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Causes of Boundary Violations

Boundaries protect the very core of the professional-patient association. The breach of a boundary whether intentional or not can lead to serious harm to all parties. The etiology of a boundary violation is complex. On rare occasion, the professional may be a sociopath, absent of conscience, who knowingly exploits his or her patients. In the majority of cases, the offending professional may suffer from a mental illness or experience crises which impair professional judgment. The professional may not be fully cognizant of the violation and may remain unaware of the damage that has occurred. In either case, the result is exploitation and harm.

Helping A Colleague

If you suspect that a colleague is in danger of perpetrating a boundary violation or has done so, do not assume that he or she recognizes the situation. In the majority of cases, the professional's denial and rationalization of their misbehavior is entrenched. When confronted, these professionals tend to distort and minimize the violation. It has been said that these violations occur within a "circumscribed detachment of reality". This means that a professional may function competently and ethically in all aspects of their practice except in regard to their interaction with the specific patient/victim. The worse thing you can do is to ignore the problem. Remember that the perception of misconduct can be as damaging as an actual event. This is a professional colleague who is in need of your help. In many aspects, it is not unlike an impaired professional who is suffering from a chemical dependence. An intervention is necessary to safeguard the professional and to protect the public. Your help may prevent further harm and in the long run, preserve the professional's career.

How To Report A Potential or Actual Ethics Violation

It is our moral and ethical responsibility to help one another when in trouble. If you feel unable to talk to the offending professional, contact a representative from an advocacy program, such as the Physicians Health Program. Contact us below if you need further assistance.

In some states, knowledge of a boundary violation is treated in the same way as a sexual abuse case. It may be your legal duty to report the knowledge of a boundary violation. Please call your Advocacy Program for guidance. Failure to do so may expose your license to disciplinary proceedings and potential criminal charges.

Get Help from the National Sexual Assault Hotline

If you feel that you have been exploited, sexually or otherwise, by a professional (doctor, therapist, teacher, coach, minister/priest, attorney, or law enforcement officer), you may need help and guidance. Anger, betrayal, and pain are common reactions to boundary violations. It may be helpful to go to one of the sites noted below or to call the National Sexual Assault Hotline at 1-800-656-HOPE for information and support.

Advocate Web

AdvocateWeb is a nonprofit organization providing information and resources to promote awareness and understanding of the issues involved in the exploitation of persons by trusted helping professionals. AdvocateWeb offers extensive free resources for victims, survivors, and their families, friends, victim advocates, and professionals. Click here to get a list of resources from their direct help page.


RAINN: The Rape, Abuse & Incest National Network is the nation's largest anti-sexual assault organization. RAINN operates the National Sexual Assault Hotline and carries out programs to prevent sexual assault, help victims and ensure that rapists are brought to justice.

Call the National Sexual Assault Hotline, operated by RAINN, for free, confidential counseling, 24 hours a day at 1-800-656-HOPE, or click here to learn more about their programs.

National Women's Health Information Center

The National Women's Health Information Center (NWHIC) is the federal government's source for women's health information, including resources for women who have been the victims of sexual assault.

For information on sexual assault, contact the National Women's Health Information Center at 1-800-994-9662 or visit their website to learn more.