Breaking the Silence:Challenges to Professional Boundaries in Therapeutic Work - A Qualitative Exploration

This thesis examines two areas of professional importance that to date have received little clinical and research attention: therapist pregnancy and therapeutic touch.A meta-synthesis of qualitative research studies explored the professional experiences of 157 pregnant psychotherapists. The paper identified 13 studies, mainly unpublished doctoral dissertations, which conducted interviews with pregnant therapists about various aspects of their experience. Findings indicated that therapist pregnancy was associated with a variety of new therapeutic challenges, including pregnancy disclosure, fluctuating boundaries and elevated guilt. It was determined that therapists lacked the necessary knowledge, support and clinical expertise to navigate this new clinical terrain. Thus, recommendations focus upon enhancing supervisory awareness of the challenges afforded by therapist pregnancy, which in turn it is hoped will increase professional dialogue and therapist support.The empirical study explored trainee clinical psychologists’ (trainees) views and experiences of touch in the therapeutic relationship. Nine trainees participated in individual semi-structured interviews that were subsequently analysed using Interpretative Phenomenological Analysis. Three super-ordinate themes emerged: Secrecy to Confession, Fear of the External Monitor, and Conflicting Identities. The empirical study indicated that the absence of teaching, supervision and professional guidance on touch contributed to trainees’ perceptions that touch was incompatible with their professional role, increasing reticence to discuss or use touch. The study calls for touch tuition to be incorporated within training curricula and greater supervisory dialogue, both of which may help to alleviate the perceived stigma surrounding therapeutic touch.The final paper details the personal reflections of the main author and examines how key study findings may be understood from various theoretical underpinnings. Priorities for future research are also considered alongside clinical implications related to both studies in this volume