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Treatment Boundaries in the Case Management Relationship: A Behavioral Perspective

Kate B Carey, Ph.D.


Williams and Swarz (this issue) provide a thoight-provoking analysis of the challenges and potential pitfalls faced by case managers working with seriously mentally ill clients. Case managers engage in a variety of interactions that lack clear guidelines for what is professional and/or appropriate helpful behavior. Several problem areas were identified by Williams and Swartz, including multidimensional relationships, use of power in the relationship, distinguishing freindship versus friendly relationships, use of self-disclosure, after-hours involvement, and issues of reciprocity.


Kanfer, F. K., & Schefft, B. K. (1988). Guiding the process of therapeutic change. Champaign, IL: Research Press. Long, S.L., & Zlutnick, S. (1996). Task analysis training of case managers to assist seriously mentally ill patients find roommates and housing. Journal of Behavior Therapy and Experimental Psychiatry, 27, 269–280. Schaap, C., Bennun, I., Schindler, L., & Hoogduin, K. (1993). The therapeutic relationship in behavioural psychotherapy. New York: Wiley. Stasiewicz, P. R., Carey, K. B., Bradizza, C. M., & Maisto, S. A. (1996). Behavioral assessment of substance abuse with co-occurring psychiatric disorder. Cognitive and Behavioral Practice, 3,91–105. Sweet, A. A. (1984). The therapeutic relationship in behavior therapy. Clinical Psychology Review, 4, 253–272.

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Contributed on 12/6/2012

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