The concept of appropriate professional boundaries in psychiatric practice: a pilot training course

Vamos, Marina

doi:10.1046/j.1440-1614.2001.00946.x

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Indeed, Neath () promotes the need to generate a holistic staff well‐being strategy that incorporates a range of mechanisms for workforce development, including multidisciplinary clinical discussion and post‐incident reviews and debriefs. In addition, training in, and appropriate time to focus on boundary management (Vamos ) and case formulation (e.g. Davies et al .…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Lived experience of working with female patients in a high‐secure mental health setting

Beryl¹,

Davies

Völlm³

2016

Int J Mental Health Nurs

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Women's secure hospitals are often considered to be stressful and demanding places to work, with these environments characterised as challenging and violent. The staff experience of working in this environment is however not well represented in the literature. This study is the first to examine the 'lived experience' of seven nurses working in the National High Secure Healthcare Service for Women. Interview transcripts were analysed with the use of Interpretative Phenomenological Analysis, and the findings presented within four superordinate themes 'horror', 'balancing acts', 'emotional hard labour', and 'the ward as a community'. These themes all depict the challenges that participants experience in their work, the ways in which they cope with these challenges and how they make sense of these experiences. A meta-theme of 'making sense by understanding why' is also presented, which represents the importance for participants to attempt to make sense of the tensions and challenges by formulating a fuller meaning. The findings suggest the importance of workforce development, in terms of allowing sufficient protected time for reflection and formulation (for example within the format of group supervision or reflective practice), and for staff support mechanisms (e.g. clinical supervision, counselling, debriefs) t o be inbuilt into the ethos of a service, so as to provide proactive support for staff 'on the frontline'.

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Section: Implications For Clinical Practicementioning

confidence: 99%

Lived experience of working with female patients in a high‐secure mental health setting

Beryl¹,

Davies

Völlm³

2016

Int J Mental Health Nurs

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“…One would hope that education and training to foster awareness in this area has had an impact. Research conducted in a medical school/ residency programme in Australia (Vamos, 2001) showed that, with very little intervention, awareness could be greatly increased -and increased awareness can go a long way to protect against future violations. The numbers in the study were perhaps too low to give such a claim any great validity, but the principles behind such intervention can easily be understood.…”

Section: Prevention and Educationmentioning

confidence: 99%

Boundary violation and sexual exploitation in psychiatry and psychotherapy: a review

Sarkar¹

2004

Adv. psychiatr. treat

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In psychiatric and psychotherapeutic practice, 'boundaries' delineate the personal and the professional roles and the differences that should characterise the interpersonal encounters between the patient/ client and the professional. Boundaries are essential to keep both parties safe. The author outlines the various types of boundary violation that can arise in clinical practice, their consequences (both clinical and legal), how professionals can avoid them and how health care institutions might respond, should they occur. He concentrates on sexual boundary violations, because these have been the subject of most empirical study.Sameer P. Sarkar is a consultant in forensic psychiatry at Broadmoor Hospital (Crowthorne, Berkshire RG45 7EG, UK. E-mail: Sameer.Sarkar@wlmht.nhs.uk) and an associate in the hospital's psychotherapy department. He has studied law at the University of Northumbria at Newcastle and at Harvard Law School and has written on the law and ethics in forensic psychiatry. He teaches ethics of forensic psychiatry to psychiatrists and mental health professionals at two London medical schools. The opinions expressed are those of the author and do not reflect the opinions of West London Mental Health Trust, of Broadmoor Hospital or of the Ethics and the Law sub-committees of the Royal College of Psychiatrists, of both of which the author is a member.

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“…Historically, the field of psychiatry has given much consideration to the topic of boundaries. There exist fairly extensive practice guidelines, 3,4 overarching principles, 5 and some published pilot curricula 6,7 to guide education on this topic. Indeed, given the high incidence of sexual boundary violations in psychotherapy practice, education on boundary vigilance and avoidance of the so-called slippery slope 8 should be mandatory in the field of mental health.…”

Section: Introductionmentioning

confidence: 99%

Physician-Patient Boundaries: Professionalism Training Using Video Vignettes

Lewis

Allan

2016

MedEdPORTAL

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Introduction The concept of professional boundaries is often not included in medical training. Historically, the field of psychiatry has given much consideration to the topic of boundaries, partially due to the high incidence of sexual boundary violations in psychotherapy practice. And while there is a perception that more formal education is needed in psychiatry, the pressure to adjust the frame of a treatment in clinical practice is ubiquitous. We developed this presentation and discussion, using stimulus videos to depict common boundary issues that crop up in everyday outpatient medical practice. Methods This 90-minute session consists of a 20-minute PowerPoint presentation introducing the concept of professional boundaries and identifies the nine boundary domains as defined by Gutheil and Gabbard. Then the class views and discusses six brief video vignettes (allowing 10 minutes per vignette) with a 10-minute break. Faculty panelists from different specialties and at different stages of training are present to discuss the video vignettes and give examples from their own practice. Results This curriculum was implemented in 2009 at the University of Vermont College of Medicine and has been held annually since. Pre and post data were obtained in March 2009 from third-year medical students who participated in the seminar just prior to beginning their clinical clerkships. Statistically significant changes between pretest and posttest means were observed in five of the 10 questionnaire items, including one knowledge-based question about prescriptions to nonpatients Discussion The two learner groups we targeted were medical students during their clerkship year and residents in their first year of training. However, this material could easily be extended to other disciplines in medicine such as nursing.

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The concept of appropriate professional boundaries in psychiatric practice: a pilot training course

Cited by 4 publications

References 24 publications

Lived experience of working with female patients in a high‐secure mental health setting

Lived experience of working with female patients in a high‐secure mental health setting

Boundary violation and sexual exploitation in psychiatry and psychotherapy: a review

Physician-Patient Boundaries: Professionalism Training Using Video Vignettes

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