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Maintaining Professional Boundaries Integral In Providing Health Services

Deputy Health and Disability Commissioner Vanessa Caldwell today released a report finding a clinical psychologist in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for entering into a personal relationship with a man previously in her care.

The man, in his thirties, received direct therapeutic contact from the psychologist while participating in a rehabilitation programme at a prison. During an individual therapy session the man revealed that he had feelings for the clinical psychologist and the psychologist disclosed this discussion with her clinical team. A plan was collaboratively developed to ensure the man was well supported, and the therapeutic boundaries were managed appropriately through supervision of the psychologist.

The man completed the programme, and in February 2018, moved to a self-care unit to learn reintegration skills. In April 2019 he was released from prison into a rehabilitation unit. The clinical psychologist resigned from her position and left Corrections in September 2018 and voluntarily removed herself from the New Zealand Psychologists Board (NZPB) register. When the man was released from prison they began communicating with each other, and developed a personal relationship.

The Deputy Commissioner considered it was inappropriate and unethical for the woman to enter into a relationship with the prisoner given that she was his clinical psychologist.

"The maintenance of professional boundaries is an integral part of the provision of health services, and its importance in the provider-consumer relationship cannot be emphasised strongly enough," said Dr Caldwell.

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"I consider the psychologist had an ethical duty to the prisoner to maintain appropriate professional boundaries after their therapeutic relationship ended, and irrespective of whether or not she continued to practise as a clinical psychologist at this time."

Dr Caldwell regarded the man as still in a vulnerable situation, having recently left prison and continuing to receive ongoing rehabilitation to re-integrate back into the community.

She recommended that should the woman return to work as a clinical psychologist, NZPB will require her to undertake further training on ethical and boundary issues and require her to have regular mentoring and report on whether the psychologist is respecting professional boundaries.

Dr Caldwell further recommended that Corrections introduce specific guidance outlining individual staff member’s responsibilities regarding how and when to escalate issues of transference (development of romantic feelings) and manager’s obligations on how to handle these issues.

The full report on case 19HDC01491 is available on the HDC website.

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