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Cowles M, Griggs M. Considering boundaries when doing therapeutic work with people who are seeking asylum: a reflective case study. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2018. [DOI: 10.1080/03069885.2018.1507535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Megan Cowles
- Avon & Wiltshire Mental Health Partnership Trust, Complex Psychological Interventions, Petherton Resource Centre, Bristol, UK
| | - Mary Griggs
- Avon & Wiltshire Mental Health Partnership Trust, Specialised Deaf Service & Traumatic Stress Service, Petherton Resource Centre, Bristol, UK
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Lewis J, Allan S. Physician-Patient Boundaries: Professionalism Training Using Video Vignettes. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2016; 12:10412. [PMID: 31008192 PMCID: PMC6464555 DOI: 10.15766/mep_2374-8265.10412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 04/28/2016] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The concept of professional boundaries is often not included in medical training. Historically, the field of psychiatry has given much consideration to the topic of boundaries, partially due to the high incidence of sexual boundary violations in psychotherapy practice. And while there is a perception that more formal education is needed in psychiatry, the pressure to adjust the frame of a treatment in clinical practice is ubiquitous. We developed this presentation and discussion, using stimulus videos to depict common boundary issues that crop up in everyday outpatient medical practice. METHODS This 90-minute session consists of a 20-minute PowerPoint presentation introducing the concept of professional boundaries and identifies the nine boundary domains as defined by Gutheil and Gabbard. Then the class views and discusses six brief video vignettes (allowing 10 minutes per vignette) with a 10-minute break. Faculty panelists from different specialties and at different stages of training are present to discuss the video vignettes and give examples from their own practice. RESULTS This curriculum was implemented in 2009 at the University of Vermont College of Medicine and has been held annually since. Pre and post data were obtained in March 2009 from third-year medical students who participated in the seminar just prior to beginning their clinical clerkships. Statistically significant changes between pretest and posttest means were observed in five of the 10 questionnaire items, including one knowledge-based question about prescriptions to nonpatients. DISCUSSION The two learner groups we targeted were medical students during their clerkship year and residents in their first year of training. However, this material could easily be extended to other disciplines in medicine such as nursing.
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Affiliation(s)
- Judith Lewis
- Associate Professor of Psychiatry, University of Vermont College of Medicine
- Director of Residency Training, University of Vermont Medical Center
| | - Scott Allan
- Clinical Assistant Professor of Psychiatry, University of Vermont College of Medicine
- Staff Psychiatrist, Howard Center
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Somers AD, Pomerantz AM, Meeks JT, Pawlow LA. Should psychotherapists disclose their own psychological problems? COUNSELLING & PSYCHOTHERAPY RESEARCH 2013. [DOI: 10.1080/14733145.2013.860996] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ghuloum S, Bener A, Commons ML, Miller PM, Burgut FT, Bhugra D. Perceptions of boundaries and cultural influences in Qatar. Int J Soc Psychiatry 2013; 59:199-206. [PMID: 22222849 DOI: 10.1177/0020764011431799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Boundary issues, which regularly arise in therapy, can present dilemmas for most clinicians. There has been substantial literature on boundary excursions in clinician-patient relationships, however, very little empirical research exists and is documented. As mental health researchers, we need to investigate a wide range of sensitive topics to enhance our understanding of the many issues that arise in the psychotherapeutic frame. AIMS We set out to empirically explore perceptions of what may constitute a boundary violation among the mental health staff in the State of Qatar and their views on the subject. RESULTS A total of 50 participants (24 psychiatrists, 2 doctorate level psychologists, 24 psychiatric nurses) responded with a response rate of 80%. Participants rated each possible boundary violation according to its degree of harm and professional unacceptability. Three distinct groupings of boundary violations were obtained: (1) core, consisting of the most serious violations; (2) disclosure and greeting behaviour, involving disclosure of information about the therapist and greeting behaviour; and (3) separation of therapist and client lives, involving encounters between therapists and clients outside of therapy. CONCLUSIONS It is important to ascertain these dilemmas so that these theoretical models can be integrated in clinical practice.
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Affiliation(s)
- Suhaila Ghuloum
- Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
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Miller PM, Bener A, Ghuloum S, Commons ML, Burgut FT. Differences and similarities in cross-cultural perceptions of boundaries: a comparison of results from two studies. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2012; 35:398-405. [PMID: 23079921 DOI: 10.1016/j.ijlp.2012.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There has been substantial literature on boundary excursions in clinician-patient relationships; however, very little empirical research exists. Even less information exists on how perceptions of this issue might differ across cultures. Prior to this study, empirical data on various kinds of boundary excursions were collected in different cultural contexts. First, clinicians from the U.S. and Brazil were asked to rate 173 boundary excursions for both their perceived harmfulness and their professional unacceptability (Miller et al., 2006). In a second study, colleagues from Qatar administered a slightly modified version to mental health care professional staff of a hospital in Doha, Qatar (Ghuloum et al., 2011). In this paper, the results of these two separate studies are compared. The results showed some similarities and some differences in perceptions of the boundary behaviors. For example, both sets of cultures seem to agree that certain behaviors are seriously harmful and/or professionally unacceptable. These behaviors include some frankly sexual behavior, such as having sexual intercourse with a patient, as well as behavior related to doing business with the patient, and some disclosing behavior. There are also significant cultural differences in perceptions of how harmful some of the behaviors are. Qatari practitioners seemed to rate certain behaviors that within therapy mix disclosing or personal behavior with therapy as more harmful, but behaviors that involved interacting with patients outside of therapy as less serious. A factor analysis suggested that participants in U.S./Brazil saw a much larger number of behaviors as making up a set of Core Boundary Violations, whereas Qatari respondents separated sexual behaviors from others. Finally, a Rasch analysis showed that both cultures perceived a continuum of boundary behaviors, from those that are least harmful or unprofessional to those that are highly harmful or unprofessional. One interpretation is that cultural factors may be most influential on those kinds of behaviors that are perceived as relatively less serious. Implications for training and supervision are also discussed.
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Affiliation(s)
- Patrice Marie Miller
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Affiliation(s)
- Amit Garg
- Department of Dermatology, Boston University School of Medicine, 609 Albany St, J207, Boston, MA 02118, USA.
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Enhancing our Understanding of the Potential Violation of Sexual Boundaries in Sport Psychology Consultancy. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2010. [DOI: 10.1123/jcsp.4.4.302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article discusses issues surrounding the potential violation of sexual boundaries in sport psychology consultancy and critically evaluates the current state of knowledge in the field. Limited discussion and research relating to this ethical issue exists within sport psychology; the discussion that has occurred has mainly focused on erotic transference and countertransference (Andersen, 2005). Research and knowledge from clinical psychology, counseling psychology, and psychotherapy proffers ideas for discussion and research into the factors that precipitate sexual boundary violations. The relevance of the controversial practice of touch as a therapeutic tool and a stimulus for sexual boundary violations is considered, alongside implications for the training of neophyte practitioners through role-playing, peer support, and supervision.
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Larkin GL, Mello MJ. Commentary: doctors without boundaries: the ethics of teacher-student relationships in academic medicine. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:752-755. [PMID: 20520021 DOI: 10.1097/acm.0b013e3181d7e016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Possessed of both instinct and intellect, physician teachers are required to be respectful exemplars of professionalism and interpersonal ethics in all environments, be it the hospital, classroom, or outside the educational setting. Sometimes, even while protecting the sanctity of the teacher-student relationship, they may surreptitiously find themselves in the throes of consensual intimacy, boundary violations, student exploitation, or other negative interpersonal and/or departmental dynamics. One may question how an academic can consistently resolve this tension and summon the temperance, humility, charity, and restraint needed to subdue lust, pride, abuse, and incontinence in the workplace. One important answer may lie in an improved understanding of the moral necessity of social cooperation, fairness, reciprocity, and respect that is constitutive of the physician-teacher role. Although normative expectations and duties have been outlined in extant codes of ethics and conduct within academic medicine, to date, few training programs currently teach faculty and residents about the ethics of appropriate pedagogic and intimate relations between teaching staff and students, interns, residents, researchers, and other trainees. This essay highlights examples from history, literature, and medical ethics as one small step toward filling this void.
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Affiliation(s)
- Gregory Luke Larkin
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut 06519-1315, USA.
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Nasrallah SM, Maytal G, Skarf LM. Patient–Physician Boundaries in Palliative Care Training: A Case Study and Discussion. J Palliat Med 2009; 12:1159-62. [PMID: 19995296 DOI: 10.1089/jpm.2009.0181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sandra M. Nasrallah
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Guy Maytal
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lara M. Skarf
- VA Boston Healthcare System, West Roxbury, Massachusetts
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Wohlberg JW. Sexual abuse in the therapeutic setting: What do victims really want? PSYCHOANALYTIC INQUIRY 2009. [DOI: 10.1080/07351699709534130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Professionals are called to high standards of behavior. The purpose of this study was to investigate nursing faculty beliefs about appropriate behaviors for nurse educators. Nursing faculty are generally conservative in their beliefs and even more conservative in their actions. Three behaviors of educators are universally viewed as inappropriate: telling a student of the educator's sexual attraction; sexual involvement with a current student; and making deliberate or repeated sexual comments, gestures, or physical contact that are unwanted by the student. Insulting or ridiculing an absent student and insulting or ridiculing a present student were considered appropriate by few respondents (5% and 2.1%, respectively). Little guidance exists for nursing faculty in determining the appropriateness of various behaviors. This exploratory research gives an introductory view of faculty perceptions of appropriate teacher behaviors.
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Affiliation(s)
- Christine M Henshaw
- Undergraduate Nursing, Seattle Pacific University, Seattle, WA 98119-1922, USA.
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Austin W, Bergum V, Nuttgens S, Peternelj-Taylor C. A Re-Visioning of Boundaries in Professional Helping Relationships: Exploring Other Metaphors. ETHICS & BEHAVIOR 2006. [DOI: 10.1207/s15327019eb1602_1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Yahav R, Oz S. The Relevance of Psychodynamic Psychotherapy to Understanding Therapist–Patient Sexual Abuse and Treatment of Survivors. ACTA ACUST UNITED AC 2006; 34:303-31. [PMID: 16780412 DOI: 10.1521/jaap.2006.34.2.303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.
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Affiliation(s)
- Rivka Yahav
- Faculty of Social Welfare, Haifa University, Har HaCarmel, Israel
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Abstract
Although therapist sexual attraction to clients is common, and therapist self-disclosure is an often-used intervention, therapist self-disclosure of sexual feelings to clients is an understudied phenomenon. In this article, I critically review the small base of literature on therapist self-disclosure of sexual feelings, including information on prevalence rates, empirical research, and case studies. By incorporating these findings with information from relevant sections of the American Psychological Association (2002) Ethics Code, my intent is to evaluate different aspects of therapist self-disclosure of sexual feelings and arrive at conclusions regarding therapists' use of these disclosures. It appears that direct, explicit disclosure of sexual feelings can run the risk of harming clients and may therefore be unethical. Therefore, the use of this technique is discouraged. I discuss the issue of using less explicit interventions.
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Affiliation(s)
- Craig D Fisher
- Argosy University, 1550 Wilson Blvd., Suite 600, Arlington, VA 22209, USA.
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Campbell RJ, Yonge O, Austin W. Intimacy Boundaries: Between Mental Health Nurses & Psychiatric Patients. J Psychosoc Nurs Ment Health Serv 2005; 43:32-9. [PMID: 15960033 DOI: 10.3928/02793695-20050501-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This was the first research study in Canada to explore intimacy boundary violations and sexual misconduct between nurses (both RNs and registered psychiatric nurses) and patients. Using a researcher-generated survey, a total of 923 mental health nurses commented on their sexual attraction to patients, and dating and sexual intercourse patterns with patients. The findings indicated that very few nurses had dated or engaged in sexual intercourse with discharged patients, and the few nurses who had done so tended to be younger men prepared at the registered psychiatric nursing diploma level. A small number of nurses believed it was permissible to have a sexual relationship with a patient while the patient was hospitalized, but none reported having a current relationship. Given the severity of this intimacy boundary violation, nurses need to be educated regarding the serious and dangerous psychiatric effects that can result for patients from engaging in a sexual relationship with nurses. The Code of Ethics of the Canadian Nurses Association and nurses' obligation to follow it needs to be reinforced. Nurses engaging in intimacy boundary violations are vulnerable to patient-initiated lawsuits.
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Affiliation(s)
- R Joan Campbell
- Caritas Health Group, Misericordia and Grey Nuns Community Hospitals, Alberta, Edmonton, Canada
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Malone SB, Reed MR, Norbeck J, Hindsman RL, Knowles FE. Development of a training module on therapeutic boundaries for mental health clinicians and case managers. LIPPINCOTT'S CASE MANAGEMENT : MANAGING THE PROCESS OF PATIENT CARE 2004; 9:197-202. [PMID: 15273605 DOI: 10.1097/00129234-200407000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
This article describes the development of a training model to teach mental health clinicians and case managers about therapeutic boundaries. Awareness of boundary transgressions is vital for establishing and maintaining the moral and ethical integrity of mental health treatment. Our structured teaching model was presented to staff from many different treatment settings throughout our mental health organization. A major portion of each session was utilized for exploration of common boundary dilemmas in the clinical setting as they relate to current policies and ethics codes. Efforts were made to mention the variety of boundary transgressions that may occur in various settings. Participants reported a broadened perspective in their work with clients, having learned about types of boundary issues that they had not previously recognized. Maintaining an understanding of boundary issues among staff requires ongoing educational efforts in training. The health organization's policies on boundaries must be clear and specific to guide the staff. Although training was given in a mental health setting, these lessons can be extended beyond the mental health arena. Safe therapeutic boundaries must be practiced in all settings.
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Affiliation(s)
- Sandra B Malone
- Intensive Substance Abuse Treatment Program, Veterans Affairs Medical Center, Kansas City, MO 64128, USA.
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Peternelj-Taylor CA, Yonge O. Exploring boundaries in the nurse-client relationship: professional roles and responsibilities. Perspect Psychiatr Care 2003; 39:55-66. [PMID: 12894599 DOI: 10.1111/j.1744-6163.2003.tb00677.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
TOPIC The creation and maintenance of boundaries as they pertain to the nurse-client relationship. PURPOSE To challenge readers to reflect on their fiduciary responsibilities by identifying boundary crossings and violations. SOURCES Review of the literature and the authors' clinical and teaching experiences. CONCLUSIONS Although self-awareness and monitoring, debriefing, and availing oneself of supervision and education are important tools in creating and maintaining boundaries, in the final analysis, the nursing profession needs nurses who have the ability to make decisions about boundaries based on the best interests of the clients in their care.
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DeJulio LM, Berkman CS. Nonsexual Multiple Role Relationships: Attitudes and Behaviors of Social Workers. ETHICS & BEHAVIOR 2003. [DOI: 10.1207/s15327019eb1301_09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Gabbard GO. Teetering on the precipice: a commentary on Lazarus's "How certain boundaries and ethics diminish therapeutic effectiveness. ETHICS & BEHAVIOR 2001; 4:283-6. [PMID: 11652800 DOI: 10.1207/s15327019eb0403_14] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVE The aim was to design and run a three-session training module for psychiatric registrars on professional practice with particular emphasis on boundary setting. This included the concept of boundary transgression, an understanding of how it occurs and how it may be avoided. METHOD Drawing on North American experience a curriculum was designed and trialed for trainees at all levels. A variety of media were employed to present a range of common clinical and professional issues. Evaluated were trainee satisfaction, trainee responses to target vignettes at the beginning and at the end of the course, and supervisor awareness and involvement in the process. RESULTS High attendance and high satisfaction ratings in most areas confirmed that a course such as this is attractive and relevant for psychiatric trainees. Vignette responses suggested some change may have occurred by the end of the course, with a more limited tendency to avoid potentially challenging situations and a higher capacity to explore them. Supervisor involvement remains largely unaddressed despite interest and enthusiasm. CONCLUSION The area of interpersonal relatedness in psychiatry, including the issue of sexual attraction and the possibility of sexual misconduct, can be introduced as a training package in a way which is acceptable to trainees and their supervisors in an Australian setting. The impact of the training module on actual registrar behaviour is uncertain.
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Affiliation(s)
- M Vamos
- Discipline of Psychiatry, Centre for Mental Health Studies, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
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Farber NJ, Novack DH, Silverstein J, Davis EB, Weiner J, Boyer EG. Physicians' experiences with patients who transgress boundaries. J Gen Intern Med 2000; 15:770-5. [PMID: 11119168 PMCID: PMC1495619 DOI: 10.1046/j.1525-1497.2000.90734.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Boundary violations have been discussed in the literature, but most studies report on physician transgressions of boundaries or sexual transgressions by patients. We studied the incidence of all types of boundary transgressions by patients and physicians' responses to these transgressions. METHODS We surveyed 1,000 members of the Society of General Internal Medicine (SGIM) for the number of patient transgressions of boundaries which had occurred in the previous year. Categories were created by the investigators based on the literature. Physicians picked the most important transgression, and then were asked about their response to the transgression and its effect on the patient-physician relationship. Attitudinal questions addressed the likelihood of discharging patients who transgressed boundaries. The impact of demographic variables on the incidence of transgressions was analyzed using analysis of variance. RESULTS Three hundred thirty (37.5%) randomly selected SGIM members responded to the survey. Almost three quarters of the respondents had patients who used their first name, while 43% encountered verbal abuse, 39% had patients who asked personal questions, 31% had patients who were overly affectionate, and 27% encountered patients who attempted to socialize. All other transgressions, including physical abuse and attempts at sexual contact, were uncommon. Only gender affected the incidence of transgressions; female physicians encountered more personal questions (P = .001), inappropriate affection (P < .005), and sexually explicit language (P < .05) than male physicians and responded more negatively to boundary transgressions. Respondents dealt with transgressions by discussion with the patient or colleagues or by ignoring the incident, but such transgressions generally had a negative impact on the relationship. Most physicians would discharge patients who engaged in physical abuse or attempts at sexual contact, but were more tolerant of verbal abuse and overly affectionate patients. CONCLUSIONS Boundary transgressions by patients is common, but usually involves more minor infractions. Female physicians are more likely to encounter certain types of transgressions. The incidence and outcomes of such transgressions are important in assisting physicians to deal effectively with this issue.
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Affiliation(s)
- N J Farber
- Christiana Care Health System, Wilmington, Del 19899, USA.
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Sexual Excitement in Therapeutic Relationships. CLINICAL SUPERVISOR 1999. [DOI: 10.1300/j001v18n02_09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Plaut SM. Boundary violations in professional—client relationships: Overview and guidelines for prevention. ACTA ACUST UNITED AC 1997. [DOI: 10.1080/02674659708408203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jorgenson LM. Countertransference and Special Concerns of Subsequent Treating Therapists of Patients Sexually Exploited by a Previous Therapist. Psychiatr Ann 1995. [DOI: 10.3928/0048-5713-19950901-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kimmel LH. Educating the Paraprofessional Staff on the Psychiatric Unit: A Neglected Topic. J Psychosoc Nurs Ment Health Serv 1994; 32:23-7. [PMID: 7932304 DOI: 10.3928/0279-3695-19940601-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Upon deinstitutionalization, a mentally ill person's awareness of the stigma attached to his or her illness can negatively influence any effort to become a productive member of society. Support systems are vital in that they facilitate such efforts. The family is perhaps the most important support system because it provides emotional support, which is crucial because it promotes a sense of self-esteem and decreases depression, anxiety, sickness, and mortality. An awareness of stigma on the part of the family could undermine its role as a support system for a relative with mental illness.
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Affiliation(s)
- L H Kimmel
- Department of Veterans Affairs Medical Center, Bronx, New York
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