Unlike Strasburger et al. (1992), some clinicians encourage boundary spanning as a way to increase the working alliance (Wolitsky-Taylor et al., 2012). Interestingly, Richard and Gloster (2007) found that maintaining appropriate boundaries was the most common ethical issue associated with exposure therapy. Not only would this be judicious information for any therapist to consider before conducting exposure therapy, but it may also explain why so few therapists engage in exposure therapy despite the evidence of effectiveness. Therapists are careful to engage in any behavior that could lead to disputes, such as boundary crossings and slippery slope violations. This may be a result of the theoretical orientations of the consultants. Deacon (2012) notes that clinicians with orientations that emphasize “neutrality, passivity, and nondirectivity, exposure may result in an uncomfortably high level of active involvement with the patient” (p. 18). Exposure therapy is a cognitive behavioral therapy (and originally behavioral therapy) treatment that is notable for producing active, directive, and more authoritative counselors (Corey, 2013). Thus, although boundary crossings may be clinically useful and relevant, it is reasonable to assume that most therapists who adapt to this approach would be uncomfortable with intentional boundary crossings. As a reiteration of my previous recommendation, a specialized training program or certification could address this issue. Conducting exposure therapy outside of the office may increase the likelihood of more casual interactions, deviations in conversation away from therapeutically relevant topics, and maintaining confidentiality more challenging (Olatunji et al, 2012; Changing… middle of paper… the ethics of using it in therapy. With so many other possible treatments that have been shown to be effective, I wonder why anyone would choose exposure therapy. It seems like the 'quick and dirty' treatment for anxiety problems using information and consent as an umbrella that covers all indiscretions and ethical violations. Exposure therapy covers many different ethical areas. After researching them all, I chose the three that I was most passionate about. Although there is a wide range of exposure therapies , I have tried to remain general to properly apply these ethical considerations to all treatment methods. I am now able to understand this treatment from all angles and through the use of the CPA Code of Ethics and CAP Standards of Practice. I wonder how many recent graduate counseling students use exposure therapy? The thought is petrifying.