Boundary Crossings and Violations in Clinical Settings (2023)

  • Journal List
  • Indian J Psychol Med
  • v.34(1); Jan-Mar 2012
  • PMC3361837

Boundary Crossings and Violations in Clinical Settings (1)

Link to Publisher's site

Indian J Psychol Med. 2012 Jan-Mar; 34(1): 21–24.

PMCID: PMC3361837

PMID: 22661802

V. K. Aravind, V. D. Krishnaram, and Z. Thasneem

(Video) Video Clip #4: Professional Boundaries - Crossings and Violations

Abstract

Principles of beneficence, autonomy, and nonmaleficence, compassion along with fiduciary partnership are the core concepts in the doctor-patient relationship in therapeutic settings. There are varieties of reasons for boundary problems. Physicians ignorance, exploitative character, emotional vulnerability moral weakness and similar factors may pave the way for boundary issues resulting in nonsexual or sexual boundary crossings and violations.

Keywords: Boundary crossings, boundary issues, boundary violations

INTRODUCTION

Physicians are held in great esteem and respect by the society. It is the duty of the medical personnel to discharge their duties toward the billions of suffering from physical or psychological disorders, with a sense of commitment and without damaging the values of ethics. The behavior of the physicians toward their clients must be consistent in all aspects with the norms of the society and culture they live. Physicians are bound to abide by Hippocratic Oath. The Hippocratic Oath is an oath historically taken by doctors swearing to practice medicine ethically.[1]

The physician must possess the competence or the need to master his task; he must practice the ethical behavior and be able to police his ranks. He must possess accountability and is also accountable to public. Public trust must be maintained. The quality of advocacy and the ability to advocate for physically and mentally ill persons by the physician will contribute to the effective preservation of the public trust that he enjoys.

Social relationships are complex with many levels of interaction. However, a covenant protects the space that must exist between the professional and the client.

This formal agreement controls the power differential in the relationship and “allows for a safe connection based on the client's needs.”[2] Physicians have an ethical obligation to care for all patients with beneficence, nonmaleficence, and confidentiality.[3] Within this privileged and trusted relationship, we must address our patients’ needs instead of our own.

Physicians behavior toward patients should always be initiated and maintained with the patients best interest in mind. The maintenance of boundaries thus helps to preserve the integrity of the relationship and expand the trust the public has in them.

DEFINITION OF BOUNDARY

A boundary may be defined as the “edge” of appropriate professional behavior, transgression of which involves the therapist stepping out of the clinical role or breaching the clinical role. Boundaries define the expected and accepted psychological and social distance between practitioners and patients. Boundaries are derived from ethical treatise, cultural morality, and jurisprudence. Sometimes, it is difficult to clearly define the perimeter of these boundaries and the integrity of the relationship.[4]

BOUNDARY ISSUES

Boundary issues are disruptions of the expected and accepted social, physical, and psychological boundaries that separate physicians from patients. The therapeutic relationship between a doctor and the patient is established solely with the purpose of therapy and whenever this relationship deviates from its basic goal of treatment, it is called boundary violation and becomes non-therapeutic. In psychiatry, as the therapeutic relationship is prolonged and more personal as many confidential matters are discussed, there is likelihood of developing strong emotional bonds. This may lead to non-therapeutic activity.[5]

Boundary issue types

Two types of boundary issues are identified by Gutheil and Gabhard—boundary crossings and boundary violations.[5] This may result or manifest as non-sexual or sexual boundary crossings and boundary violations. A boundary crossing is a deviation from classical therapeutic activity that is harmless, non-exploitative, and possibly supportive of the therapy itself. In contrast, a boundary violation is harmful or potentially harmful, to the patient and the therapy. It constitutes exploitation of the patient. Similarly, boundary crossings and violation may arise from the therapist or from the patient.

Ethical principles in boundary issues

Respect for the dignity of the patient is the fundamental ethical principle in boundary problems.[6] The patient's authentic goals or choices must be respected. The concept of autonomy that is fostering the patient's independence and separateness as a self-directing person, along with promoting the self-determination attitude of the patient form the central core in the perseveration of the boundary concepts. The fiduciary relationship, namely the concept of trust or good faith, must be maintained. A fiduciary in healthcare is one whose actions are worthy of trust. A fiduciary partnership has been described as being characterized by “sincerity without reserve” and “loving care” (Guttentag 1968).[7] Fiduciary rubric components like altruism, beneficence, nonmaleficence, and compassion have to be observed in the treatment setting. The therapist has to observe and see that his personal gain does result in exploitative situation and damage the principles of neutrality and abstinence.

Clear professional boundaries create safety for both patients and physicians as well as for society. Boundaries establish clear roles for physicians and define the therapeutic territory; they do not undermine the physician-patient relationship. If boundaries are ignored, physicians can find themselves acting in their own best interest instead of the patient's best interest.

Slippery slope concept

The doctor is responsible for preserving the boundary and he should ensure that boundary violations do not occur. If even a minor violation occurs, it is better to transfer the patient to a colleague. The boundary violation typically starts small and become incrementally problematic and the dyad starts sliding down the slope. This is known as Slippery Slope Concept.

Non-sexual boundary issues

The role played by a physician is to be “synonymous with the Hippocratic obligation to act always in the interest of the patients and avoid harming them.” It is essential that the psychiatrist not reverse his or her professional role with that of the patient. Role boundaries may be crisp, flexible, or fuzzy, depending on the role under consideration and on the cultural climate.

The boundary examines the quality and quantity of time spent with the patient. When physicians spend great lengths of time with attractive patients but less with unattractive ones, there is a potential boundary difficulty. Likewise, scheduling patients outside regular hours, giving “special” late appointments, or offering more frequent follow-up than is medically necessary suggests that physicians’ needs are being met before patients needs.

Patients should be treated similarly when deciding where treatment is to occur either in the consultation room, bedside, or if needed at home and must be seen in similar contexts. The place of consultation should be clinic and the time should also be during the consultation hours. If the psychiatrist charges fees, he should keep charges that are reasonable for that area.

It would be difficult to claim that gifts from a physician to a patient are beneficial. The most obvious form of gifts are consumer goods, but there are more subtle “gifts,” such as generous prescriptions or excessively large amounts of drug samples to selected individuals. These medication favors are particularly dangerous with addictive medications, because they place the patient in a dependent position. Likewise, the physicians must relent to accept gift or favors from the patient. Very often, influential people like politicians and government officials may offer special privileges for the doctor or his department, but all such concessions or allurements are also unethical.

Whenever the psychiatrist and the patient start becoming friendly, then the therapeutic relationship is compromised. The objectivity is compromised and factors outside the therapeutic relationship may become destructive to the therapeutic process. Business relationship with a current patient is unethical except when one is living in a small community where such relationship cannot be avoided.

Physicians should avoid seductive or revealing dress when treating patients. Clinical apparel can help maintain the appropriate professional distance between physician and patient. The way the physician addresses his client is most important. Doctor should be dressed formally. Dresses that are flashy or reveal body part in a provocative manner should be avoided. The language used should be formal and abusive or double meaning words should be avoided.

Physicians sometimes reveal increasingly personal details to patients and end up violating appropriate boundaries. Unlike regular social conversation, our main task is to listen, not to talk.

(Video) Professional Boundaries and Ethics

Any clinical decision should be based on what is best for the patient; the physician's ideology should play as little apart as possible in such decisions. The physician may be against inter-religion marriages, but if the patient wants it, then his wishes should be respected.

Touch is an extremely powerful bonding tool, but like most tools, it cannot be used indiscriminately. Though touch is a necessary component of diagnosis and healing in medicine, it can be misunderstood. Physicians must be clear about why touch is necessary.[8]

Boundary issues involve circumstances in which health professionals encounter actual or potential conflicts between their professional duties and their social, sexual, religious, or business relationships.

Health professionals should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. A professional enters into a dual relationship whenever he or she assumes a second role with a client, becoming mental health professional and friend, employer, teacher, business associate, family member, or sex partner.

Conflicts of interest occur when professionals find themselves in “a situation in which regard for one duty leads to disregard of another or might reasonably be expected to do so.” Health professionals should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment.

Boundary issues may thus result or originate from the way in which the physician schedules his working with the client by the time and place of consultations, contacts on phone, in social meetings, etc., or by accepting or giving of gifts, money, or by the types of clothes the doctor wears and the language he uses. Boundary issues involve the therapist's role and his relationship with the patient and his family.[9]

Sexual misconduct

Four elements appear in all boundary violations, and these are particularly notable in sexual abuse of patients by physicians. The elements are role reversal, secrecy, double bind, and indulgence of professional privilege.

First, sexual misconduct usually begins with relatively minor boundary violations, which often show a crescendo pattern of increasing intrusion into the patient's space that culminates in sexual contact. A direct shift from talking to intercourse is quite rare; the “slippery slope” is the characteristic scenario. As Gabbard and Simon have pointed out, a common sequence involves a transition from last-name to first-name basis; then, personal conversation intruding on the clinical work; then, some body contact (e.g., pats on the shoulder, massages, progressing to hugs); then, trips outside the office; then, sessions during lunch, sometimes with alcoholic beverages; then dinner; then movies or other social events; and finally, sexual intercourse. Second, not all boundary crossings or even boundary violations lead to or represent evidence of sexual misconduct.[1012]

(Video) Understanding Boundary Crossings and Dual Relationships in Psychotherapy

CONCLUSION

It will be apt to conclude with the following remarks by T. L. Beauchamp. “An absolutist position concerning treatment boundary guidelines cannot be taken. Otherwise, it would be appropriate to refer to boundary guidelines as boundary standards. Effective treatment boundaries do not create walls that separate the therapist from the patient. Instead, they define a fluctuating, reasonably neutral, safe space that enables the dynamic, psychological interaction between therapist and patient to unfold.”[6]

REFERENCES

1. The Hippocratic oath: Text, translation and interpretation By Ludwig Edelstein. 1943:56. ISBN 978-0-8018-0184-6. [Google Scholar]

2. Peterson MR. At personal risk: Boundary violations in professional-client relationships. 1 edition. New York: W.W Norton and Company; 1992. Apr 17, [Google Scholar]

3. Pelligrino ED. Metamorphosis of medical ethics. JAMA. 1993;269:1159–60. [Google Scholar]

4. Guthiel TG, Simon RI. Nonsexual boundary crossings and boundary violations: The ethical dimension. Psychiatr Clin N Am. 2002;25:585–92. [PubMed] [Google Scholar]

5. Gutheil TG, Gabbard GO. The concept of boundaries in clinical practice: Theoretical risk-management. Am J Psychiatry. 1993;150:188–96. [PubMed] [Google Scholar]

6. Beauchamp TL. The philosophical basis of psychiatric ethics. In: Bloch S, Chodoff P, Green SA, editors. Psychiatric ethics. 3rd ed. Oxford: Oxford University Press; 1999. pp. 25–48. [Google Scholar]

7. Guttentang OE. In: The role of the physician in today's society, in Ethical Issues in Medicine: The role of the Physician in Today's Society. Torrey EF, Little, Brown, editors. Boston: 1968. pp. 195–226. [Google Scholar]

8. Linklater D, MacDougall S. Boundary issues. Can Fam Physician. 1993;39:2569–71. [PMC free article] [PubMed] [Google Scholar]

9. Agarwal AK. Ethical Issues in the practice of Psychiatry. Indian J Psychiatry. 2001;43:16–21. [PMC free article] [PubMed] [Google Scholar]

10. Gabbard GO. Psychodynamic Psychiatry in Clinical Practice. Washington DC: American Psychiatric Press; 1996. [Google Scholar]

11. Gabbard GO, editor. Sexual Exploitation in Professional Relationships. Washington, DC: American Psychiatric Press; 1989. [Google Scholar]

12. Simon RI. Sexual exploitation of patients: How it begins before it happens. Psychiatr Ann. 1989;19:104–22. [Google Scholar]

(Video) How to Handle Boundary Violations - Part 3 in the Boundaries series

Articles from Indian Journal of Psychological Medicine are provided here courtesy of Indian Psychiatric Society South Zonal Branch

(Video) Professional Boundaries in Nursing- Full Version

FAQs

What is boundary crossing and violation? ›

A boundary crossing is a deviation from classical therapeutic activity that is harmless, non-exploitative, and possibly supportive of the therapy itself. In contrast, a boundary violation is harmful or potentially harmful, to the patient and the therapy. It constitutes exploitation of the patient.

What are examples of boundary violations? ›

You could probably list some obvious boundary violations, such as nonconsensual touch, name-calling, unsolicited advice, taking what's not given, and sharing confidential information without permission.

What is considered a violation of a professional boundary? ›

Boundary violations are potentially harmful actions that violate your professional relationship with patients. The most obvious violation is any sexual involvement with a patient. Boundary violations are often clear-cut, with damaging results.

What are some examples of crossing professional boundaries? ›

Examples of crossing professional boundaries may include:
  • Sharing personal or intimate information.
  • Flirting or indiscriminate touching.
  • Keeping secrets with or for patients.
  • Acting as if you are the only one who can care for or understand the patient, positioning yourself as the “super nurse”
21 Jul 2021

What is a boundary violation in healthcare? ›

Boundary violations can result when there is confusion between the needs of the nurse and those of the patient. Such violations are characterized by excessive personal disclosure by the nurse, secrecy or even a reversal of roles.

What are the five main types of boundary violations? ›

In an Instagram post shared by Nicole LePera, PhD, who goes by The Holistic Psychologist, the five types of boundaries are defined as emotional, material, time/energy, physical, and mental.

What are the 4 types of boundary disputes? ›

Boundary disputes are a type of property litigation, most boundary disputes fit into one of four categories:
  • Plot line & party wall disputes.
  • Fence, landscaping and outbuilding disputes.
  • Access disputes.
  • Adverse possession claims.
24 May 2021

What are the 7 boundaries? ›

7 Types of Boundaries You May Need
  • What boundaries do you need? ...
  • 1) Physical Boundaries. ...
  • 2) Sexual Boundaries. ...
  • 3) Emotional or Mental Boundaries. ...
  • 4) Spiritual or Religious Boundaries. ...
  • 5) Financial and Material Boundaries. ...
  • 6) Time Boundaries. ...
  • 7) Non-Negotiable Boundaries.
23 Apr 2020

What is an example of a boundary violation between healthcare providers and patients? ›

Boundary violation: danger

Keeping a patient in the hospital when a qualified caregiver is available could fall under this category. Another example is the nurse disclosing the patient's personal information, which violates the privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA).

What are three 3 breaches of practitioner client boundaries? ›

This is a clear boundary violation, a breach of the code of conduct, a breach of privacy legislation and a breach of the trust given to the profession.

What are three 3 examples of when your professional boundaries must be maintained? ›

Re: Professional Boundaries

No slang or swear words. Not being too 'familiar' with individuals. - keeping people's privacy. -use 'professional' language eg.

What are 6 warning signs of crossing a therapeutic boundary? ›

What are the warning signs of boundary crossing?
  • Showing favoritism.
  • Having more physical contact than is required or appropriate.
  • Spending breaks or time off with a client.
  • Discussing personal or intimate issues with a client not related to their care or your nursing role.

What is a professional boundary in healthcare? ›

Professional boundaries are a set of rules which protect patients and staff from harm. Staff must understand they are in a position of power within this relationship, and this must not be abused. Most staff follow these rules.

What are examples of barriers in accessing healthcare? ›

Five key barriers to healthcare access in the United States
  • Insufficient insurance coverage. A lack of insurance often contributes to a lack of healthcare. ...
  • Healthcare staffing shortages. ...
  • Stigma and bias among the medical community. ...
  • Transportation and work-related barriers. ...
  • Patient language barriers.
27 Jul 2022

How do you handle a boundary violation? ›

Boundaries need to be especially clear and consistent when youre dealing with someone who doesnt respect you. Such a person is looking for holes in your boundaries and using them against you. So, be sure youre assertively and clearly telling him/her that this behavior is not OK and follow through with consequences.

What is the meaning of crossing boundaries? ›

A boundary crossing is typically defined as an acceptable, perhaps inevitable, or unavoidable dual relationship. For example, you may live in a small or rural community where it is inevitable that you are going to encounter clients in the community outside of the professional context, that is a boundary crossing.

What is an example of a boundary crossing in counseling? ›

Possible examples of boundary crossings include shaking a client's extended hand upon first meeting or extending the time of a treatment session for a client who is in crisis.

How can boundary crossing practices be prevented? ›

Preventing boundary issues
  1. Give clear, timely explanations of: ...
  2. Ensure that sexual histories are: ...
  3. Ensure touching will not be misinterpreted.
  4. Use a chaperone during intimate exams.
  5. Respect the patient's right to privacy: ...
  6. Look for early signs of emotional involvement (yours and your patient's).

What are boundaries in health and social care? ›

Boundaries are the framework within which the clinician/client relationship occurs. Boundaries make the relationship professional and safe for the client, and set the parameters within which psychological services are delivered.

What are boundaries in the workplace? ›

Examples of workplace boundaries include the following: Saying no to working on the weekends. Committing to your family time after work hours by not continuing to check emails. Giving yourself permission to say no to job opportunities that, while enticing perhaps monetarily, don't suit your lifestyle needs.

What is the 7 year boundary rule? ›

The Seven Year Rule

So this is different from the so called 'Seven year rule' which comes from Section 157(4) of the Planning and Development Act 2000. This means local authorities can't serve enforcement notices for an unauthorised development when seven years have passed since the commencement of the development.

What is a toxic boundary? ›

Unhealthy boundaries involve a disregard for your own and others' values, wants, needs, and limits. They can also lead to potentially abusive dating/romantic relationships and increase the chances of other types of abusive relationships as well.

What is the 12 year boundary rule? ›

If a neighbour trespasses on land for a period of 12 years of more prior to 13 October 2003, they can claim ownership of the land through adverse possession and apply to the Land Registry to register the land in their name.

What are examples of boundaries? ›

Some examples of personal boundaries might be: I'm cool with following each other on social media, but not with sharing passwords. I'm comfortable kissing and holding hands, but not in public. I'm okay with regularly texting, but I don't want to text multiple times in an hour.

How do you enforce boundaries? ›

The 5 Ways to Set and Keep Emotional Boundaries in Relationships
  1. Communicate with your partner. ...
  2. Take absolute responsibility for your actions. ...
  3. Choose your battles. ...
  4. Uphold the integrity of your boundaries. ...
  5. Recognize when it's time to seek help.
9 May 2020

What are the laws of boundaries? ›

THE LAW OF EXPOSURE

A personal boundary like is a property line: It defines where you begin and end. Your boundaries define your relation to others. In order for others to honor your boundaries, they need to be made visible and communicated with others. The path to real love is to communicate your boundaries openly.

How do you maintain professional boundaries with patients? ›

Maintaining patient boundaries
  1. Don't pursue a sexual or close emotional relationship with a patient or someone close to them.
  2. Act quickly to re-establish boundaries if a patient behaves inappropriately.
  3. Avoid sharing personal information with patients in person or online.

How do you enforce boundaries with clients? ›

How to Set Boundaries with Clients
  1. Respect your own time. Starting late or staying late are options for extreme situations. ...
  2. Communicate effectively. ...
  3. Stay in control. ...
  4. Say no and mean it. ...
  5. Set client expectations early and consistently. ...
  6. Be done with guilt.

What are the three categories of boundaries related to professional ethics? ›

There is three main types of boundaries we deal with include: professional boundaries, and personal boundaries and legal boundaries, Professional boundaries are determined by many things, such as your type of practice, your business rules and practices.

What are responsibilities in keeping boundaries with clients? ›

  • Expectations. Set clear expectations with clients at the beginning. ...
  • Your role. Be clear about your role and its limits.
  • Assertiveness. Be assertive and let clients know if they are behaving inappropriately.
  • Clear relationship. ...
  • Personal information. ...
  • Unnecessary information. ...
  • Objectivity. ...
  • Triggers.

What are examples of setting boundaries at work? ›

Examples of mental boundaries include:
  • Establishing the set hours you work.
  • Advising management on strategies for more efficient meetings.
  • Not gossiping with colleagues at work.
  • Setting messages on instant messaging to alert others that you're focusing.

When nurses suspect that a colleague has crossed a boundary they should consider? ›

If you believe that a colleague is crossing a boundary, assess the situation and speak to the colleague about what you saw, how that behaviour is perceived and the impact on the client-nurse relationship. Refer the colleague to the College's Ethics and Therapeutic Nurse-Client Relationship practice standards.

What is an inappropriate boundary invasion? ›

An inappropriate boundary invasion means an act, omission, or pattern of such behavior by a school employee that does not have an educational purpose; and results in abuse of the staff/student professional relationship.

What are some boundary issues in counseling? ›

Important Boundaries to Consider in Counselling and Psychotherapy
  • Time, Number of Sessions and Location. These are the practical boundaries relevant to each encounter. ...
  • Dual Relationships. ...
  • Self-Disclosure. ...
  • Touch. ...
  • Gifts. ...
  • Out of Session Contact. ...
  • Social Media. ...
  • Confidentiality.

Why are professional boundaries important when working in healthcare? ›

Professional boundaries help ensure the safety of both the worker and service user and reduce anxiety as the roles and boundaries of the relationship are clear, allowing for a therapeutic environment rooted in mutual respect.

Why is it important to maintain professional boundaries in care? ›

Relationship centred working may cause uncertainty for some about how to carry out their roles and responsibilities. Professional boundaries help us to make sense of this and can be described as the 'boundary between what is acceptable and unacceptable for a professional both at work and outside work'.

What is an example of a professional boundary? ›

Some examples of professional boundaries may include: Not discussing a client's private health information with others; Keeping work contact numbers separate to your personal contact numbers; Not performing additional favours for clients, outside of the scope of your role.

How do you set reasonable boundaries with clients? ›

  1. Set And Reiterate Expectations. Set clear expectations up front and reiterate them. ...
  2. Say 'No' When You Need To. ...
  3. Be Willing To Walk Away. ...
  4. Make A List Of Your Own Boundaries. ...
  5. Be Clear On Your Own Priorities. ...
  6. Have Proactive Conversations. ...
  7. Put Systems And Processes Into Place. ...
  8. Create Boundaries With A 'Container'
25 May 2021

What would you do if you suspect a breach of a professional boundary? ›

Managers should consult the HR Advisor in circumstances of alleged or suspected breaches of Professional Boundaries. Professional boundaries should be discussed during the induction process to ensure employees are fully aware of the implications of failing to meet expected standards.

› Online CPD › Articles ›

Professional boundaries are those rules and limits that prevent the lines between carer and client from becoming blurred. Professional boundaries are set by leg...
Most members treat their clients respectfully, compassionately and responsibly and would not knowingly compromise the professional relationship established with...
Professional boundaries are those rules and limits that prevent the lines between carer and client from becoming blurred. Professional boundaries are set by leg...

What is the meaning of crossing boundaries? ›

A boundary crossing is typically defined as an acceptable, perhaps inevitable, or unavoidable dual relationship. For example, you may live in a small or rural community where it is inevitable that you are going to encounter clients in the community outside of the professional context, that is a boundary crossing.

What is an example of a boundary crossing in counseling? ›

Possible examples of boundary crossings include shaking a client's extended hand upon first meeting or extending the time of a treatment session for a client who is in crisis.

What to do when a boundary is violated? ›

You can't control other people, but you can react to the situation in such a way that the broken boundary is clearly stated. Calmly let the person know that what they did wasn't okay. If this person continues to violate your boundaries, you may have to rethink the boundary or accept that the behavior will never change.

What is boundary crossing in teaching community and occupational community? ›

Such discontinuities between school and work practices have frequently been reported as problematic. Boundary crossing is defined as the efforts by individuals or groups at boundaries to establish or restore continuity in action or interaction across practices.

What are examples of boundaries? ›

Some examples of personal boundaries might be: I'm cool with following each other on social media, but not with sharing passwords. I'm comfortable kissing and holding hands, but not in public. I'm okay with regularly texting, but I don't want to text multiple times in an hour.

What are 6 warning signs of crossing a therapeutic boundary? ›

What are the warning signs of boundary crossing?
  • Showing favoritism.
  • Having more physical contact than is required or appropriate.
  • Spending breaks or time off with a client.
  • Discussing personal or intimate issues with a client not related to their care or your nursing role.

What is a boundary violation in counseling? ›

Boundary violations involve transgressions that are potentially harmful to or exploitative of the patient. They can be either sexual or nonsexual. They are usually repetitive, and the therapist usually discourages any exploration of them. By contrast, boundary crossings are benign and even helpful breaks in the frame.

What are three 3 breaches of practitioner client boundaries? ›

Examples of improper boundary-crossing behaviour (non‑therapeutic behaviour) by a health practitioner, include:
  • having sex with a patient (consent is not a defence);
  • breaches of patient confidentiality or privacy;
  • use of social media between the parties - blurring the lines between professional and personal lives;
11 Jun 2019

How do you respond when someone crosses your boundaries? ›

How to Deal with Someone Crossing Your Boundaries
  1. Communicating boundaries.
  2. Setting consequences.
  3. Limiting engagement.
  4. Persistence.
  5. Remain calm.
  6. Next steps.

How do you manage typical boundary conflicts and violations? ›

To resolve typical boundary conflicts...
  1. make sure your true Self guides your other subselves;
  2. admit the conflicts without blame, shame, or guilt; ("We have a boundary conflict.")
  3. identify your respective boundaries ("You'll tolerate _____ and I won't")

What is boundary crossing competence? ›

Professionals in the environmental domain require boundary crossing competence, i.e. the competence to learn from and work together with others outside one's own scientific domain, institute, and/or culture, in order to respond better to emerging global challenges.

What are the benefits of boundary crossing? ›

Taking a shared boundary-crossing approach, such as working with cases from the students' work context and stimulating them to test assignments at work, will centrally orient the learner without negating differences in contexts and is generally considered a more effective adult learning practice (Viskovic 2006).

What are boundaries and consent? ›

CONSENT: A Very Special Kind of Boundary

Consent is a particular kind of boundary, in which one person gives permission for something to happen or agrees to do something. We often hear this word in the context of sexual consent, which can mean anything from holding hands to kissing to having sex.

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