Boundary Issues in Psychotherapy
"A boundary violation is something in which the patient feels exploited, something that is not discussible between the therapist and patient, and which often is a repetitive phenomenon within the therapy." Glen Gabbard
Historically, boundary violations for psychotherapists were understood to mean sexual contact with clients. Over the past twenty years, the concept of boundary violations has been expanded to encompass all aspects of the therapeutic relationship. In this video series, Glen Gabbard and others describe the many ways in which boundary issues may surface in a therapists work, and outlines strategies for the prevention of boundary violations. Released 1997.
Uncertain Borders I: Boundary Issues
(#251, 47 min.)
Boundary Crossings and Violations
Role of the Therapist
Time and Place of Therapy
Money, Gifts, Services
Clothing, Language, Touch
Need for consultation and supervision
Uncertain Borders II: Sexual Boundary Violations
(#252, 39 min.)
Incidence; Damage Done to Clients
How Sexual Relationships Start
Therapists' Needs and Lack of Self-Care
The Rescue Fantasy
Trauma Survivors' Need For Boundaries
Purchase: One VHS/DVD $150, both $250
Rental: One VHS/DVD $50, both $85
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About the Presenters
Glen O. Gabbard, MD is Bessie Walker Calloway Distinguished Professor of Psychoanalysis and Education in the Menninger School of Psychiatry and Mental Health Sciences at the Menninger Clinic, and director of the Topeka Institute for Psychoanalysis. He is author of Boundaries and Boundary Violations in Psychoanalysis.
Nanette K. Gartrell, MD is Associate Clinical Professor of Psychiatry at the University of California, San Francisco, where she teaches ethics and feminist therapy theory. She has a private psychotherapy practice in San Francisco.
Thomas G. Gutheil, MD is Co-Director of the Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School, and Director, Charles C. Gaughan Fellowship in Forensic and Correctional Psychiatry, Bridgewater State Hospital. He is also Professor of Psychiatry, Harvard Medical School, and the author of nearly 200 articles, book chapters and books..
Richard P. Kluft, MD, PhD practices psychiatry in Philadelphia. He is Clinical Professor of Psychiatry at Temple University School of Medicine, and Visiting Lecturer at Harvard Medical School. He is author of over 225 scientific articles and book chapters, and is Editor-in-Chief of the journal Dissociation.
Laurie Anne Pearlman, PhD is Director of Research at the Traumatic Stress Institute. She is co-author with Karen Saakvitne of Trauma and the Therapist.
Anne C. Pratt, PhD (drannepratt.com) is a forensic psychologist who practices in Springfield, MA.
The Trainer’s Guide
The 27-page trainer’s guide includes objectives, reproducible outlines for note-taking, review and discussion questions, a resource list, and a journal article, described below.
Gutheil and Gabbard’s article, "The Concept of Boundaries in Clinical Practice: Theoretical and Risk-Management Dimensions," is abstracted as follows:
The authors systematically examine the concept of boundaries and boundary violations in clinical practice, particularly as they relate to recent sexual misconduct litigation. The 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.experiences promotes taming of terror and desomatization of traumatic memories.