Treatment boundary violations: clinical, ethical, and legal considerations [published
errata appear in Bull Am Acad Psychiatry Law 1992;20(4):504 and 1994;22(1):132].
R. I. Simon,
Bull. Amer. Acad. Psychiatry & the Law
20(3): 269-88, 1992.
The observance of treatment boundaries maintains the integrity of the therapist-patient relationship.
It is the therapist's professional duty to establish appropriate treatment boundaries. Basic boundary
guidelines are reviewed. The principles underlying these boundary guidelines are explored. A clinical
vignette describing the sexual exploitation of a patient by her therapist dramatically illustrates
progressive boundary violations. Boundary violations involving money are particularly common.
Double agent roles also are likely to lead to the establishment of dissonant treatment boundaries with
patients. The clinical, ethical, and legal issues surrounding the maintenance of treatment boundaries
are discussed. [References: 63]