Sage Journals: Discover world-class research

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.

Keywords

Boundary boundary violation psychotherapy culture Qatar

Get full access to this article

View all access options for this article.

References

Blatt

S. J.

(2001). The therapeutic process and professional boundary guidelines: Commentary. Journal of the American Academy of Psychiatry and the Law, 29, 290–293.

Dattilio

F. M.

Commons

M. L.

Adams

K. M.

Gutheil

T. G.

Sadoff

R. L.

(2006). Pilot Rasch scaling of lawyers’ perceptions of expert bias. Journal of the American Academy of Psychiatry and the Law, 34, 482–491.

Gabbard

(2001). Commentary: Boundaries, culture, and psychotherapy. Journal of the American Academy of Psychiatry and the Law, 29, 284–286.

Gabbard

G. O.

Nadelson

(1995). Professional boundaries in the physician–patient relationship. Journal of the American Medical Association, 273, 1445–1449.

Galletly

C. A.

(2004). Crossing professional boundaries in medicine: The slippery slope to patient sexual exploitation. Medical Journal of Australia, 181, 380–383.

General Medical Council. (2006). Good medical practice. London: General Medical Council.

Godlaski

T. M.

Clark

J. J.

(in press). Ethics for an evolving profession in an evolving world. Substance Use and Misuse.

Gutheil

T. G.

Gabbard

G. O.

(1993). The concept of boundaries in clinical practice: Theoretical and risk management dimensions. American Journal of Psychiatry, 150, 88–96.

Gutheil

T. G.

Gabbard

G. O.

(1998). Misuses and misunderstandings of boundary theory in clinical and regulatory settings. American Journal of Psychiatry, 155, 409–414.

10.

Hess

A. K.

(1998). Psychotherapy supervision: Theory, research, and practice. New York: Wiley.

11.

Kroll

(2001). Boundary violations: A culture-bound syndrome. Journal of the American Academy of Psychiatry and the Law, 29, 274–283.

12.

Linacre

J. M.

(2003). WINSTEPS: Multiple-choice, rating scale and partial credit Rasch analysis. Chicago, IL: Mesa Press.

13.

Miller

P. M.

Commons

M. L.

Gutheil

T. G.

(2006). Clinicians’ perceptions of boundaries in Brazil and the United States. Journal of the American Academy of Psychiatry and the Law, 34, 33–42.

14.

Psychopathology Committee of the Group. (2001). Re-examination of therapist self-disclosure. Psychiatric Services, 52, 1489–1493.

15.

Rasch

(1980). Probabilistic models for some intelligence and attainment tests. Chicago, IL: University of Chicago Press [original work published in 1960].

16.

Strasburger

L. H.

Jorgenson

Sutherland

(1992). The prevention of psychotherapist sexual misconduct: Avoiding the slippery slope. American Journal of Psychotherapy, 46, 544–555.

Perceptions of boundaries and cultural influences in Qatar

Abstract

Background:

Aims:

Results:

Conclusions:

Keywords

Get full access to this article

References