The authors systematically examine the concept of boundaries and
boundary violations in clinical practice, particularly as they relate to
recent sexual misconduct litigation. They selectively review the literature
on the subject and identify critical areas that require explication in
terms of harmful versus nonharmful boundary issues short of sexual
misconduct. These areas include role; time; place and space; money; gifts,
services, and related matters; clothing; language; self- disclosure and
related matters; and physical contact. While broad guidelines are helpful,
the specific impact of a particular boundary crossing can only be assessed
by careful attention to the clinical context. Heightened awareness of the
concepts of boundaries, boundary crossings, and boundary violations will
both improve patient care and contribute to effective risk management.Abstract Teaser