Touch, Boundaries and Contracts in Counselling and Psychotherapy

Why touch is worth talking about

Touch in therapy is neither forbidden nor routine. It is something to be agreed, openly and in advance, like every other part of how we work together.

Many people arriving for a first session wonder, quietly, whether the therapist will shake their hand, offer a hug, or keep a careful distance. Few ask. This post sets out what UK professional guidance says, what the research shows, and how a contract-based way of working keeps touch, and its absence, safe and meaningful.

What UK professional bodies say

Neither the BACP nor the UKCP bans non-sexual touch. Both make sexual contact with clients an absolute prohibition.

• It depends on the model. BACP’s boundaries guidance (GPiA 110, updated March 2023) notes that a hug may be acceptable in some humanistic therapies but seen as crossing a boundary in some psychodynamic ones.
• Talk first, touch second. The same guidance asks therapists to discuss touch with the client, ask permission, and explore its purpose and meaning.
• Check your own motives. BACP’s complaints learning advises never touching or hugging a client without checking with them first and reflecting on why.
• Flexibility can be an inclusion issue. A disabled client may need to be guided to the room, while for another client, closeness or touch may feel culturally wrong. The answer is to agree in advance what helps.
• Autonomy and no exploitation. The UKCP Code (2019) requires respect for client autonomy, no sexual contact, and no exploitation of the relationship for the therapist’s emotional, sexual or financial gain.

BACP also notes that physical sexual advances to a client may be a criminal offence as well as a professional conduct matter.

What the research says

Most clients who are touched in therapy experience it as supportive, but around 1 in 20 experience it as negative or inappropriate. That minority is why consent matters so much.

The largest study so far is Tanzer et al. (2025), published in Psychotherapy Research. It drew on 6,878 UK adults who had had therapy in the previous ten years.

Attachment style shaped the experience. People higher in avoidant attachment rated touch less positively. People higher in anxious attachment wanted touch more, yet were also more likely to find it inappropriate.

The authors are clear that wanting touch does not mean it should be offered. They also point out that choosing not to touch carries its own meaning in the relationship.

Earlier work points the same way. In Horton et al. (1995), most of 159 clients said touch deepened their sense of connection. The few negative accounts mostly involved sensing the therapist’s discomfort, or feeling the touch did not meet the client’s needs. Other research (Geib, 1998) found some clients felt touch served the therapist more than them, or reduced their sense of control.

Rituals: the handshake is touch too

The most common touch in therapy is a ritual, not an intervention, and rituals carry meaning precisely because they are predictable.

Eric Berne, the founder of transactional analysis (TA), described six ways people structure time together, in Games People Play (1964):

1. Withdrawal — retreating into our own thoughts.
2. Rituals — familiar, predictable exchanges such as greetings and goodbyes.
3. Pastimes — light, safe conversation about familiar topics.
4. Activities — working together on a shared task.
5. Games — repeated patterns with a hidden payoff.
6. Intimacy — open, authentic contact without a hidden agenda.

The list runs roughly from least to most emotional risk. Rituals sit near the safe end: they offer recognition (what Berne called “strokes”) without asking much of either person.

In a therapy room, rituals include the greeting at the door, the same chair, the same start time, a handshake on arrival or departure, and “see you next week”. They help build a dependable frame, which is often what makes harder work possible.

Three things follow for touch:

• A ritual can still be unwelcome. Some people prefer not to shake hands for cultural, religious, health or sensory reasons. Others became less comfortable with handshakes during the pandemic. The ritual should be agreed, not assumed.
• Changing a ritual says something. If a therapist starts or stops shaking hands, or a client asks for a hug at the last session, the change is worth noticing and talking about.
• One person’s ritual can be another’s intimacy. A hug meant as a polite goodbye may be felt as deep closeness, or as an intrusion. Naming which kind of moment it is helps both people stay on the same page.

Contracting: the heart of safe touch

In transactional analysis (TA), nothing important is left to assumption. Client and therapist make an open, two-way agreement about what they are doing together, and touch sits naturally inside that agreement.

What “agreed” means

This post uses the word “agreed” a lot. Between therapist and client, something counts as agreed only when all of the following are true:

• Explicit. It has been put into words. Not objecting, going along with something, or a therapist’s assumption is not agreement.
• Informed. The client knows what is being proposed, why, and what it might stir up.
• Freely given. The client can say no, or not yet, without any cost to the relationship or the work.
• Mutual. Both people choose it. A therapist can decline too, if something would not serve the work.
• Made when thinking clearly. Ideally it is agreed calmly and in advance, not in the middle of acute distress. In TA terms, from the Adult rather than from a wish to please.
• Specific. It is clear what kind of contact, when, and for how long.
• Revisable. Either person can change or withdraw it at any time, and checking in again is normal, not a sign something is wrong.

If any of these is missing, the honest answer is that it has not yet been agreed.

What a contract is: Berne

Eric Berne defined a contract as “an explicit bilateral commitment to a well defined course of action” (Principles of Group Treatment, 1966). Explicit means it is spoken, not assumed. Bilateral means both people commit. Well defined means both know what they are agreeing to.

Berne wanted to move away from the idea of the therapist as expert and the client as passive patient. He asked people what they saw as the problem and what they wanted from him, then agreed together whether and how he could help.

He described three levels of contract, explained in detail by Charlotte Sills in Contracts in Counselling and Psychotherapy (2006).

The psychological level is where touch most often goes wrong. A client may hope, without saying so, that a hug will prove they matter. A therapist may feel pulled to comfort rather than stay with distress. Neither is chosen, which is exactly why it needs naming.

What makes a contract sound: Steiner

Claude Steiner, in Scripts People Live (1974), borrowed four requirements from contract law:

1. Mutual consent — both people genuinely agree. For touch, either can say no without consequence.
2. Valid consideration — something of value is exchanged, usually time and skill for a fee. Touch is never part of that exchange: not a reward, a payment or a favour.
3. Competency — both are able to make the agreement. A yes given in the middle of acute distress is not the same as a yes agreed calmly beforehand.
4. Lawful object — the agreement is legal and ethical. Sexual or sensual touch fails this test and can never be contracted.

Holding contracts flexibly: Sills

Sills distinguishes hard contracts, with observable goals (“I will make three new friends this year”), from soft contracts, which are more subjective (“I want to start enjoying my life”). She warns that hard contracts can backfire: some clients adapt to what they think the therapist wants, or turn the goal into another test to pass.

Her contracting matrix offers four kinds of agreement, depending on how clear the goal is and how well the client understands what needs to change:

Sills also nests contracts inside one another, like Russian dolls: with society, with the organisation, with the client for the overall work, for each session, and moment by moment. Each level holds the next safely.

On touch she is direct: clearly negotiated contracts protect both people, and any body-based work must be explained at the outset. Her book includes a written touch consent form by body psychotherapist James Kepner. He stresses that a form is only one part of consent: touch work belongs inside an established relationship and an ongoing conversation.

Making contracts precise: Stewart

Ian Stewart, author of Transactional Analysis Counselling in Action (1989) and Developing Transactional Analysis Counselling (1996), focuses on the craft of making contracts work. He distinguishes the outcome the client wants from the actions that lead there. He also recommends contracts that are sensory-based (you would know when they are met), finishable, clear and flexible.

With Vann Joines in TA Today (1987), Stewart argues that a key job of the contract is to bring any hidden agenda into the open, and that contracts work best phrased positively — what someone will do, not what they will stop. Making the hidden explicit helps both people avoid the repeated, unhelpful patterns TA calls games.

Third parties: English

Where an employer or insurer pays for sessions, Fanita English’s three-cornered contract (1975) is a reminder to be clear what each party expects. An agency’s own policy on touch may also apply, and the client should know about it from the start.

Putting it together: touch at each level of contract

Adrienne Lee’s process contract

A single agreement at the start is not enough for touch. Adrienne Lee’s process contracts treat consent as something renewed, moment by moment, as the work unfolds.

Lee wrote the chapter on process contracts in Sills’ Contracts in Counselling and Psychotherapy (2006). As summarised in Self & Society, she describes contracting as a sequence:

1. Administrative contract — sets the scene and prepares the client for the central question: “What do you want now?”
2. Treatment contract — the overall direction of the work, usually held more loosely, and arrived at through experience rather than reasoning alone.
3. Process contracts — small, spontaneous agreements within a session, which work as miniature versions of the overall contract.
4. Completion contracts — agreeing how the work ends.

Lee emphasises that change is co-created by client and therapist, not done by one to the other.

Applied to touch, this approach suggests:

• Ask, don’t reach. In a moment of distress, the therapist asks what would help now, rather than deciding on the client’s behalf.
• Yes once is not yes always. A handshake agreed in week one can be revisited in week ten. Either person can change their mind.
• The question is the intervention. Being asked “What do you want now?” can matter more than the touch itself, because it returns choice to the client.
• Endings need contracting too. How to say goodbye, including whether a final handshake or hug is wanted, belongs in the completion contract rather than being improvised at the door.

How I work with touch

All touch in my work is contracted, and I never initiate it. I use contracting for contact and touch with every client: from a greeting at the door to any form of touch, nothing physical between us is assumed, and anything that happens is agreed together in the sense described above.

• Handshakes. I won’t offer my hand first. If you’d like to shake hands, you’re welcome to say so; if you’d rather not, that is completely fine and needs no explanation.
• In our first session. We agree how we will work together, including boundaries around contact and touch, contact between sessions, and confidentiality.
• During the work. If you are distressed, I won’t reach out to you. I’ll ask what would help, and we can talk about it together.
• Changing your mind. Anything we agree can be revisited at any time, by either of us.
• Endings. We’ll agree together how we say goodbye.
• Online sessions. Touch doesn’t arise, but the same principle applies to any grounding or body-based exercises: they are offered, explained and always optional.

I also support clients in exploring what contact means to them and making sense of it. Touch, and the absence of touch, can stir up feelings, memories and expectations. Understanding what a handshake, a hug or keeping distance means for you can be a valuable part of the work, at your own pace.

I am an Individual Member of the BACP and work within its Ethical Framework. I take questions about boundaries, including touch, to regular clinical supervision.

Questions you can ask any therapist

A good therapist will welcome these questions in a first session or consultation:

• Do you ever use touch in your work, and if so, how and why?
• Will you shake my hand, and is it OK if I’d rather not?
• What would you do if I became very upset during a session?
• How do we agree, and change, the boundaries of our work?
• Which professional body do you belong to, and how could I raise a concern?

If something in therapy ever felt wrong to you, it is worth raising with the therapist directly. BACP also runs a Get help with counselling concerns service for clients.

References

• BACP (2023) Good Practice in Action 110: Boundaries within the counselling professions. Lutterworth: BACP.
• BACP What complaints tell us: boundaries.
• Berne, E. (1964) Games People Play. New York: Grove Press.
• Berne, E. (1966) Principles of Group Treatment. New York: Oxford University Press.
• English, F. (1975) The three-cornered contract. Transactional Analysis Journal, 5(4).
• Geib, P. (1998) The experience of nonerotic physical contact in traditional psychotherapy. In E. Smith, P. Clance and S. Imes (eds) Touch in Psychotherapy. New York: Guilford Press.
• Horton, J.A., Clance, P.R., Sterk-Elifson, C. and Emshoff, J. (1995) Touch in psychotherapy: a survey of patients’ experiences. Psychotherapy, 32(3), 443–457.
• Lee, A. (2006) Process contracts. In C. Sills (ed.) Contracts in Counselling and Psychotherapy, 2nd edn. London: Sage.
• Sills, C. (2006) Contracts and contract making. In C. Sills (ed.) Contracts in Counselling and Psychotherapy, 2nd edn. London: Sage.
• Steiner, C. (1974) Scripts People Live. New York: Grove Press.
• Stewart, I. (1989) Transactional Analysis Counselling in Action. London: Sage.
• Stewart, I. (1996) Developing Transactional Analysis Counselling. London: Sage.
• Stewart, I. (2006) Outcome-focused contracts. In C. Sills (ed.) Contracts in Counselling and Psychotherapy, 2nd edn. London: Sage.
• Stewart, I. and Joines, V. (1987) TA Today. Nottingham: Lifespace Publishing.
• Tanzer, M. et al. (2025) Touch in psychotherapy: experiences, desires and attitudes in a large population survey. Psychotherapy Research.
• UKCP (2019) Code of Ethics and Professional Practice.