Boundary violations are an uncommon but nonetheless important cause of malpractice action against the psychiatrist. Although not all boundary crossings are boundary violations, boundary violations include various breaches ranging from sexual liaisons to inappropriate online behaviors. Sexual boundaries merit consideration not only with patients but also with former patients and family members of patients, partially because of the imbalance of power in the relationship. Some states have also imposed criminal penalties for certain types of boundary violations. Internet and e-mail boundaries also are critical for psychiatrists to consider. Online behaviors that are problematic or risky are explored. Questions for ethical self-reflection are posed. Recommendations are made throughout the article regarding avoiding boundary violations.
Keywords: boundaries; email; malpractice; professionalism; social media.
Copyright © by the American Psychiatric Association.