I also want to address the issue of self-disclosure and reinforce Mathew’s point-of-view as this has been an ongoing issue for me a ‘sexual health’ counsellor who has worked within the GLBT community for 5+ years. I should also include here that I am openly gay and have been HIV+ for close to 25 years. Having lived with HIV for what constitutes my entire adult life, my ‘lived experience’ often provides me with insights and perspectives inaccessible to non-HIV+ therapists, however, does not always have appropriate therapeutic value, even to HIV+ clients. That said, there are particular clients, circumstances and interventions (acute crisis (suicidal intention/plan) triggered by HIV+ diangosis) which may benefit from such intimate self-disclosure. Although I have no empiral evidence, I can say with confidence that sharing this with clients in such cases is often the most effective means of demonstrating empathetic support who might otherwise lack any connection or experience to such a stigmatized condition/experience.

Initially, I purposely avoided bringing this into sessions with clients and struggled with the inherent conflicts of being a gay, HIV+ counsellor (working at the AIDS Council of NSW aka: ACON), however with the support of my very experienced and skilled supervisor, developed confidence in my therapeutic skills to guide this aspect of my practice.

There are/will always be extenuating circumstances to any ‘frame’ and as such it becomes increasingly important to remain mindful of (to quote yet another of your previous podcasts) “throw the baby out with the bathwater”.

Thank you for your time and tireless efforts in providing such a useful resource through your podcasts.

Kind regards,
Ron

It’s hard to provide a list of “rights and wrongs” that will fit every situation, and Langs’ ideas may be a bit extreme, but they certainly make people think about boundaries and their importance in the therapeutic relationship and that’s a good thing.

Psychotherapeutic Orientation: I think you ought to explicitly acknowledge that these are basically psychodynamic rules. DBT would give different answers about what constitutes appropriate boundaries.

On touch: I was in a therapy group led by two residents. It was primarily behavioral, being focused on midfulness and *some* of the principles of DBT. (It ended abruptly, because the residency program decided to drop all group therapy at its 2 private sites. Since both of our leaders were leaving the clinic that year, we only had a week’s notice. A rising resident had already been chosen, but she wasn’t going to start by terminating over 2 months, but that’s another story.) As the female resident got ready to go, our all female, all straight group gave her a hug goodbye. In context, I don’t think that was inappropriate. When one of the other leaders left to go to a child fellowship, one of the group members bought her some flowers. Again, not inappropriate in my book. Of course, this was in a clinic setting, so some of the baseline rules had been established from above.

As far as whether therapists are trained to not their opinions interfere with their advice: yes, I’d say that most therapeutic training programs do emphasize this. However it is one thing to try to train people to do it, and another (hard) thing for therapists to be constantly aware of what they are doing and to be able to separate themselves and their needs from their patients. The hope is that most all of them can do this.