An emphasis on the need for appropriate physical, emotional, cultural, relational boundaries is found in all therapeutic environments and AT practitioners should draw from these general standards. However, the unique nature of the AT intervention creates a number of situations that are outside of the bounds of what is typically encountered in other settings, and therefore additional considerations are necessary (Newes, 2000).
Dual Relationships and Conflict of Interest
This tenet involves avoiding relations where there may be the potential for participants to be exploited or misled, typically based on the power differential between staff/client. It also speaks to the need to intentionally avoid dual relationships that may impair judgment.
The nature of AT interventions by nature creates a wider range of client/staff relationships than are found in more traditional settings, creating particular ethical conundrums when practitioners are held to the aforementioned dual ethical standards (Newes 2000). Particular factors to consider include:
- Proximity - Staff and clients often spend extended periods of time together; often in close proximity as well. This is particularly prevalent on expeditions or in other situations where staff and client share the same living space (e.g., cabin, tents, etc.). Care must be taken to fully consider the impact of this, as well as any ways that this might adversely impact treatment outcomes.
- Practitioners are often in multiple roles that expand the typical client staff relationships. For example, during a climbing activity, staff may be responsible for belaying and spotting a client, as well as facilitating outcomes. In addition, many activities warrant full staff participation with clients, so they are also personally responsible for their individual performance.
- Sexual/romantic relationships: As in all therapeutic settings, sexual relationships are always inappropriate between client and staff; regardless of setting. However, the intensity of the experience, along with the degree of time spent together, close living situations, etc. tend to create situations where sexual/romantic relationships between staff flourish. While at first glance, it may seem fairly straightforward to allow or not allow such relationships; this has implications not only for staff but also longer-term consistency of programs. Again, there are no clear answers but factors to consider include the impact on staff of the lack of time off and privacy during course, the degree of freedom staff have to pursue other relationships (this is particularly salient for expedition-oriented and wilderness therapy programs), the fact that clients are not paying for staff time spent on their personal relationships, the potential impact on clients/groups of conflict that may occur between involved staff, potential differences between adult/youth groups, potential differences between groups with different stated goals (e.g., mutual aid or self-help vs. therapy) and length and stability of staff involvement. What is recommended is that staff and supervisors carefully consider where the practitioner's primary responsibility lies, and look to the guidelines (both formal and informal) adhered to in other professions.
This refers to staff disclosing to clients about personal experiences or knowledge, such as previous life experiences, emotional states or reactions, or current life circumstances (e.g. marital status, parental status).
- What is most important to consider is the reason behind the desire to disclose. Typically, these reasons include the desire to build rapport, the desire to prove competence, and the related issue of informed consent (e.g., when a client asks, "Do you know how to climb?" or "Do you know how to canoe?").
- Supervision on this issue is important, and the ability to differentiate the value of disclosing different types of information for different reasons is crucial. For example, there may be great benefit in assuring a client that you know how to climb, while disclosing about more personal issues in an attempt to create rapport/shared understanding has a high potential to negatively impact staff/client relationships.
- When relationship and/or rapport building is the goal, it may be useful to consider other ways to achieve the same effect.
Adventure activities often include various forms of physical contact between professionals and participants or among participants (e.g., spotting, checking climbing harnesses, holding hands, touch due to activity structure, sharing small spaces during river crossings).
- Practitioners are sensitive and respectful of the fact that clients experience varying degrees of comfort with physical contact; even when it is offered for safety, encouragement, or support.
- Whenever possible, inform, explain, and gain consent for usual and customary forms of physical contact. It is essential that practitioners be aware that some clients (e.g., those struggling with PTSD) may react to physical touch/proximity in ways that can adversely impact the treatment process (that may extend beyond the particular activity), and facilitate activities in a way that maintains a high degree of sensitivity to this. This should also include allowing clients the choice not to participate. This should be done in a way that allows for the maintenance of client dignity, as well as for participation in another way that does not entail physical contact. Careful consideration should be given to circumstances when specific activity completion is thought to be necessary for program completion. NOTE- blindfolded activities in particular can trigger PTSD reactions in clients, and it is essential that sensitivity to this and associated factors be maintained in such cases. Some clinical supervision may be necessary.
- Participants should be given the right to limit or refuse physical contact with professionals and participants except when safety is a concern (e.g., essential spotting, medical - first aid response).
- It is important that practitioners maintain awareness of their own individual need when initiating physical contact with clients, especially if the contact is meant to communicate support (e.g., hugs, pats) and is otherwise not required for a particular activity. Care must be taken to differentiate touch that is in the client's best interest from that which mainly serves the needs of the practitioner.
- Practitioners should be aware of the effect of close physical proximity between clients and/or practitioner (s) during activities where that is inherent to the activity itself, and use that awareness to inform into their activity choice.
It is important to recognize that clients have a right to maintain emotional boundaries that are appropriate to their treatment goals and the goals of the particular situation.
- Practitioners should be trained in appropriate sequencing of activities in order to not push clients too quickly into emotional areas that they may be unready for. Training is also necessary on the potentially adverse treatment impact on clients of not maintaining emotional boundaries appropriate to the situation at hand, as well as the potentially detrimental effect on practitioner/client relationships.
- Practitioners should also have the level of training necessary to be able to make judgments about when it is appropriate to respect a clients stated emotional boundary and when it might be useful to encourage a deeper level of sharing/emotional openness.
- Constant awareness of the emotional safety of a group is paramount, and practitioners must intervene when this safety is compromised; either by a situational factor or another group member/staff.
- Practitioners must be aware of the impact on clients of disclosing about core therapeutic issues (e.g., trauma) at less optimal points in treatment or in less optimal situations; and take care to support clients to disclose at a time that is deemed most appropriate based on individual treatment goals. When less optimal disclosures occur, staff must take care to act in ways that maintain emotional safety while also helping to create a more appropriate emotional boundary. This must be done in a sensitive manner, and training/supervision on this is essential.
- Practitioners must maintain awareness of the stated goals of the group, and maintain emotional boundaries that are in line with these goals (e.g., an intact therapeutic group vs. a group that participates in a personal growth oriented one-day experience).