| Description |
The issues of The issues of exploitation, boundary violation, and sexual misconduct by mental health professionals have received increased attention in recent years from professional and legal communities as well as from the media. Studies addressing the incidence of boundary issues have been conducted with professionals in psychology, psychiatry, and social work, but not such information exists related to advanced practice registered nurses in psychiatric mental health (APRNs-PMH). The purpose of this research was survey APRNs-PMH using self-administered Exploitation Index to assess APRNs-PMH reported incidence of exploitative behaviors and to compare their responses with psychiatrists' responses from previous data. In addition, APRNs-PMH were also asked if the identified behaviors engaged in sometimes or often were viewed as detrimental to clinical practice and weather or not these behaviors would serve as a catalyst to change clinical practice. Open-ended questions sought information related to where APRNs-PMH received formal instruction on how to handle sexual feelings when working with clients, where they received formal supervision, and what training/education resources would be helpful to keep nurses consciously aware of boundary issues while conducting psychotherapy. Results showed that APRNs-PMH engaged in exploitative behavior at a low to no rate behavior, thoughts, and feelings that represent boundary crossings. The behaviors reported were early warning indicators of potential boundary violations, but there behaviors were generally not seen as detrimental to clinical practice. APRNs-PMH also reported that they would not change clinical practice. Both groups endorsed calling clients by first name, clients calling psychiatrists and APRNs-PMH accepting referrals from client and professional contacts. Touching was endorsed twice as frequently by nurses compared to psychiatrists. Yet they did not see this endorsement as detrimental to clinical practice and would not change the practice. A fine line exists between caring, professional relationship and over involved relationship. Although exploitation and boundary violations may or may not lead to sexual misconduct, mental health professionals need to be consciously aware of the warning signs and behaviors that could lead to more serious violations |
