The Concept of Appropriate Professional Boundaries in Psychiatric Practice: A Pilot Training Course

Abstract

Objective: The aim was to design and run a three-session training module for psychiatric registrars on professional practice with particular emphasis on boundary setting. This included the concept of boundary transgression, an understanding of how it occurs and how it may be avoided. Method: Drawing on North American experience a curriculum was designed and trialed for trainees at all levels. A variety of media were employed to present a range of common clinical and professional issues. Evaluated were trainee satisfaction, trainee responses to target vignettes at the beginning and at the end of the course, and supervisor awareness and involvement in the process. Results: High attendance and high satisfaction ratings in most areas confirmed that a course such as this is attractive and relevant for psychiatric trainees. Vignette responses suggested some change may have occurred by the end of the course, with a more limited tendency to avoid potentially challenging situations and a higher capacity to explore them. Supervisor involvement remains largely unaddressed despite interest and enthusiasm. Conclusion: The area of interpersonal relatedness in psychiatry, including the issue of sexual attraction and the possibility of sexual misconduct, can be introduced as a training package in a way which is acceptable to trainees and their supervisors in an Australian setting. The impact of the training module on actual registrar behaviour is uncertain.