MY DUAL RELATIONSHIP AND BOUNDARY CHALLENGES

My Dual Relationship and Boundary Challenges



My Dual Relationship and Boundary Challenges

Background

For the purpose of this assignment, we have interviewed three individuals who are related to mental health. They are serving mental health profession since more than two years each. The results have been compiled by performing a thorough analysis of the responses of these mental health professionals.

Introduction

The intrinsically stressful nature of rural health practice is well recognized. One aspect of this stress relates to the complexity of professional and ethical dilemmas in rural environments, with dual relationships a key feature of rural practice. A dual relationship is defined as 'two or more distinct kinds of relationship with the same person'.

Rural mental health workers are often required to provide treatment for patients with whom they have had a previous or concurrent personal or other relationship. These dual relationships pose particular challenges in a rural setting. For example, rural mental health professionals may experience difficulties in maintaining their own privacy encountering current and past patients outside the clinical situation. While the dual relationship may provide some benefits, it has traditionally been considered unethical in some areas of health practice, particularly mental health.

While dual relationships are part of the fabric of rural health practice, this has received scant attention in the research literature. The limited research evidence available focuses on the impact of a dual relationship on the patient, rather than the clinician. Similarly, advice provided by decision-making models addressing the ethics of dual relationships focuses on considerations of whether to enter a dual relationship, implying that the clinician has a choice, and stops short of advising how such relationships should be managed.

When considering dual relationships, distinction has been drawn between boundary crossings and boundary violations with the latter used in the context of clinician violation: 'actions on the part of the clinician that are harmful, exploitative and in direct conflict with the preservation of clients' dignity and the integrity of the therapeutic process'. Such violations perpetrated by clinicians or patients are deemed unacceptable. Boundary crossings, on the other hand, are 'benign and sometimes beneficial departures from traditional therapeutic settings or constraints', p. 955].

Aims and research questions

The aims of the study were to:

explore the frequency of dual relationships and boundary crossings

explore the nature and impact of professional boundary crossings

identify strategies clinicians use to manage dual relationships



Method

Three mental health professionals were selected for individual interviews in order to achieve the aims of this research. The research questions were addressed through a total of three individuals interviews conducted metropolitan settings. Individuals capture communication between research participants in order to generate data . Their added benefit, above individual interviews, comes through the synergy generated between individuals and their 'permissive' support function in encouraging participants to divulge opinions and beliefs that might not emerge through an individual interview

Data analysis

Qualitative content analysis was used to identify themes in the data . Data were then compared across sites to ensure that themes were pursued in subsequent focus group interviews until ...