Chapter 30. Professional Boundaries in Psychotherapy

Glen O. Gabbard, M.D.
DOI: 10.1176/appi.books.9781585623648.376535



Psychotherapy, regardless of orientation, must take place in a context that is safe and conducive to therapeutic possibilities. Psychotherapy is a professional relationship that, above all, is focused on helping patients with problems that they identify. Psychotherapeutic treatments occur within an envelope that is often referred to as the therapeutic frame. However, the metaphor of a frame implies a rigidity that may not be in the best interest of the process. The concept of professional boundaries, with some degree of inherent flexibility, may be more suited to most discussions of sound psychotherapeutic practice than the concept of therapeutic frame. A simple definition of professional boundaries is that they are the parameters defining the limits of a fiduciary relationship in which one person (a patient) entrusts his or her welfare to another (a psychotherapist), who is paid for the provision of a service (Gabbard and Nadelson 1995). Boundaries suggest a professional distance and respect that is characteristic of ethical professional behavior, but they also allow for some degree of bending in the service of individualizing treatment.

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Table Reference Number
Table 30–1. Dimensions of professional boundaries


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