J Am Acad Psychiatry Law 34:1:33-42 (2006)
Copyright © 2006 by the American Academy of Psychiatry and the Law.
Clinicians’ Perceptions of Boundaries in Brazil and the United States
Patrice Marie Miller, EdD,
Michael Lamport Commons, PhD and
Thomas G. Gutheil, MD
Dr. Miller is Research Associate, Dr. Commons is Assistant Clinical Professor, and Dr. Gutheil is Professor, Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA. Dr. Miller is also Professor of Psychology, Salem State College, Salem, MA. Dr. Gutheil is also Co-Founder of the Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA.
Address correspondence to: Michael Commons, PhD, Department of Psychiatry, Harvard Medical School, 234 Huron Avenue, Cambridge, MA 02138. E-mail: commons{at}tiac.net
Although there has been considerable discussion of boundary excursions in clinician-patient relationships, little empirical research exists. This pilot study adds to the existing theoretical discussion by comparing perceptions by mental health professionals in Brazil and the United States of what may constitute boundary violations. Participants rated each possible boundary violation according to its degree of harm and professional unacceptability. Three distinct groupings of boundary violations were found: (1) core, consisting of the most serious violations; (2) separation of therapist and client lives, involving encounters between therapists and clients outside of therapy; and (3) disclosure and greeting behavior, involving disclosure of information about the therapist and greeting behavior. The U.S. and Brazilian perceptions were found to be surprisingly similar, with only a few differences.
Copyright © 2006 by the American Academy of Psychiatry and the Law.
