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Maintaining Appropriate Professional Boundaries

Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.

Guideline 5: Maintaining Appropriate Professional Boundaries

It is your responsibility, not your patient's, to maintain appropriate boundaries in your professional relationship. All complaints of inappropriate behavior by licensed professionals are taken very seriously. The Regents Rules define as unprofessional conduct a licensed professional exercising undue influence on a patient in such a manner as to exploit the patient or conduct that evidences moral unfitness to practice the profession of a licensed mental health practitioner.

You should be especially vigilant regarding any conduct that could impair your objectivity and professional judgment in serving your patient, and any conduct that carries the risk and/or the appearance of exploitation or potential harm to your patient. If a current or former patient files a complaint against you, it will be your responsibility to demonstrate that you have not exploited or coerced the patient, either intentionally or unintentionally.

The practice of the mental health professions, including counseling and psychotherapy, requires interaction with patients, which may be emotional. In most cases, it is advisable to avoid hugging or other physical contact that could imply that you have a personal, rather than a professional, relationship with the patient. If a situation arises that leads you to believe that a hug or similar contact is appropriate, you should still seek the patient's consent before touching or hugging him or her to minimize the risk of misunderstanding or allegations of inappropriate contact.

You should recognize and avoid the dangers of dual relationships when relating to patients in more than one context, whether professional, social, educational, or commercial. Dual relationships can occur simultaneously or consecutively. Some of the types of situations that may lead to problems include, but are not limited to:

  • accepting as a patient anyone with whom you have had a prior sexual relationship;
  • forming a sexual relationship with a current or former patient;
  • treating patients to whom you are related by blood or legal ties;
  • bartering with patients for the provision of services;
  • supervising applicants for licensure or other training when you are related by blood or legal ties, or when you are having or have previously had a sexual relationship with the trainee;
  • referring patients to services in which you have a financial relationship, without disclosing that you may stand to benefit financially from their use of the service; and
  • entering into financial relationships with patients other than their paying for your professional services.

Citations of Pertinent Law, Rules or Regulations: