Therapeutic Contract and Ethical Practice in Counselling and Psychotherapy
Professor Sunjida Shahriah
Sunjida Islam
Khalid Arafat
Therapeutic Contract and Ethical Practice in Counselling and Psychotherapy
Professor Sunjida Shahriah
Sunjida Islam
Khalid Arafat
Abstract: Psychotherapists and counsellors confront several ethical dilemmas as they tend toprovide effective services. There has been much debate among psychotherapists and counsellors alike around the utility of therapeutic contracts. Some view contracts as being restrictive to the therapeutic process and often hindering the work done in sessions. In contrast, many counsellors and psychotherapists use those agreements to revisit specific therapeutic topics and establish the guidelines necessary for this professional arrangement. No matter the opinion or preference of contracts, the development of written and/or verbal consent of specific topics in psychotherapy remains essential. This remains one of the formal features of the arrangement and starting relationship in current counselling and psychotherapy practice. This paper aims to discuss the necessity and ethical demand of therapeutic contract in counselling and psychotherapy practice.
Introduction: Therapeutic contract is a
mutual agreement in counselling or
psychotherapy, among the therapist and the
client.It indicates the rights and
responsibilities of both to ensure target
treatment goal.Contracting also ensures that
“the counseling process will be performed in
a good and safe manner and, as a written
document, provides the necessary space for
legal intervention if the responsibilities
outlined are not met”. Specific contract is
mandatory to assess the output of individual
session to ensuring both ethical concerns
and the therapeutic process. A practitioner
evaluates the situation and context of a
contract for better management of the client.
The practitioner and client are related to
each other as equals. Hence, they share
responsibility for the change the client wants
to make.There are already considerable discussions and debate on the utility of
contracts among psychotherapists and
counsellors alike.Some see contracts as
restricting the healing process and often
hindering the work conducted in sessions.
The agreement can restrict both the capacity
to perform specific treatment procedures and
the scope of the role of the therapist.The
innovation and ability for clients to extend
their limits of freedom could be undermined
by defined protocols or contracts.On the
contrary, those arrangements are used by
certain therapists to revisit specific
individual therapy subjects and create the
appropriate criteria for this professional
structure.Contracts create an equilibrium of
power and balance for sessions very often.
No matter the view or desire of contracts, it
remains important to develop written and/or
verbal agreement for a particular psychotherapy subject/patient.This part is
one of the official aspects of the
psychotherapy agreement and original
partnership, whether in private practice,
community clinics, hospitals, schools, or in
the legal system.This paper aims to discuss
the necessity and ethical demand of
therapeutic contract in counselling and
psychotherapy practice.
Theoretical Concepts: Psychotherapists
differ widely in the utility of contracts in
practice, beyond the theoretical origins of
psychotherapy contracts. Traditionally from
the psychoanalytic field, the first contracts
used formally in therapy emerged, where the
arrangement was used mostly like a one-way
negotiation with the client’s desires that the
therapist had. In Freudian perspectives, both
the client and the therapist are allowed to
break a contract at any point, as this
“separation was not seen as a negative
reaction, but rather a choice to leave certain
problems unresolved”. Family structures
and ecological constructs were the first to
incorporate contracts as an integral method
of boundary setting, as the utility of a
therapeutic contract grew over time.
Contracts not only offered protections
between other family members but from
individuals involved in the treatment process
outside of therapy. In the 1960s, during the
development of brief therapy approaches
and treatments, therapeutic contracting
became more prevalent in psychotherapy.
The use of contracts as a critical aspect of
treatment has been highlighted by short-term
models, as described by Tudor. The method
that therapy can occur over time has always
been determined by contracts that are
organized and precise in course of care and nature. It is especially applicable for those
who are placed in residential treatment,
hospital or short-term rehabilitation settings
and have specific contracts to address
certain medical or mental health issues.
However, more recently, psychotherapists
and counsellor from the postmodern
perspective see therapeutic contracts as a
socially constructed process, as they came
into the therapeutic agreement with
preconceived notions about what the
contract looked like or what the expectations
for therapy entailed, along with the goals for
therapy most often phrased in the “language
of the clients, where more strengths,
solutions, and narratives are emphasized in
the initial contract”.