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Robert S. Epstein in his book Keeping Boundaries:The Nature and Function of Therapeutic Boundaries (1994) writes on page 18:

'The therapist's role is that of a fiduciary (Frank and Frank 1991);(R.I.Simon 1987). The patient's compliance with treatment requires vulnerability and trust. Patients lack the objectivity and the expert knowledge to treat themselves, and must rely on professionals with special training. Peterson(1992) emphasized that some exploitative therapists attempt to disavow this responsiblity by disclaiming any disparity in the treatment relationship. They employ pseudo-egalitarianism to exculpate themselves with the excuse that the patient is a 'consenting adult.'

(eg: These pseudoegalitarians deny the existence of both the power imbalance in which they as poweholders are at advantage, by denying their accountability for responsible use of power they dis-avow that they are accountable to an ethos of care. A classic method of false empowerment is the favorite, 'There are no victims, only volunteers.' In this line of reasoning, there is no conscious way to acknowlege the power imbalance in which the person who claims its nonexistence--continues to stay on top--and shoves all accountability onto the underling the moment something goes wrong C)

In their book, Science and Pseudoscience in Clinical Psychology, Lielienfeld, Lynn and Lohr provide a chapter on New Age therapies and discuss the fiduciary relationship in greater detail:

'Under the laws of most states, both licensed and unlicensed clinicians who hold themselves out to the general public as performing the functions of a therapist establish a relationship with their clients based on trust, confidence, and confidentiality. (Corboy comments--how is confidentiality maintained in an LGAT setting? Do LGATs sign paperwork promising to hold records, videotapes and recordings confidential? Many gurus collect adoring letters from devotees or demand written grovelling apologies as a price of regaining favor. Do they ever promise to keep such letters confidential or return them to anyone who later chooses to leave?)

Back to Lilienfeld and Lohr: 'In the law, when a relationship exists between individuals, based on trust and confidence, and one individual has greater knowledge, experience, training and skill, than the other, (that is, a power imbalance--C), then that relationship is generally considered in the eyes of the law to be a fiduciary relationship. In many states therapists are considered fiduciaries. Because of their disproportionate knowledge, training, and experience, fiduciaries are held to a higher standard of care and responsiblity for 1) the services provided to a client and 2) the appropriateness of the services to aid the client in overcoming problems.

'We propose' state the authors 'that all therapeutic relationships be considered fiduciary relationships and that the standard of care against which a therapist is judged be the standard applied to fiduciaries. That same standard should be applied to the New Age or traditional therapist, regardless of espoused ideology.'

(Lilienfeld Lynn and Lohr: Science and Pseudoscience in Clinical Psychology, 2003, page 191)

'Clients have the right to know in advance that they are being subjected to experimental approaches. Therapists have the fiduciary obligation of informing clients when such methods are being used. Therapists have the further responsibility of informing clients that alternative therapeutic approaches are available and that these approaches are based on methods commonly accepted within the professional psychological community....as fiduciaries, therapists must ensure that psychotherapy furthers the aims and purposes of clients (my italics-C), rather than adding to the prestige, self image, or feelings of power and control of the therapist. (Lilienfeld, Lynn and Lohr, 201)

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Continuing Education--Confidentiality

Robert S Epstein has an entire chapter on confidentiality in his book, Keeping Boundaries:Maintaining Safety and Integrity in the Psychotherapeutic Process
(1994)

In the section, 'Counterindicated Forms of Release', Dr. Epstein writes:

'In the absence of an authorized release, requests for (patient) information from third parties should be refused. A breach of this rule is likely to seriously interfere with the patient's ability to trust the therapist. At times, such an impropriety can lead to injurious consequences that neither the therapist nor the patient could have anticipated...

'Third parties frequently make unauthorized requests. Such requests are often couched in ways calculated to elicit shame in the therapist. The embedded message is "How can you be such an unfeeling and uncooperative person as to refuse a simple request?"

'Because this induced feeling of shame appears to center around the high value that most therapists place on being helpful and facultative, it is important that therapists be prepared for the demeaning intonation and subtle pressure that frequently accompany unauthorized requests. (my use of bolding-C) Many people, even trained therapists, simply fail to understand the high risks involved.

'Some third parties, such as relatives of the patient, attorneys, journalists, and other health care professionals, are quite aware of the laws regarding confidentiality, but use guile to intimidate or trick the therapist
into revealing forbidden information. Therapists must understand their obligations in this regard, regardless of whether anyone else does'(my underlining-C). (Epstein, page 191)

Quote

Robert S. Epstein in his book Keeping Boundaries:The Nature and Function of Therapeutic Boundaries (1994) writes on page 18:

'The therapist's role is that of a fiduciary (Frank and Frank 1991);(R.I.Simon 1987). The patient's compliance with treatment requires vulnerability and trust. Patients lack the objectivity and the expert knowledge to treat themselves, and must rely on professionals with special training. Peterson(1992) emphasized that some exploitative therapists attempt to disavow this responsiblity by disclaiming any disparity in the treatment relationship. They employ pseudo-egalitarianism to exculpate themselves with the excuse that the patient is a 'consenting adult.'

(eg: These pseudoegalitarians deny the existence of both the power imbalance in which they as poweholders are at advantage, by denying their accountability for responsible use of power they dis-avow that they are accountable to an ethos of care. A classic method of false empowerment is the favorite, 'There are no victims, only volunteers.' In this line of reasoning, there is no conscious way to acknowlege the power imbalance in which the person who claims its nonexistence--continues to stay on top--and shoves all accountability onto the underling the moment something goes wrong C)

In their book, Science and Pseudoscience in Clinical Psychology, Lielienfeld, Lynn and Lohr provide a chapter on New Age therapies and discuss the fiduciary relationship in greater detail:

'Under the laws of most states, both licensed and unlicensed clinicians who hold themselves out to the general public as performing the functions of a therapist establish a relationship with their clients based on trust, confidence, and confidentiality. (Corboy comments--how is confidentiality maintained in an LGAT setting? Do LGATs sign paperwork promising to hold records, videotapes and recordings confidential? Many gurus collect adoring letters from devotees or demand written grovelling apologies as a price of regaining favor. Do they ever promise to keep such letters confidential or return them to anyone who later chooses to leave?)

Back to Lilienfeld and Lohr: 'In the law, when a relationship exists between individuals, based on trust and confidence, and one individual has greater knowledge, experience, training and skill, than the other, (that is, a power imbalance--C), then that relationship is generally considered in the eyes of the law to be a fiduciary relationship. In many states therapists are considered fiduciaries. Because of their disproportionate knowledge, training, and experience, fiduciaries are held to a higher standard of care and responsiblity for 1) the services provided to a client and 2) the appropriateness of the services to aid the client in overcoming problems.

'We propose' state the authors 'that all therapeutic relationships be considered fiduciary relationships and that the standard of care against which a therapist is judged be the standard applied to fiduciaries. That same standard should be applied to the New Age or traditional therapist, regardless of espoused ideology.'

(Lilienfeld Lynn and Lohr: Science and Pseudoscience in Clinical Psychology, 2003, page 191)

'Clients have the right to know in advance that they are being subjected to experimental approaches. Therapists have the fiduciary obligation of informing clients when such methods are being used. Therapists have the further responsiblity of informing clients that alternative therapeutic approaches are available and that these approaches are based on methods commonly accepted within the professional psychological community....as fiduciaries, therapists must ensure that psychotherapy furthers the aims and purposes of clients (my italics-C), rather than adding to the prestige, self image, or feelings of power and control of the therapist. (Lilienfeld, Lynn and Lohr, 201)