The inability of substantial numbers of battered women to terminate or extricate themselves from violent relationships is of grave concern to clinical practitioners. Despite professional intervention, many victims of domestic violence return to the batterer and to repetitive battering, demonstrating that, for these women, traditional psychosocial interventions are ineffective. In a sample of 53 battered women, 92% reported having received blows to the head in the course of their battering; 40% reported loss of consciousness. Correlations between frequency of being hit in the head and severity of cognitive symptoms were significant, strongly suggesting that battered women should be routinely screened for traumatic brain injury and postconcussive syndrome. Development of treatment strategies to address the potentially damaging sequelae of head trauma in this population is essential.

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This article identifies specific factors that place therapists at risk for engaging in sexual activity with clients and provides guidelines to minimize the likelihood of such behavior. In a national, randomly drawn sample of 323 mental health practitioners, 3 of 5 men who reported severe childhood sexual abuse and whose psychological symptoms met the criteria for a high degree of psychological distress reported sexual boundary violations with clients. High-risk clinicians should avoid the isolation of private practice, closely monitor their boundaries with clients, obtain ongoing professional supervision, and seek personal psychotherapy to address any remaining abuse-related issues. HELENE JACKSON received her PhD in social work from Smith College in 1982. She is associate professor at Columbia University, School of Social Work. Her research interests are child and adolescent mental health, family violence, and professional boundary violations. RONALD L. NUTTALL received his PhD in social psychology from Harvard University and his MPH in biostatistics from the Harvard School of Public Health. He is a professor at the Lynch School of Education at Boston College. His interests include applying research and statistical methodology and performing public policy research.

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