10 Types of Touch That Can Happen in Therapy

Knowing touch is the foundation of human experience and that it is essential for healthy growth and development, we need to pause and ask ourselves… When did touch become a bad word?

In the 13th century, the Holy Roman Emperor Frederick II took 50 infants from their mothers and placed them with foster mothers. The foster mothers were instructed to feed and bathe the children, but not to touch, speak or interact with them in any other way. While his experiment was intended to discover what natural language the infants would speak, Frederick II would never find his answer because the children perished: unable to live and thrive without the clapping of hands and interaction of touch.

It should come as no surprise how crucial touch is to our development. It is the first sense that we develop in the womb, and the last sense we use before death. Knowing touch is the foundation of human experience and that it is essential for healthy growth and development, we need to pause and ask ourselves… When did touch become a bad word?

No touch rules were instituted to try to stop sexual abuse of children. These rules, while well intended, placed additional pressure on therapists, and started a new ethical battle.

  • How do you respond to a client’s spontaneous hug?
  • How do you ethically incorporate touch with play therapy?
  • Do you need a consent form to touch your client?

Today, there are many ways you can include touch in therapy sessions while maintaining your ethical standing. Here’s a list of 10 types of touch identified by Janet Courtney that can happen during therapy if deemed developmentally appropriate.

  1. Greeting touch
    • Shaking hands with child or parent
  2. Patterned playful touch
    • Quick, synchronized hand movements (such as pat-a-cake)
  3. Reorienting touch
    • Touching a child that appears to be drifting off
  4. Task-oriented touch 
    • Hands touch passing a toy, paper, markers, etc.
  5. Physical (related to an injury) touch
    • A child shows you a hurt finger
  6. Excited/happy touch
    • When a child is sharing good news
  7. Containment touch
    • When a child is in danger (like standing on a chair)
  8. Intentional touch
    • Measuring a child’s height on the wall
  9. Assistance touch
    • Help standing or completing a task
  10. Attentional touch
    • When a child is touched to gain their attention about something

Want more training on the ethics of touch? We invite you to learn more with Janet Courtney’s Ethics of Touch in Child Psychotherapy & Play Therapy DVD.


Before you leave, watch this TED talk from Janet Courtney on the Curative Touch of a Magic Rainbow Hug.

It’s Just a Little Crush: When client relationships lean romantic.

When a client ruffles your feathers in all the right ways, how you respond determines your ethical standing. Here’s one therapist’s confession…

In our consultation group, the subject of falling in love with a client was once broached purely theoretically, and everyone became uncomfortably quiet. Nobody shared a personal experience. The message we gave each other was clear: Whatever you do, don’t talk about having a crush on a client!

I want to break our conspiracy of silence so that we can get help when we need it. And believe me, when it came to Scott, I needed help.

Scott was 34 years old when he was referred to my therapy center by the courts. He had a violent and explosive past. He was unmarried, childless, and an amateur jazz musician. He was gorgeous, at least to my taste: tall, well-built, and (like many men with a history of violence) charming, intelligent, and a champion at forming relationships.

Bemused, Bothered, and Bewildered

In my initial work with Scott, I could see that he was uncomfortable to be in a relationship in which he was not totally in control. Usually, I quickly get a feel for how to establish a collaborative relationship where I am, nevertheless, in charge. Not with Scott.

With Scott, I was flirting instead of guiding.

In session, he worked hard to please me and often told me what a fabulous therapist I was. I’d heard it all before, but this time, I did not use a client’s compliments as therapeutic material; I simply let them wash over me. I loved participating vicariously in his exciting life, and I was flattered that he kept me emotionally present even when we were apart.

Instead of keeping him engaged in the process, I was working hard to keep him engaged in our relationship. This was not the Mary Jo I knew.

The worst part was the terrible isolation I felt. For two months, embarrassed and ashamed, I struggled internally and alone. I didn’t tell my husband, Dennis, or anyone else.

In Consultation Group

I finally addressed my crush in my consultation group. We began exploring my feelings. “What is he bringing up in you?” they asked. “What’s getting stirred?”

As I began to talk openly about my feelings, I realized that danger existed only if I behaved unethically. I was clear on my marital and professional responsibilities. I was not about to act out my crush.

Scott reminded me of my own carefree younger days, when I’d first fallen in love with Dennis. Dennis made me feel special then–he read everything I wrote, told me I was brilliant and came to my speeches. We hiked and lifted weights together, went out for dinner and stayed up talking long into the night.

I told Dennis about what had been going on. We started working out together again and taking walks without the kids. We went away together and spent a wonderful weekend in New Orleans.

With time, I stopped feeling like a deer frozen in the headlights. I began working with Scott with an easier mix of head and heart. Our consultation group also changed: we began taking greater risks with one another and the therapy we did subsequently improved. We commented on the new level of intimacy we had reached together.

Scott finished therapy six months later without ever having known about my crush.

Have you had a crush on a client? How did you handle it?
Tell us in the comments below.


Don’t put your career at risk. Learn how to protect yourself when boundaries blur.


This post is based on an article originally brought to life by our partner, Psychotherapy Networker.

Click to read the full article, “The Crush,” written by Mary Jo Barrett.

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