Phoenix

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”.

Professor Sanjida Shahriah

Physician, Counselor, Psychotherapy Practitioner.

Phoenix Wellness Centre BD,

Dhaka, Bangladesh.

 

Sanjida Islam

Psychologist, Counselor, Psychosocial Trainer, Psychotherapy Practitioner.

Phoenix Wellness Centre BD,

Dhaka, Bangladesh.

Khalid Arafat

Coordinator, 

Phoenix Wellness Centre BD,

Dhaka, Bangladesh.

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