Breaking Boundaries: In Political Entertainment Studies

Breaking down the boundaries

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The media is at the heart of cultural, social, political and economic events throughout the world. But now modern media and communications take on a whole new life and have posed unique challenges. No dimension of human life has been unaffected by the developments in communication; family life, business, religion, education, recreation, international relations—all these and more have been influenced by the capabilities that media provide. The field of Media and Communication is undoubtedly very progressive and dynamic, developing in tandem with technology development.

The advent of new media with practical and ideological changes of traditional media has impacted social change and subsequently transformed the world communication landscape. Therefore, there is a perpetual need to understand and evaluate the impact of media communication that is increasing in line with technological development. Likewise, as the audiences now are more proactive in seeking information, they have the power to voice out their desire and have the capability to create space for social and cultural change in society. Transformation, in a nut shell, is inevitable and demanding agility, adaptability, and efficiency from communication professionals worldwide.

With society moving into the electronic age, more people are communicating in cyberspace not only to access more information, but also to create a reality of their own Parks, There is a revolution occurring in virtually every corner of the world today — the media delivery revolution! Children of today and tomorrow will likely not remember broadcast, radio, music, or any type of information or entertainment media being limited to one device, one screen, or one delivery system.

These new technologies offer vast new opportunities for public participation and engagement and have the potential to expand media use even further.

Much of the recent explosion in the stock of human knowledge is linked with developments in media and communication. Communication has been around for a long time as a paradigm in development theory but as the times are changing, so are the communications for social change paradigms. In recent years, the world has witnessed the fastest transformations brought about by advancements in communications technology.

People are increasingly mobile and urban. Geographical, political and social landscapes are changing. All of these have impact on the way we communicate. These changes have posed valid questions to the existing paradigms in communication for social change. Where is the discipline headed? What are the prospects that have accrued from the changing times? What kind of social change can we expect from all this? Are we to experience a more just world anytime soon? Communication is like lever which drives the modern world, across every sphere of life, and the media, is the fulcrum, that connects, opines and influences society, through its evolution.

Media no longer involves astronomical costs which led to centralized one-to-many dissemination of messages and content. Today, anyone with a computer and an internet connection has the potential of being a key media influencer and a mass media agenda-setter themselves. The past generation has seen a blizzard of mind-boggling developments in communication, ranging from the World Wide Web and broadband, to ubiquitous cell phones that are quickly becoming high-powered wireless computers in their own right. Firms such as Google, Amazon, Craigslist, and Facebook have become iconic.

The change has been rapid as digital technologies remove the barriers associated to the traditional media. The format, location, distance and time are no longer considerations, the transfer of content and information can be instantaneous and to anywhere in the world. Immersion in the digital world is now or soon to be a requirement for successful participation in society. This is the age of communication, and the current information revolution is dramatically increasing the potential for sharing information across the globe. The information revolution we are witnessing today has been compared to the invention of moveable print in the fifteenth century or to the transition from an agrarian to an industrial society in the nineteenth century.

Economic liberalization has concentrated ownership of the global media in the hands of a few large companies, but the communication environment in developing countries is changing nevertheless. Technologies and media are becoming more appropriate for conditions in rural areas. Democratization, government deregulation policies and pluralism have encouraged the decentralization of information production away from central governments while horizontal, people-to-people processes are replacing vertical, traditional lines of communication.

Participatory approaches have paved the way for community-based ownership and use of various communication media, for example rural radio. The field of Media and Communication is a relative young discipline; many of us have first-hand experience of its gestation and birth. The study of media and mass communication has evolved steadily since the s. Changes in contemporary political systems, the cross-fertilization or conflict of different cultures, the development of social institutions and organizations, not to mention new information technologies, have influenced the development of the discipline significantly.

The number of scholars in the field of Media and Communication Research has increased dramatically during the last decade, and some excellent research communities have been created. But, there are aspects that arouse some critical reflections — most of which concern whether and to what extent the work in our field raises relevant questions about the relations between media and society. Today, the media industry has been punctuated by a very small number of very sharp and very important junctures. Media and Communication have been facing stiff challenges due to digitization and, in particular, due to the internet, which can be seen as the most important platform for convergence developments and as a driver of numerous changes in the communication and media industries.

In the world of multilevel governance with private and public actors media landscapes and media cultures are undergoing fundamental and far-reaching metamorphoses. Not to mention the ramifications of phenomena like ICT, media convergence and global media structures. We are witnessing the erosion of a previous communicational paradigm and the emergence of a new one. Such an emergence has implications for the economy, for our daily lives and for the balance of power that the media provides to political, economic and cultural actors of our societies.

This communicational change might be witnessed in a series of events and transformation in practices and representations towards media and their role in society. Examples are diverse and can be found in more visible trends as sharp falls in the sale of newspapers, the growing proliferation of P2P distribution of audiovisual content, the increasing presence of advertising on the Internet, or in the less visible as the role of social networks on the daily routines of citizens and organizations, the sometimes competing and occasionally symbiotic relationship between journalist and citizens on the coverage of events twittering in twitter or other micro-blogging sites, the appropriations of Open Access, Open Source and Open Science practices by scientists and the decommodification of media production for online sharing.

What exactly do we mean by new media and how has it changed the media environment? How has this in turn impacted upon different parts of the globe given the reality that power is not distributed equally amongst all nations who are at different levels of development? The main question is the gap between north and south. The gap between the rich and poor still prevails as a result of disparities in access to resources, knowledge and technology, especially in rural areas. But, the divide is also reproduced within virtually every country of the world and often reflects other gaps — those between income groups, the sexes and ethnic groups.

Believing that it is possible to empirically argue that the changes witnessed in communication go beyond a simple reconfiguring of the mass communication model, by adding the Internet to a set of practices and representations already present, I would like to argue that as the communicational model of the industrial model of development was we are now witnessing the building of a new Mass Communication with communicational model taking place under the informational model of development in our societies.

So we should consider that Networked Communication is slowly, but steadily, replacing Mass Communication and its communicational paradigms in our societies. Such replacement, of Mass Communication by Networked Communication, occurs with different nuances in the different cultural backgrounds and different media systems around the world, [ 1 - 6 ] but at the same time keeping in common a set of features that give it the consistency of argument that we are witnessing a global change in models of communication. In the rapidly changing global environment, there is a need for a conceptual frame that takes account of the wide range of theories and explanations for developments in media and communication, which also encompasses drivers like globalization, individualization and the growing importance of the market economy as a reference system.

We need to better understand how media and communication may be used, both as tools and as a way of articulating processes of development and social change, improving everyday lives and empowering people to influence their own lives and those of their fellow community members [ 7 ]. The communicational change results from the transformation of media consumption, that is, entertainment, communication and provision of news and information, but also knowledge creation in general, including the scientific dimension. Because the education system is based on the communication of the produced knowledge and, in turn, the scientific system depends on knowledge production, a change in the communication paradigm is also felt in the scientific dimension - therefore influencing also all society.

In this digital age it is easy to marginalize traditional media as radio, newspapers, journals and books, and fail to confront critical issues such as the lack of media freedom in many parts of the world, the rising global concentration of private media ownership, the absence of media legislation and the challenges facing public service media In a world where consumption is no longer entirely driven by media companies and begins to be shared by participants, through the availability of technology, this dimension of communicational change is also a change of cognitive character, that is, it also surfaces in tensions within the educational system, that is, through oppositions like: While Allende begins each new book on the same day of the year, Shafak always writes hers wearing a pair of purple, fingerless gloves.

Around her neck she wears a small talisman to ward off the evil eye. Born in Strasbourg as the only child of a philosopher father and a diplomat mother, Shafak remained with her mother when her parents divorced and led a nomadic life growing up in Madrid and Amman. She admits she has found it hard to settle down.

The story tells me which language to write it in. She published her first novel at 24, taking her mother's first name as her pen name which is also spelt Safak and Shafik. Now she divides her time between Turkey and the US with her husband, a journalist, and two children. She employed an unorthodox technique in her latest novel, The Forty Rules of Love , writing it first in English, and then, when it was translated into Turkish, rewriting not only the Turkish version but going back to the English original and reworking it "in a new spirit.

I built two parallel books in the same time span. When it was published in Turkey, Forty Rules sold , copies in eight months "that's without counting our huge market in pirated books". She is the country's highest-profile writer after the Nobel winner Orhan Pamuk, with whom she shares the distinction of having been accused of "insulting Turkishness" an offence punishable with a jail sentence for her discussion, in The Bastard of Istanbul , of the Armenian genocide and her country's unwillingness to recognise it as such.

Although the prosecution against her was eventually dropped, it is still a subject that makes her uncomfortable and today she is clearly unwilling to discuss it. She smiles tightly when I ask her whether Pamuk expressed any solidarity with her but does not reply. For a writer who is so politically engaged, so candid and so committed to ideas, her stance is puzzling but unbending. She stonewalls me at every turn. All she will say is that "I did not expect the accusations but ultimately it was a very positive experience for me. In Turkey today, we are young? The Forty Rules of Love is imbued with sufi mysticism, which may puzzle Western readers unfamiliar with the teachings of Rumi, the 13th-century Persian poet, philosopher and mystic whose followers founded the order of Whirling Dervishes.

The novel shifts to and fro between his travels on a spiritual path and the world of Ella Rubinstein, an American Jewish housewife think of a heroine written by Australia's Lily Brett who is reading a manuscript about Rumi for a publishing house. It expresses a universal, timeless spiritual yearning," says Shafak, who feels, like many writers, that she is channelling stories from a higher power.

We had a termite problem that we fixed but the place needs a new floor. If you or a loved one are struggling with depression, or anger issues, or bipolar, he is your man. He is an excellent counselor. We have our own non-profit and give to others without charging so our financial situation is limited, but looking to trade! Does she really want an angry plumber in the bathroom? So far, we have discussed exchanging a service for a service. Here, we explore more fully the exchange of professional services for tangible objects.

It has been suggested that this form of bartering is less problematic because a fair market price can be established by an outside, objective source. However, the actual value of goods often depends heavily on what buyers are willing to pay. This means that determining the true value can prove challenging, and charges of exploitation could easily arise.

We know of instances of service-for-item bargaining that turned out poorly. Therefore, we urge considerable caution when an object is traded for professional services, and even when purchasing an item outright from a client. When Manifold Benz, Ph. Benz expressed an interest in one of the cars. The client stood hours in arrears at the time. Benz is exploiting his client by committing him to a specific number of future therapy sessions that the client may not need. Further, we do not know if the price Benz suggested represents fair market value, and this may prove difficult to determine precisely given the rarity of the item.

The fact that Benz had allowed a client to fall hours in arrears demonstrates another ethical issue. Channel set it up in his home, the colors were faded, and the picture flickered. He told Penny that the television was not as she had represented it, and that she would have to take it back and figure some other method of payment. Penny angrily retorted that Dr. Channel must have broken it because it was fine when she brought it to him.

When Channel insisted that the TV was defective, Penny terminated therapy and contacted an ethics committee. She charged that he broke both a valid contractual agreement and her television set. Channel found himself in a no-win situation because of the television fiasco. A therapeutic relationship was also destroyed in the process. Channel could have avoided a confrontation and perhaps saved the relationship by junking the TV without mentioning it to Ms. Nevertheless, the therapeutic alliance might have suffered anyway due to lingering resentment that might leak out toward his client.

In the actual case, the client sought therapy to deal with sexual abuse as a child. Boundary crossings with clients who were badly betrayed are contraindicated Keith-Spiegel, It is important to recognize two points: First, therapists have the responsibility of assuring that they do not take advantage of their clients. Second, therapists should not get involved in helping clients sell their property. If clients have something of true value to sell, they can easily find many ready markets through Internet sites, reaching thousands of potential buyers at little or no cost to sellers.

We contend that it is impossible to confidently ascertain which clients will be well-suited to a nontraditional, negotiated payment system and which should be turned down, especially near the outset of the therapeutic relationship. By definition, bartering involves a negotiation process. Is a client in distress and in need of professional services in a position to barter on an equal footing with the therapist?

Furthermore, even therapists feel attracted by a good deal. How does this pervasive human motive play itself out in a bartering situation with clients? Second, must a therapist accept something unneeded or unwanted? These predicaments may not end up on ethics committee tables, but illustrate sticky matters, with a potential to cause the kinds of hassles that therapists certainly would prefer to avoid. A rarely discussed and serious bartering complication involves restrictions typical in many professional liability insurance policies that specifically exclude coverage involving business relationships with clients Canter et al.

Liability insurance carriers may interpret bartering arrangements as business relationships and decline to defend covered therapists when bartering schemes go awry. To obscure matters even further, recipients must declare the fair market monetary value of bartered goods or services as income on their income tax returns. Failure to do so constitutes tax evasion. The client may seek to deduct the cost of goods paid for mental health services and will need proper receipts.

To fully meet legal requirements and thereby behave in a fully honest and ethical manner requires detailed documentation, creating another type of interaction with the client. We further recommend that therapists avoid instigating a bartering relationship. The use of such resources can defuse most of the ethical risks we have discussed. However, new concerns about client confidentiality, screening clients for appropriateness, and the integrity of the bartering organization remain as potentially sticky issues.

Friends and family members frequently seek advice from mental health professionals. When more than factual information or casual advice is requested, a temptation may arise to enter into professional or quasi-professional relationships with good friends or family members. Therapists may reason that they can more easily provide especially good counsel because trust already exists.

Despite the seeming advantages of offering professional services to friends or family members, sustained therapy relationships should be avoided. Although close relations and psychotherapy exist in the context of intimacy, striking differences exist between the purpose and process of the two. Professional relationships, on the other hand, normally involve payment to the therapist and aim for:.

When we superimpose these two types of relationships, the potential for adverse consequences to all concerned increases substantially. Notice how the differences become oppositional, meaning that expectations can clash and trust can more easily be broken. Short-term support in times of crisis may qualify as an exception. Responding to a frantic call from a friend in the middle of the night is something friends do for each other.

Should the friend require more than temporary comforting, offer a referral. Otherwise, as the following case illustrates, unexpected entanglements can occur, even when therapists intend to be benevolent. Weight-reduction specialist, Stella Stern, L. Progress was slow, and most of Bluto's weight returned shortly after she lost it. Stern became impatient because Bluto did not seem to take the program seriously. Bluto became annoyed with Dr. Stern's irritation as well as the lack of progress.

Bluto expressed disappointment in Dr. Stern, whom she believed would be able to help her lose weight quickly and effortlessly. The once close relationship grew distant. Stern's friend could not commit to the obligations of the professional alliance, but expected results anyway. Faulty expectations, mixed allegiances, role confusion, and misinterpretations of motives can lead to disappointment, anger, and sometimes a total collapse of relationships. In conclusion, therapists are free to be completely human in their friendship and family interactions and to experience all of the attendant joys and heartaches.

Their skills might prove helpful by offering emotional support, information, or suggestions. When the problems become more serious, however, the prudent course of action involves help in finding appropriate alternative care. A member of the same gym or church may request professional services. Disallowing casual acquaintances as potential clients would, in general, qualify as unacceptable to consumers as well as to therapists. This section illustrates cautions that one should consider before taking on clients who base their request for your services on the fact that they know you slightly from another context.

The small talk before and after treatment sessions usually involved cats. Clients also occasionally expressed interest in purchasing kittens from Dr.

She agreed to sell them to her clients, which eventually came back to haunt her. When the therapy process did not proceed as one client wished, he accused Dr. Breed of using him as a way to sell high-priced kittens. Another client became upset because Dr. Breed sold her a cat that never won a single show prize. Breed did not adequately meet her responsibility to suppress her acquaintance role while engaging in a professional role.

This disconnection can usually occur without untoward consequences if the continuation of the former acquaintance role does not require more than minimal energy or contact and avoids any conflicts of interest. The risks and contingency plans for likely incidental contact with clients should be discussed during the initial session. Breed's case, that would have meant refraining from extended discussions of cats before or after the therapy session and abstaining from selling cats to any ongoing therapy client.

So what differences exist between a friend who one should not accept as a therapy client, and an acquaintance who may appropriately become one? Making the distinction is not clear-cut because sociability patterns among therapists themselves vary considerably. Contextual issues, such the potential for frequent interactions with the acquaintance in other settings, also demands consideration.

You might ask yourself questions such as: Is the person seeking my services also a person I would invite home for dinner, or whom I would visit in the hospital rather than just send a get well card, or with whom I would share more than routine information about my personal life? A twist on the acquaintance peril involves dealing appropriately with solicitations for services by someone who also holds some influence or advantage over you. Examples include a request to work with his alcoholic wife from the head of admissions of the local college to which your daughter has applied, or a call for an appointment for marriage counseling from the advisor who manages your financial portfolio.

Unless alternative services are unavailable, we encourage therapists placed in such awkward positions to explain the dilemma to prospective clients and offer to help find alternative resources. Friendships should ideally begin on an equal footing, with each party capable of voluntarily agreeing to the relationship. The various complications that can arise when ongoing clients become friends are illustrated in the following cases. Chum and his wife to spend the weekend at their beach house.

The outing was enjoyable for all. During the next few sessions, however, Ms. Pal became increasingly reluctant to talk about her problems, insisting that things were going well. She broke down and admitted that she had been experiencing considerable distress, but feared that if she revealed more Chum might choose to no longer socialize with her and her husband. Patty Pal found herself in a double bind. As Peterson observed about boundary violations in general, the client is always faced with a conflict of interest; No matter what they do, they risk losing something.

Pal did not press ethics charges, but had she done so, a committee would likely have found Dr. Chum guilty of exercising poor professional judgment. They had also invited each other to their homes. During one such event where liquor flowed freely, Flash and Dr. Crony argued over what, to Crony, seemed a trivial political disagreement. However, Flash terminated therapy and wrote to an ethics committee, complaining that Dr. Crony had kept him as a client for the sole purpose of capitalizing on his social status.

When can more intimate social friendships be formed with former clients without the danger of multiple role complications? The American Psychological Association and the American Association of Marriage and Family Therapists ethics codes do not specify prohibitions against nonsexual post-termination friendships. If a post-therapy friendship disappoints or turns sour, elements of issues that came up during therapy may resurface, raising new doubts in the client.

The therapist a client believed he or she knew so well may not completely resemble their professional persona as in a nonprofessional context and may fail, as Neale puts it, to be that idealized friend. However, Nullify found Dr. She also began to suspect that the previous therapy was probably inept.

She felt exploited and lost and sought the counsel of another therapist who encouraged her to press ethics charges against Nami. Nullify's charges against Dr. Nami came before an ethics committee, but not because of the allegations that Nullify brought forward. Proof of alleged incompetence failed to materialize, but what became clear to both a surprised respondent and the complainant was the finding of a multiple role relationship violation.

Ironically, Nami herself provided these facts as a defense against Nullify's charges. This scenario also illustrates how one can never count on a new, imposed role working out as well as the first one. So, can therapists ever safely establish friendships with former clients?

The findings in a critical incident survey by Anderson and Kitchener suggest that nonsexual, nonromantic relationships occur with some regularity among therapists and their previous clients, but the judgments of the ethics of such relationships reveals little consensus.

The view that friendships with clients are always off limits might deny opportunities for what could become productive, satisfying, long-term relationships. Gottlieb , , a strong supporter of maintaining clear professional boundaries, also believes that social relationships with some types of ex-clients may prove acceptable. Here is one example from our files:. The therapeutic relationship went well and terminated after 16 sessions. The two men found themselves in the same race a few months later and realized that they enjoyed knowing each other on a different basis.

The relationship between Wheel and Speedo was not superimposed or even contemplated during active therapy and the connection that drew the men together and sustained them was not based on therapeutic issues. Clients offering gifts to their therapists has been a matter of lively discussion. Gifts should always be understood and evaluated within the context in which they are given Hundert, ; Zur, The less discussed issue is when therapists offer gifts to their clients, creating an instant multiple role relationship of therapist and benefactor.

Offering clients gifts requires special forethought. Many clients coming into therapy feel ignored, abandoned, violated, or uncared for and may more easily misinterpret the motivation of therapists who give them gifts. Besides the potential complications and misunderstandings, there is an ever-present possibility that the therapists' own motives of benevolence are unconscious rationalizations for self-serving intentions. The gifts included decorative key chains, figurines, and stuffed animals.

He also sent them cards when he went on vacation, hugged them often, worked out alongside them at the gym, and met them for lunch. Eventually, several clients complained about Dr. Nowalls for a variety of reasons, most dealing with abandonment issues. Nowalls felt stunned that some of those to whom he had been, in his own mind, so kind and giving, turned on him. He could never grasp how the multiple intrusions of his personal essence into his clients' lives initiated dependencies he could never ultimately satisfy. From another perspective, seeking gratification by attempting to please clients presents a serious problem, whereas helping clients to manage their feelings toward the therapist, both positive and negative, can prove beneficial.

The question arises as to whether clients can feel free to address negative feelings with a therapist who gives them gifts Gabbard, The next case illustrates a therapist who had a strategic purpose in mind. Hustle wants to drum up business and is attempting to enlist clients as his sales force. Clients will not likely complain, and the tactic does not violate any ethical rule, but it borders on the unprofessional. Some clients may also feel obligated to reciprocate. So, can therapists ever give their clients gifts or do favors for them? Offering a book to a client may prove helpful when therapeutically indicated, especially if the client has a limited budget.

Therapists may also go out of their way to help clients locate other needed resources relevant to improving their overall life situation. Small favors based on situational needs and common sense, such as giving a client a quarter for the parking meter, would raise no concerns. In these acceptable cases, no ulterior motives pertain, and the scope either relates to the therapy or is of a very specific and limited nature. A special situation can arise with child clients.

Here, at times, it may be appropriate to give a small gift attending to the symbolic meaning that would advance the therapeutic function. For example, an anxious child about to leave for three weeks of summer camp might feel soothed and emboldened by the gift of a flashlight. Finally, consider the generous therapist who agrees to see a financially strapped client at no cost. This also deflects the negative impact on the proud client who would not welcome charity. Jane Dumped reluctantly accepted Casa Nova as a client when he showed up at her office three years after Nova left her sitting alone in an expensive restaurant, a date to celebrate her 33rd birthday.

Nova claimed that Dumped was the only one who would understand his wayward ways with women.

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Nova felt ripped off and pressed ethics charges, claiming that Dr. Dumped only wanted to humiliate him for rejecting her years earlier. Word of mouth from colleagues and current or previous clients generates many referrals. However, care must be taken when satisfied clients recommend you to their own close friends or close relations. The potential for conflict of interest, unauthorized passing of information shared in confidence, and compromises in the quality of professional judgment constitute ever-present risks.

Carefully considering what could go wrong and estimating its likelihood may both save a therapeutic alliance and avoid an ethics complaint. Dum Tweedle felt pleased with his individual therapy and asked Rip Divide, Ph. Dum eventually pressed ethics charges against Dr. Divide for contributing to a breakup, a process that began, Dum alleged, at the time Dee entered therapy.

He contended that Dr. Divide encouraged Dee to change in ways that were detrimental to him and to their relationship. Divide contended that it was his responsibility to facilitate positive growth in each party as individuals, a responsibility he felt he had upheld. Sometimes warning signals appear, even if in a somewhat offhanded way, that the unwary therapist might miss.

The next case, loosely adapted from a scenario provided by Shapiro and Ginzberg , illustrates one such situation. Paris Jug told her therapist, Ed Ipus, M. Ipus was elated because these were self-paying clients. Therapy with the mother was difficult because her main complaints were about Paris, and Paris spent much of her time attempting to manipulate Ipus into saying that she was sane compared to her crazy mother. He decided to make things simpler by terminating the mother, who then pressed ethics charges for abandonment and emotional harm.

Ipus was highly remiss in taking on the referral in the first place, knowing the intense issues between his ongoing client and her mother. He obviously should have told Paris that he could not ethically treat her mother and maintain a professional obligation to her. One interesting challenge with respect to accepting referrals of close acquaintances or current clients can arise with cultural overtones. A friend, relative, or acquaintance may feel disrespected if the therapist declines their request for services or attempts to make a referral.

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We do not suggest that accepting referrals from current clients is necessarily inappropriate. If things have the potential to become sticky, we advise referring the potential client to a suitable colleague. Role clashes become impossible to avoid for mental health professionals working in small or isolated communities. The goal is not to vigorously attempt to avoid all situations where roles may be blended but to thoughtfully manage them Barnett, b.

As anyone who has lived in a rural town can readily attest, face-to-face contacts with clients outside of the office inevitably occur, sometimes on a daily basis. Clients likely belong to some of the same groups or engage in activities that bring them face-to-face outside of the office.

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Sometimes in specific incidents, management requires some creativity. One psychologist, who was the only mental health provider within a mile radius, relayed to us the special care taken to ensure that he and his client, the only sixth-grade teacher in town, could avoid difficulties that might arise due to the presence of the psychologist's rebellious year-old son in her class. Another small-town marriage counselor shared the burden of scheduling neighbors so as to avoid unwelcome face-to-face meetings in the waiting room.

The few therapists in town will know many of their clients in other contexts, and the townspeople will also know a great deal about the therapists and their families. Therefore, in small rural areas, boundary guidelines demand consideration in relation to the sociocultural contexts of the community Roberts, Battaglia, and Epstein, Attributes of small communities further complicate ethical dilemmas in the context of delivering therapy services.

Information passes quickly, and standards of confidentiality among professionals and community service agencies may become relaxed to the point where information, originally shared in confidence, becomes widely known. In smaller, isolated communities, gossip can be rampant, making it even more difficult to ensure client confidentiality Sleek, Residents of small communities are often more hesitant to seek professional counseling and do not quickly trust outsiders, preferring to rely on their kinship ties, friends, and clergy for emotional support.

Because those who do seek therapy prefer someone known as a contributing member in the community, it may not be possible to simply commute from a neighboring town and expect to have much business. Ironically, then, earning acceptance and trust means putting oneself in the position of increasingly complicated relationships Stockman, ; Campbell and Gordon, Consider, for example, what might happen when a client also works as a salesperson at the local car dealership.

When the therapist buys a new car, the client may feel deeply offended if the therapist purchases it from someone else. Yet, would the therapist have the same latitude to negotiate the price? Would the client feel obligated to give the therapist a better deal than anyone else would receive? And what if the car turns out to be a lemon?

This is the kind of dilemma that small town therapists must routinely manage and perfect answers are not always obvious. Just because mental health professionals in smaller communities cannot easily separate their lives entirely from those of their clients does not mean that professional boundaries become irrelevant. On the contrary, therapists must make deliberate efforts to minimize possible confusion. For example, no matter how small the community, a therapist and a client should never need to socialize only with each other, such as meeting for dinner.

Potentially risky acts over which therapists always have complete control regardless of community size can still be easily avoided. The therapist can maintain confidentiality and refrain from chiming in during gossip sessions taking place outside of the office. The therapist in the next case failed to attend to more than one ethical requirement, despite the more accepted practice of bartering in rural communities.

Due to stresses caused by economic hardships, the Peeps required more marriage counseling sessions than originally estimated. The Peeps' chicken farm income was insufficient to pay the regular bills, let alone therapy. Soon thereafter, a lethal virus dangerous to humans and believed to be carried by poultry resulted in the destruction of millions of chickens in Canada, driving up the price of chickens from their non-flu area. The Roosters made a huge profit, and, at the same time, found themselves in business competition with the Peeps.

The Peeps felt locked into a therapy situation that they felt very uncomfortable with, and eventually successfully sued Dr. Taking an exchange in advance for services that may not be needed is only the tip of the iceberg. Small communities also exist outside rural areas or geographical isolation. Close-knit military, religious, cultural, or ethnic communities existing within a much larger community can pose similar dilemmas.

Therapists working in huge metropolitan settings can experience what amounts to small-world hazards, and the same need to view role conflicts in a sociocultural context pertains. The primary advantage of working in a heavily populated area is the availability of more alternatives. Yet still, even when one cohesive population is embedded in a large city, complications similar to those faced by rural therapists can arise. She accepted a client new to the city into her therapy group, and during the second session the new woman announced that she had just met someone named Sandra Split and that they were going to be seeing each other.

Another less dramatic situation that may cause complex interactions that require vigilance for gay, lesbian, bisexual, or transgendered therapists involves frequent socialization venues, both private and public. Discoveries that may emerge during the course of therapy can often be handled by maintaining the professional role without regard for the coincidences that link the therapist and client in other ways.

Things can, however, become more complicated, as illustrated in the next case. Sid Fifer consulted Ron Wrung, Ph. Early in therapy, Fifer casually revealed that he and the therapist's wife worked for the same large company, though in different locations and different departments.

Several weeks later, Fifer was fired. He charged that Dr.

A Turkish feminist sees similarities between the modern corporate world and the sultan's harem.

Wrung must have told his wife about what he talked about in therapy, which she, in turn, shared with the company boss. Wrung vehemently denied sharing material about Fifer or any other client with his wife or anyone else. Wrung was a casualty of the type of circumstances that one could neither easily predict nor prevent. Therapists will more likely be judged culpable when they recognize a small-world hazard in advance and when other alternatives clearly existed.

Here, other treatment options did exist, but Wrung assumed that the remote connection between the client and his wife would preclude any conflict. Wrung was not found guilty, enduring an ethics investigation is stressful. The matter might have been avoided had Wrung instigated a discussion about confidentiality and how it related to this distant connection. The future will likely see an increase in the use of electronically-based distance forms of therapy. Of course, with Teletherapy, other ethical challenges pertain. Therapeutic goals can sometimes be better achieved outside a professional office-style setting.

Action-oriented therapies, including crisis modalities, may involve ecological involvements with clients. A stress reduction group might hold a special weekend at a serene lakeside lodge. When employing an atypical setting or technique, it becomes critical to clarify the therapeutic context and the activity. Homa Cloister feared crowds. Her therapist, Rip Vivo, Ph. He did not charge an additional fee for the after-hour activity, but did require her to pay the dinner bill.

The treatment proved ineffective and uncomfortable for this client. Homa later charged that Dr. Vivo exploited her by disguising a free meal ticket as psychotherapy. Lynn Bones broke both legs skiing and would not be able to drive for six weeks. Upon arriving, he found that Bones had prepared lunch for the two of them, including wine. They chatted about politics and the weather while eating.

Visit as a friend rather than as a therapist. Six week later when sessions resumed in the office, Visit attempted to get things back on track in his professional setting. An affronted Bones decided to find another therapist. Vivo's technique with his claustrophobic client may have an appropriate therapeutic rationale, but he included the trappings of a social event and structured the financial aspects poorly.

Visit settled too comfortably into the temporary therapy venue, and the relationship shifted just enough to compromise it. Those who make home-based visits or offer community-based treatment of those with serious mental problems must remember that boundaries are challenged in ways that do not ordinarily present themselves in professional office or hospital settings Knapp and Slattery, ; Perkins, Hudson, Gray, et al. Visit should have anticipated the dynamics of a home-based setting and prepared his client with the ground rules, which would not have included meals or alcohol.

If one must conduct therapy in a private home, the room should be furnished along the lines of a typical therapy office, and ideally have its own entrance. Some clients, however, may find receiving therapy anywhere in the therapist's home even in a dedicated home office or converted garage confusing, and their emotional status could become compromised by connotations attached to the setting. The therapist who practices out of her own living quarters also risks professional isolation, unless colleagues are actively sought out in other venues.

Some clients could potentially become burdens or pose risks to the family if the client acts out in strange or frightening ways. Unless the home-office therapist has another location available to screen new clients for suitability, one cannot know in advance what level of pathology may walk through the door.

Every mental health professional is at the mercy of coincidence, and a totally unexpected compounding of roles may occur by chance Barnett, b. Although the appropriate response may prove difficult to discern, therapists must actively attempt to ameliorate the situation as best they can, trying to avoid devaluing or diminishing anyone in the process. Confidentiality issues usually pertain. Unless the therapist and client have discussed how to handle situations when they encounter each by chance, the therapist will not know how to take the client's preferred option into account.

The urgency of the situation can also become a factor. When dealing with unforeseen factors, most of the time no lasting multiple role relationship actually develops. The nature of the encounter itself determines, in large measure, the impact of the unanticipated encounter. Seeing each other in line at the post office sits at one end of the continuum, meeting naked in the gym shower falls near the other.

Most therapists who have had unintended encounters with ongoing clients express surprise, uncertainly about what to do, discomfort, anxiety, and embarrassment. Whereas fluke crossings will more likely occur in smaller communities, unexpected situations can arise anywhere. In fact, both incidents described in the next cases occurred in large metropolitan areas. This client is particularly sensitive about therapy and constantly worries about anyone finding out that she even knows a psychotherapist.

Close thinks she may be able to stay in her corner of the dining area, but as people begin to drink they also move around the room to chat with others and make new friends. Close may have to figure out how to keep a low profile at the New Year's Eve event. She should not become intoxicated. Given the client's intense feelings, it would have been quite appropriate for Close to have earlier attempted to ensure that important events do not overlap with those of her client.

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