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Bull Menninger Clin. 1990 Fall;54(4):450-65.

The Exploitation Index: an early warning indicator of boundary violations in psychotherapy.

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Department of Psychiatry, Georgetown University School of Medicine.


Exploitive behavior by therapists is highly disruptive in psychotherapy because it violates the sense of trust derived from a coherent treatment boundary. Such behavior may be difficult to detect because it is often associated with self-deception. The compensatory need to feel "special," a state of mind often associated with exploitiveness, suggests that narcissistic mechanisms play a significant role. The authors present an "Exploitation Index" (EI), a self-assessment questionnaire for therapists that is designed to serve as an early warning indicator of boundary violations.

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