Publication Date


Document Type

Masters Thesis


School for Social Work


Psychiatric hospitals-Outpatient services, Psychotherapy-Decision-making, Psychotherapist and patient, Boundaries, Boundary crossings, Clinician(s), Psychotherapist(s)


This research study was a quantitative, exploratory investigation of the experiences and opinions of outpatient psychotherapists regarding decisions about crossing boundaries within clinical practice. The focus was on boundary-crossing behavior, as distinguished from boundaryviolating behavior, in that boundary crossings are not necessarily harmful, and at times may be helpful to the client. An electronic questionnaire, developed specifically for this research, was administered anonymously to 46 practicing clinicians in the United States. The major areas of inquiry were the following: boundary-crossing decisions with which clinicians experienced the most difficulty, factors influencing decisions regarding boundary dilemmas, and types of resources that clinicians have utilized in the past and would find helpful in the future for assisting them in making these decisions and maintaining awareness of their own professional boundaries. Additionally, demographic characteristics of the clinicians were correlated with their reported behaviors, decisions, and preferences. Although participants perceived many of the boundary crossings addressed in the study to cause minimal difficulty to their own and other clinicians' decision-making, a major finding was in the detailed accounts of how complex and challenging specific boundary dilemmas were experienced in their practice. Participants noted a range of contextual factors that were influential in making boundary decisions. Additionally, participants perceived a need for training, supervision, and practice guidelines to be provided for assistance with boundary management. Many felt that the most effective resources were supervision and collegial consultation, but noted several barriers to accessing and utilizing these resources.




v, 117 p. Thesis (M.S.W.)-Smith College School for Social Work, Northampton, Mass., 2012. Includes bibliographical references (p. 96-98)