Susan M. Rogers, PsyD, is a 2012 graduate of the PsyD Program in Clinical Psychology at Antioch University New England.

Dissertation Committee

  • Roger Peterson, PhD (Committee Chair)
  • Elaine Campbell, PsyD (Committee Member)
  • Kathy McMahon, PsyD (Committee Member)


outreach training, ethics and outreach, boundaries and outreach

Document Type


Publication Date



The need for outreach psychotherapists has increased considerably over the past few decades. Research suggests graduate training has not kept up with this phenomenon. Graduate students continue to be trained for in-clinic work, and are not prepared for the challenges of going into clients’ homes and into the community. The literature supports the necessity for therapists who will be doing outreach psychotherapy to be trained in working in these atypical settings, as many innate challenges exist in this work. Challenging mental health issues, distracting environmental issues, safety concerns, lack of collegial support and supervision in the field, feelings of isolation, role confusion, and blurred boundaries are just some of these concerns. This research study reviewed the literature on home-based psychotherapy, and ethical and boundary challenges as they relate to working in atypical settings. A six-hour training to explore ethical and boundary challenges in outreach psychotherapy was created, and given to nine pre-doctoral psychology interns. Topics included: advantages and challenges of working in atypical setting, boundaries, confidentiality, self-disclosure, dual-relationships, safety, and self-care. Ethical decision-making models were reviewed and used to explore hypothetical vignettes of potential ethical challenges in the community. A post-training survey was given to participants to assess participants’ perceived gained knowledge, gained skills in using ethical decision-making models, and to evaluate the training. Descriptive statistics revealed that the training was found to be useful to all participants, and that all participants would be able to use ethical decision-making models in their work. An open comment section is summarized and discussed. Future research is needed to explore the supervisory needs of outreach clinicians with the goal to create trainings for these supervisory staff.