempowering and injuring to the women
Fear-based, illogical slippery slope idea that non-sexual touch
inevitably leads to sexual exploitation.
Recent crisis in clergy and day-care incidents in regard to sexual
exploitation
Why prohibited
Touch in therapy is not inherently unethical
No professional code of ethics, including NAADAC, view touch as
unethical
Can be used when likely to have positive therapeutic effect
Ethical touch:
employed considering context of therapeutic
relationship
sensitivity to clients' variables, such as gender,
culture, history, diagnosis, etc.
Ethical Consideration: Non-Sexual Touch
Polling Question #2
Do you document when there is touch with a
client?
Seek ethical consultation
Critical thinking, thorough ethical-decision making a must prior to
ethical use of touch in counselling
Documentation!!!!
Counselors: thoroughly process own feelings, attitudes, thoughts
regarding touch in general and the often, unavoidable attraction
to particular clients
Ethical considerations
Practicing risk management by rigidly avoiding touch
Therapists are not paid to protect themselves, they
are hired to help, heal, support, etc.
Avoiding touch in therapy due to fear of reporting or suit
Stopping therapy in order to engage in sexual touch or
sexual relationships is (often illegal too)
Ethical Consideration: Unethical
Rigidly withholding touch from children and other
clients who can benefit from it, such as those who are
anxious, dissociative, grieving or terminally ill can be
harming
Sexual, erotic or violent touch in therapy is ALWAYS
unethical.
Ethical Consideration: Unethical
Used according to the therapists training and competence
Thorough deliberation of the clients' potential perception/
interpretation of touch
Foundation of client safety and empowerment before using touch
Guidelines For Appropriate/Ethical Touch
Clarity regarding boundaries
Clients' perception of
being in control of physical contact
that touch is for his/her benefit rather than
therapists
Stated clearly “no sexual contact”
Clear about type of touch to be used
Guidelines
“Touch is usually contraindicated for clients who are
highly paranoid, actively hostile or aggressive, highly
sexualized or who inappropriately, implicitly or
explicitly demand touch. “
Special care with people who have experienced:
assault, neglect, attachment difficulties, rape,
molestation, sexual addictions, eating disorders,
intimacy issues.
Special Care
How can touch lead to dual relationships?
Could this be considered therapeutic?
Why or why not?
Risk of dual relationships
Mike runs a family group which is attended primarily by women.
One evening he closes group by asking everyone to close their
eyes and remember a happy time in their childhood. One client
begins to sob and when asked what he problem was she stated
“I can’t remember any happy times”. He then instructs the
woman next to her to put her arm around the other client’s
shoulders.
What problems could arise from this?
Encouraging hugging/touch among
clients
Larry runs a co-ed addictions treatment group. There is generally
at least two or three women in a group of twelve. At the end of
group Larry tells all to join hands and say the serenity prayer. At
the end of the prayer, he states “OK. Give each other a hug and I
will see you next time.”
Is this appropriate?
What should Larry consider in his closing remark?
Making touch a ritual in treatment
I held a client in my arms for an extended hug while the client
cried.
A client asked me for a hug and I said “no”
A male client hugged me without asking
Appropriate or Not?
Agency policies
Therapist’s experience and comfort level with touch
Client’s: Personal history, Diagnosis, Culture
Have client’s permission
Not a way to gain trust
Who’s needs are being met?
Physical touch considerations
All situations and behaviors, including
touch in therapy, should be open to
supervision• Do you have resources?
Talk to colleagues Network of people you trust
Unwilling to talk to someone? What is
that about?
Protecting ourselves and clients
Frances Patterson, Ph.D., MAC, BCPC, CCJAS,
QSAP, QCS(615) 289-4905
www.footprints-cs.com
Thank You!
Your
Footprints Consulting Services, LLC
www.naadac.org/ethic-in-touching
Cost to
Watch:
Free
CE Hours
Available:
1 CEH
CE
Certificate
for
NAADAC
Members:
Free
CE
Certificate
for Non-
members:
$15
To obtain a CE Certificate for the time you
spent watching this webinar:
1. Watch and listen to this entire webinar.
2. Pass the online CE quiz, which is
posted at
www.naadac.org/ethic-in-touching
3. If applicable, submit payment for CE
certificate or join NAADAC.
4. A CE certificate will be emailed to you
within 21 days of submitting the quiz.
CE Certificate
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