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PERSONAL HEALTH : Therapists Must Honor Boundaries


Almost anyone would agree that when a psychiatrist or psychologist becomes sexually intimate with a patient, the relationship has become too close.

But what of the mental health professional--the psychotherapist, the social worker, the family counselor--who brews coffee for a patient?

What about the therapist who sets two patients up on a blind date?

Or the shrink, male or female, whose attire is just too seductive for office hours?

A recent article in "Harvard Women's Health Watch," the newest periodical from Harvard Medical School, addresses the sensitive issue of "boundary crossings" in the therapeutic relationship.

Warning signals that a therapist may be trying to exert too great an influence include telling a patient not to discuss his or her therapy with anyone else or, worse, insisting that the treatment be kept a secret.

Patients should also be wary of a therapist who advises severing ties with family or friends, demands absolute trust, offers to protect a patient from "the outside world" or threatens to "expose" a patient to family, friends or business associates.

Only rarely does the patient-therapist relationship move from talk to sexual action. But if this does happen, a complaint to the state licensing board is definitely in order. California is among a handful of states where sexual contact between a therapist and a patient is a crime.

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