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Professional Boundaries: Crossing a Line
or Entering the Shadows?
Mark Doel, Peter Allmark, Paul Conway,
Malcolm Cowburn, Margaret Flynn, Pete Nelson,
and Angela Tod
Professor Mark Doel is Research Professor of Social Work in the Centre for Health and Social
Care Research (CHSCR) at Sheffield Hallam University and his research publications concern
social work practice education, social work in groups and international perspectives on social
work. Dr. Peter Allmark is Principal Lecturer in the Centre for Health and Social Care
Research (CHSCR) at Sheffield Hallam University and his research publications in health
care ethics and philosophy; his recent focus is ethics and public health. Paul Conway is the
Information Adviser for Social Work, Learning and Information Services. Dr. Malcolm
Cowburn is Principal Lecturer in Criminology at Sheffield Hallam University; his research
publications concern prisons, sex offenders, masculinities, diversity and the application of
ethics in research and practice. Dr. Margaret Flynn is the Independent Chair of Lancashire
County Council’s Adult Safeguarding Board, an editor of the Journal of Adult Protection and
a Senior Associate of CPEA Ltd. Pete Nelson is Principal Lecturer in the Department of
Social Work, Social Care and Community Studies at Sheffield Hallam University and his
teaching and research concern social work values and ethics, social work practice learning
and social work with children and families. Dr. Angela Tod is a Prinicipal Research Fellow in
the Centre for Health and Social Care Research at Sheffield Hallam University. Her research
publications concern nursing, public health, health inequalities and ethics.
Correspondence to Professor Mark Doel, Ph.D., MA (Oxon), CQSW, Research Professor
of Social Work, Centre for Health and Social Care Research, Sheffield Hallam
University, 32 Collegiate Crescent, Sheffield S10 2BJ, UK. E-mail: m.doel@shu.ac.uk or
doel@waitrose.com
Abstract
This article explores the professional boundaries guidance for social workers. It presents
research findings from the formal literature, from agency codes of practice, from tele-
phone interviews with regulatory and professional bodies and from an exercise using
‘snowballing techniques’ in which informants responded to brief scenarios illustrating
boundary dilemmas. The findings suggest that formal research plays little part in the
guidance that individuals use to help them determine professional boundaries. Similarly,
only 10–15 per cent of informants made regular reference to regulatory and pro-
fessional codes of practice, with an even smaller percentage quoting specific sections
from these codes. A slightly larger group (15 – 20 per cent) made fairly regular reference
#The Author 2009. Published by Oxford University Press on behalf of
The British Association of Social Workers. All rights reserved.
British Journal of Social Work (2009) 1–24
doi:10.1093/bjsw/bcp106
British Journal of Social Work Advance Access published October 14, 2009
to their agency’s policy documents. However, a clear majority relied on their own sense
of what is appropriate or inappropriate, and made their judgements with no reference
to any formal guidance. Agency guidance tended to ignore the ambiguous areas of
practice and seemed to act as an insurance policy, brought out and dusted off when
something goes awry. The authors caution against ever-increasing bullet points of
advice and prescription, and advance a notion of ethical engagement in which pro-
fessionals exercise their ethical senses through regular discussion of professional bound-
ary dilemmas.
Keywords: Professional boundaries, professional ethics, code of practice, professional
relationship, practice dilemmas
Background
The research on which this article is based was commissioned by the
General Social Care Council (GSCC, 2008) following the publication of
Raising Standards: Social Work Conduct in England 2003– 2008. This pub-
lication constituted the GSCC’s first report covering the work undertaken
to uphold standards and protect people who use social care services. In
the light of findings revealing that 40 per cent of conduct cases involved
allegations of ‘inappropriate relations’, the GSCC committed itself to
developing professional boundaries guidance for social workers. This
article reports the findings from the research to assist this task (Doel
et al., 2009).
The research had two main purposes: first, to establish what professional
boundaries guidance currently exists for social workers in the UK and,
second, to identify and discuss a number of other examples of professional
boundaries guidance (from outside the UK and from other professions)
which would act as illuminative points of reference.
A note on terminology
‘Professional boundaries’ is used to describe the boundary between
what is acceptable and unacceptable for a professional to do, both at
work and outside it, and also the boundaries of a professional’s practice
(e.g. whether complementary therapies can be undertaken by the
professional as part of their work). It should not be confused with bound-
ary disputes between different professions, namely inter-professional
boundaries.
The research process
The research had four components.
Page 2 of 24 Mark Doel et al.
Literature review
A literature search was conducted using twenty-two databases in seven
related professional areas: social work, nursing, criminal justice/policing,
health and allied professionals, physiotherapy, counselling and teaching.
Keywords used were:
†professional boundar* OR professional guid* OR professional conduct AND
†social work*; nurs*; criminal justice OR law; police OR policing; counsel*;
physiotherapy OR health or therap*; teach*
†professional standard* OR professional ethic* AND
social work*; nurs*; criminal justice OR law; police OR policing;
counsel*; physiotherapy OR health or therap*; teach*
†GSCC or General Social Care Council AND
social work*; nurs*; criminal justice OR law; police OR policing;
counsel*; physiotherapy OR health or therap*; teach*.
The search was restricted to post-2000 results, except where an article title
seemed especially relevant. A first sift of titles was undertaken, leading to a
second sort of abstracts. One hundred and nine articles of core relevance
were selected and read for inclusion in the analysis.
Scenarios
Twelve very brief scenarios were developed to illustrate different kinds of
ambiguous boundary issues (see Appendix). They were designed to provide
a picture of actual responses to professional boundary issues, how these
conclusions are made and what actions are considered.
The scenarios were e-mailed, with an introductory and personalised
message, to a convenience sample of 142 informants across nine countries
(UK, Eire, USA, Canada, Australia, New Zealand, South Africa, Sweden
and, with translation, Germany) and to a convenience sample of six
related professions (social work, nursing, medicine, educational psychol-
ogy, probation and occupational therapy). The largest proportion of infor-
mants before and after snowballing was UK social work professionals in a
range of agencies in the statutory and voluntary sectors and in educational
settings and in a variety of different job roles. Each informant was asked to
forward the scenarios to further potential informants. There were forty-
nine responses within the deadline, of which 59 per cent were derived
from ‘snowballing’ (i.e. they were not direct informants). There was a
total of 504 separate scenario responses and these were analysed and
coded for themes. The nature of the sample meant that the survey gener-
ated illustrative rather than systematically representative responses.
Professional Boundaries Page 3 of 24
Policy documents
Informants were asked what codes of practice (e.g. BASW, 2002; GSCC,
2002; NASW, 2008; SSSC, 2005) and agency policies would be relevant to
each scenario and were requested to return electronic copies of these.
Seventeen policy documents were received from eight respondents (seven
UK, one Australian) amounting to 269 pages of information and represent-
ing a wide spread of agencies—statutory city and county, small local volun-
tary organisations and large national charities. The content, style and
purpose of these documents were analysed.
Telephone interviews
Telephone interviews were conducted with three types of professional body:
†regulatory bodies (General Medical Council, GMC; General Teaching
Council, GTC; Health Professions Council, HPC; Nursing and Midwifery
Council, NMC);
†overseeing regulator (Council for HealthcareRegulatoryExcellence, CHRE);
†professional organisations (Chartered Society of Physiotherapy, CSP;
College of Occupational Therapists, COT; College of Radiographers, COR).
In all cases, the person interviewed was put forward by the organisation in
the light of e-mail and phone enquiry. The precise title and role of the inter-
viewee varied but, in all cases, it was someone senior who felt able to give an
organisational view on the topics.
Strengths and limitations of the research
The seven-strong research team comprised several professions and had a
strong background in ethics. Individual members were well connected so
that the snowballing technique had a wide and immediate reach. The
team included the specialist help of an Information Advisor to manage
the complex task of electronic literature searches.
As indicated, there was a range of strategies in the research design and
this gives us some confidence that the findings are ‘triangulated’. The gath-
ering and analysis of policy documents actually in use, linked to the snap-
shots gained through the scenarios about their use, were unusual and
produced some interesting findings.
However, the convenience sample is both a strength and a limitation. It
does not provide a representative sample but it did generate considerable
illustrative material. With hindsight, it would have been useful to have
asked informants to rate the seriousness of each scenario, which would
have provided a quantitative measure by which to compare responses
(within each scenario from informant to informant, and across scenarios).
Page 4 of 24 Mark Doel et al.
Any comparisons between the scenarios—and any sense of the hierarchy of
principles that is discussed in some of the literature—had to be inferred
from the text of the responses.
Research ethics
Approval to pursue the research elements of the project was obtained from
the Chair of the Faculty Research Ethics Committee at Sheffield Hallam
University. Respondents were assured of anonymity and confidentiality
and no particular ethical issues were identified.
Findings from the review of the literature
Prevalence, kind and range
The prevalence of professional boundary issues is difficult to estimate, not
least because of the differing definitions as to what is considered to be a
crossing, a transgression or a violation (Austin et al., 2006). The number
of formal expulsions from professional bodies is one way to measure preva-
lence. The evidence from Stromm-Gottfried (2003) and Phelan (2007), both
in the USA, suggests that rates are steady or even in decline, but that they
vary across organisations. Our findings also suggest that very different
actions are likely to be taken in different agencies in the UK with no
obvious factors to explain this.
Sexual violations are the most commonly reported of boundary violations
(Halter et al., 2009; Stromm-Gottfried, 2000), but the focus of our research
was the grey areas rather than obvious violations. Examples of professional
boundary breaches in allied health professions varied from severe acts of
cruelty involving de-humanising patients and abuse and harassment
(Boon and Turner, 2004) to the less serious, such as accepting gifts
(Browne and Russell, 2005). Financial transgressions figure more promi-
nently in the US literature, where a distinction is made between pro-
fessional boundaries and other kinds of violation around issues such as
poor practice, competence, record keeping, honesty, confidentiality,
informed consent, collegial actions, reimbursement and conflicts of interest
(Stromm-Gottfried, 2000). Of course, any single reported incident might
result in a number of different violations.
A report of social work activity in England between 2003 and 2008 (GSCC,
2008) recorded that allegations were received about less than 1 per cent (n¼
503) of the registered workforce in 2007– 08 and in 2006 – 08, only 0.04 per
cent (n¼36) of the total workforce of social workers and students have
appeared before a hearing. The largest source of complaint was the public
and people who use services (44 per cent), followed by the employer
(35 per cent). By far the largest category of complaint was poor professional
Professional Boundaries Page 5 of 24
practice (46 per cent). Only 9 per cent of complaints related to inappropriate
relationships. However, the pattern was for multiple and related transgres-
sions. The most common professional boundary breach was related to
‘behave in a way, in work or outside work, which would call into question
your suitability to work in social care services’ (GSCC, 2008, p. 18).
Recognition and reporting
Reporting of incidents is an important theme in the literature. A study of
students revealed a high level of willingness to act in situations viewed as
detrimental to service users, but this form of self-report is unreliable (Man-
sbach and Bachner, 2009). Asquith and Cheers (2001) examined the moral
issues that fifteen social workers faced over a one-month period and discov-
ered that the main source of influence to resolve these issues were the prac-
titioners’ personal moral perspectives. Tellingly, most of these resolutions
did not conform to accepted social work ethical practice principles. This
finding is reinforced by a study that suggested that professional socialisation
did not seem to affect the ethical judgement of the social workers and stu-
dents in the study; the only variable that significantly affected their ethical
judgements was religiosity (Landau, 1999).
Reamer (2000) suggests that social workers should perform a kind of
‘social work ethics’ audit regularly in order to facilitate confidence in
reporting. The Social Work Ethics Audit is described as an ‘easy-to-use
tool to [help practitioners] examine their ethics related practices, policies
and procedures’ (Kirkpatrick et al., 2006, p. 225), but the literature suggests
that making boundary decisions requires ethical competence rather than fol-
lowing a framework of instructions (Peternelj-Taylor and Yonge, 2003).
Integrating ethical codes more fully into professional training is seen as
one way of managing the tension between over-vague principles and over-
instructive diktats (Gastman, 2002). In an American study, Masters of
Social Work (MSW) students indicated that they did not feel adequately
prepared to handle sexual feelings towards or from a service user
(Berkman et al., 2000).
Dobrowolska et al. (2007) argue that norms are established according to
recurring situations, such as by publishing professional misconduct case
studies and considering these in the light of relevant clauses of the pro-
fessional code (see Castledine, 2003).
Context
The importance of context is highlighted by research indicating that social
workers change their professional and personal ethical hierarchies depend-
ing on their professional situations (Landau and Osmo, 2003). Given social
Page 6 of 24 Mark Doel et al.
work’s holistic perspective, it is unsurprising that issues of relativism and
universalism are considered in the literature. Squaring the circle of respect-
ing culture while upholding professional ethics is difficult. Healy (2007) rec-
ommends a moderately universalist stance; that is, one in which certain
principles or rules of ethics are said to hold universally (e.g. not to abuse
children). Nevertheless, a comparative study of Cuban and Canadian pro-
fessionals found very different stories about the meaning of professional
ethics, reflecting the strength of collectivist and individualist societies,
respectively (Rossiter et al., 2002); prevailing ideologies clearly have an
impact on specific codes of practice.
Another significant contextual factor is the kind of work that the social
worker is undertaking. Du
¨vell and Jordan (2001) found that the boundary
issues for social workers with asylum seekers were exceptionally sharp,
given the workers’ acknowledgement that the prevailing standards in their
agencies were unacceptable, in terms of human rights, decency, efficiency
and social justice. The rural/urban context also emerges as significant, with
the likelihood of dual relationships (knowing service users in other guises)
more common in rural communities (Austin et al., 2006; Pugh, 2007).
Organisational contexts were strong in the scenario responses, less so in
the literature. Banks (2004, 2006) sees the increasing proceduralisation of
social work and other changes in role as a threat to the idea of a single
code of professional ethics, especially with the strengthening of a consumer-
ist approach to the social work profession. Dietz and Thompson (2004) con-
trast a patriarchal ‘distance’ model of social worker– client relationships
and a feminist ‘relational’ model; they view the drive to proceduralise
social worker– service user relationships as a strengthening of the patriar-
chal model. Indeed, the agency’s desire to protect itself can lead to a
failure to meet service user needs (Browne and Russell, 2005).
The local context can become a strong sub-culture. This was particularly
noted in the policing literature (Alain, 2004; Marc and Martin, 2008; West-
marland, 2001, 2005), with a focus on anti-corruption and ‘integrity’ policies
and strong leadership (Lamboo et al., 2008; Moran, 2002; Punch, 2000). Local
sub-cultures can introduce alternative ethical hierarchies, including a code of
silence (Ekenvall, 2002). Also of wider relevance is the notion of ethical
burnout; Catlin and Maupin (2002) found that new male police
recruits were predominantly ‘idealistic’, whilst their counterparts of one
year’s experience in the job were predominantly ‘relativist’. Similar
changes were identified in Alain and Gre
´goire’s (2008) study of Quebec
police recruits.
Professional identity
Meulenbergs et al.’s (2004) finding that codes of ethics are part of the pro-
fessionalisation of nursing as a means of self-assertion and an expression of
Professional Boundaries Page 7 of 24
identity is probably true of other professions. Similarly transferable is the
conclusion that if interpreted in a literal way, codes produce the opposite
effect from that intended, forcing nurses to disguise their errors and not
making accurate reports (Esterhuizen, 1996); the professional’s commit-
ment to act rightly according to moral standards is transferred to a focus
on compliance with the code (Pattison, 2001). Yoder (1998) sees ethical
expertise as inter-disciplinary and, therefore, wider than clinical expertise,
with codes unable to replace a professional’s ethical sensitivity and individ-
ual decision making.
Balance
The successful resolution of professional boundaries issues might depend
on achieving a balance between personal privacy, the safety of vulnerable
individuals and the protection of the wider public. Clark (2006) suggests
that there should be more focus on the collective common good to
balance current obsessions with defending individual interests.
Our understanding of professional boundaries should be balanced by
research into the views of service users, but these do not figure strongly in
the research. However, Lord Nelson et al. (2004) discovered that the families
in their study had a preference for practitioners who were flexible with bound-
aries, and who went beyond a strict interpretation of the professional’s role.
Findings from the scenarios
In the tradition of vignettes used for training (Bowman and Hughes, 2005),
twelve brief scenarioswere designed to act as a trigger for informants to con-
sider the actual response likely from their agency (see Appendix). A fewinfor-
mants responded as a pair or as a team. Some asked to use the scenarios in the
future for continuing professional development purposes. Every scenario
drew wide and varying opinions with little consensus and the sub-samples
were too small to draw any comparative conclusions. Even when there was
a consensus that action should or would be taken (such as 89 per cent of
those responding to Scenario 2, A social worker overclaims mileage allowance
in order to fund a group for services users), there was a wide range of opinion
about what the action should be (see later). No obvioussubgroups are evident,
though we will propose one possible explanation for these differences later.
Contextualisation
Most informants explored a range of contextual factors for each scenario
and these frequently differed from one to another. They included: first
Page 8 of 24 Mark Doel et al.
time or recurrent; attitude of the professional to the discovery of the trans-
gression; medical condition; care plan; inside work, outside work.
Pragmatism
There were frequent comments suggesting that no action would occur if the
breach was ‘out of sight, out of mind’. ‘We have a specific policy on this but
common-sense would prevail!’ (Scenario 5, Informant 7). Notions of scale
(‘is it just the price of a cup of tea that is borrowed?’—Scenario 8) and
‘common sense’ influenced whether action would be triggered. For two
respondents, it was not necessarily the nature of the action, but a pragmatic
view as to whether the worker undertaking the behaviour could be traced to
the specific agency (Scenario 12a).
Wide range of responses
There was a wide range of responses, not just concerning whether action
would or should be taken, but what the likely course of the investigation
would take and the different outcomes, frequently varying from a quiet
word in supervision through to dismissal.
Levels of (un)certainty
Levels of certainty anddoubt varied as widely as the decisions recorded. One
person was ‘stumped’ by virtually all the scenarios: ‘I don’t really know the
honest answer to 1– 10’ (Informant 39). Others felt able, even on the quite
limited information from the brief scenario, to make definitive judgements.
Local culture and possible subsets
The numbers were insufficient to generalise, but there was a hint of notable
differences in some subsets such as the responses of a group of five African
doctors and nurses. ‘Some of these questions do not fit our own context in
Nigeria .... The supervision of staff is not that close and stringent .... Same
sex marriages are not allowed and making wrong allowance claims is not
uncommon’ (Informant 45).
Roles and remits
Although there were disagreements about what the social work (or other
professional) role is, there was a more consistent view that professional
Professional Boundaries Page 9 of 24
boundaries were related to role and to ideas of good practice. Crossing
boundaries inappropriately is not, then, just a moral issue, but a question
of fitness to practise.
Pre-emption
Frequently, the make-or-break position was whether there had been prior
agreement with the agency about the boundary crossed. In addition,
there was an onus on the agency to make it clear when they employed
new staff what was and was not considered to be acceptable. ‘Prospective
employees are reminded at interview that they cannot discriminate, so
they have had the opportunity to discuss these issues before (which
would make it worse if they now refused to do this work?)’ (Scenario 3,
Informant 32).
Reporting is uncommon
Even when there was considerable unanimity that a code has been
breached (as in §12) and when dismissal was being considered, only
in one case did one person consider informing the professional body
(Scenario 2, Informant 37). Informants were more likely to refer to
agency codes of conduct than professional codes of practice; but they
were even more likely to refer to neither of these, relying on an implicit per-
sonal code.
Power of individual manager
The employer seemed to be a stronger reference point than the profession,
and the individual manager appeared to have exceptional power in terms of
whether action would be taken, irrespective of the existence of the agency
code. Two managers in the same city, for example, were at odds in their
response to Scenario 12a (the lap dancer), starkly revealing the significance
of the operational manager in making decisions about whether action
would or would not be taken—and that this was dependent more on the
manager’s moral stance than on the employment code or professional
code of practice.
Service user rights
The reference points for informants tended to emphasise either the agency
(possible disrepute, etc.) or the service user (protection, power, safety, etc.).
Page 10 of 24 Mark Doel et al.
Some of the former responses placed service users at great distance, almost
as an out-caste. ‘The [former] service user [who became engaged to a social
worker] could not receive future services from the agency UNLESS the
social worker no longer works there’ (Scenario 1, Informant 7). Human
rights were not mentioned in any of the scenario responses, which suggests
that this part of the equation (balancing protection with notions of fellow
citizenship) was weak.
Findings from the policy documents
The seventeen policy documents elicited from the snowballing exercise
were reviewed for content, style and purpose. Their overarching purpose
seemed to be to set the parameters within which employees should
operate. Broadly, they described measures to reduce the likelihood of inap-
propriate behaviour and to improve management processes in preventing
and responding to allegations of professional boundary crossings. There
was an expectation that employees would read and be familiar with their
contents.
The documents stated principles and expectations that were considered
to be binding for professionals. Some codes implied a distinction between
misconduct (a failure to follow a workplace rule) and poor performance
(failure to work to an acceptable level). Typically, they made reference
to complementary and conduct-related policies.
The policies outlined courses of action that were intended to influence
and determine the decision making and behaviour of professionals.
While there were differences in emphases, the guidance outlined what
professionals should do by stating particular courses of action. Similarly,
the procedures and protocols specified particular steps to be followed.
They hinged on methods and ways of proceeding at micro and macro
levels.
The documents cited legislation, principles and values to different
degrees. Few, however, confirmed the existence of ‘grey areas’ or of the
complexity of dilemmas requiring judgements of value where there may
be grounds for misgivings about the possibilities for full resolution.
However, there were glimpses of a more reflective approach, with employ-
ers exploring competing understandings of professional boundaries:
Personal and professional boundaries need to be established by all members
of staff .... Service Z will strive to ensure that staff do not seek to control
clients or colleagues and will not tolerate abuse within the workplace ....
The need to establish, maintain or modify boundaries will be discussed as
part of induction .... Training in boundary issues is compulsory for staff
...staff requiring additional training relating to boundaries will be sup-
ported to do this as part of their individual training programme (from the
Boundaries Policy and Procedures of a National Voluntary Organisation).
Professional Boundaries Page 11 of 24
The documents were concerned with the reputation of employers. Thus,
statements included:
Please inform the communications department of any activity that could
positively (or negatively) impact upon our reputation ...(from a National
Organisation’s Media Contact Policy).
You are employed by X City Council and that means you are a local govern-
ment officer. You and the services you provide are paid for by public money
and therefore you are accountable to the public for your behaviour, actions
and decisions. You must not only behave properly, you should also be seen
to behave in a way that is beyond question (from a Code of Conduct for
Employees).
Starkly expressed directives, duties and obligations were not consistently
accompanied by a rationale or explanatory framework and might be
described as pre-reflective. They acknowledged that professional boundary
violations existed and confirmed that employers would have no truck with
breaches of professional trust. They suggested a preparedness for the claim,
‘But no one said I couldn’t have a relationship with a client’ and a readiness
to take action when professional boundaries are violated. All made clear
the limits to individuals exercising their professional power and authority.
The tasks of the authors of these documents appeared similar to those of
software companies. The latter write codes to protect their software,
which expose flaws, and as more products are developed, more codes are
required. Similarly, service managers identify new boundary violation pro-
blems and describe them in up-dated and revised policies and codes of
conduct.
Broadly, the documents conveyed a greater readiness to engage with the
boundary violations arising from sexual relationships with service users
than among staff themselves. The ‘Dealing with Complaints about
Service Delivery’ policy of a city acknowledged that this may be the
vehicle via which ‘alerts’ pertaining to professional boundary violations
may occur—perhaps confirming the reluctance to speak out about the
actions of colleagues or those who are in positions of trust.
Findings from the consultation interviews
Telephone interviews were conducted with representatives of a number of
professional organisations to understand how these organisations view pro-
fessional boundary issues. There were three types of professional organis-
ation represented. The first were regulatory bodies (n¼4). Their role is
to maintain a register of professionals. They do this in various ways: some
set the standards that determine who enters a register; all keep a register
of professionals; and all have some process for determining the fitness to
practise of practitioners in the light of complaints. The second group
Page 12 of 24 Mark Doel et al.
were overseeing regulators (n¼1). Only one such is represented here: the
Council for Healthcare Regulatory Excellence (CHRE). It oversees nine
regulatory bodies. This involves inter alia an annual performance review,
a scrutiny of all fitness to practise decisions (around 1,000 annually), and
referral of cases to the High Court if the CHRE believe the regulatory
bodies have been too lenient. The third group interviewed were the Pro-
fessional Bodies (n¼3). These work on behalf of professionals as a type
of Trade Union. However, they also provide advice on professional issues
and publish various documents and codes.
The phone interviews lasted thirty-five to forty minutes and took the
form of fairly informal discussion during which the researcher made
notes that were sent to the interviewee to check over. In most cases, the
report was sent back with some changes and clarifications. The interviews
were structured around general questions concerning the definition of a
professional boundary issue and the types seen by the organisation. The
interview then turned to some specific examples of professional boundary
issues.
Themes from the interviews
In deciding what actions are acceptable both at and outside work, two key
factors were commonly cited. The first was fitness to practise: the pro-
fessional organisations would ask to what extent lack of such fitness was
represented by the action. Broadly, this seemed to translate into whether
the professional was able to do his or her job reasonably well and without
undue risk of harm to the service user. This covered bare competency, as
in the requirement that those taking on additional roles or treatments
must be suitably qualified, but it also covered normative behaviour. A pro-
fessional’s membership of a racist political party might indicate an inability
to work with ethnic minorities and, therefore, to work at all in the pro-
fession. Similarly, a professional who makes lewd or suggestive comments
to some service users would be of concern. Hence, behaviour both at
work and outside was relevant in indicating fitness to practise. One of the
most important reasons for enforcing professional boundaries was to
protect people.
The second factor commonly cited as relevant in decisions about pro-
fessional boundary violations was public confidence in the profession or
the professional. This was sometimes described in consequentialist form:
for example, behaviour X is unacceptable because the public would not
have confidence in the professional who did that sort of thing. There is
no necessary suggestion here that the behaviour itself is wrong, only that
it undermines confidence. Sometimes, the behaviour was described more
deontologically: for example, behaviour X is unacceptable because it
shows lack of integrity; professionals should have integrity and this shows
Professional Boundaries Page 13 of 24
that he or she does not. This might lie behind some difference in emphasis
in some of the replies. Those who were more inclined to be concerned by
legal but disapproved-of behaviour sometimes cited public concern.
However, the thought that, for example, being a member of a private Swin-
gers’ club could be of concern might also reflect idea that this reveals some-
thing unacceptable about the professional himself or herself. It could be
argued that if the public’s confidence is undermined, then so what? They
should not expect professionals to be superhuman or saintly.
Overall, the interviews suggested that it might be useful to think of pro-
fessional boundaries as a circle of two, as shown in Figure 1. The inner
circle of boundaries concerns fitness to practise; someone who violates this
circle is harming or likely to harm people. Someone who is racist at work
or a rapist outside would clearly be in this category. So also would be the pro-
fessional with serious drink or drug problems. The outer circle concerns the
public confidence in the professional or the profession. Someone who vio-
lates this circle is undermining confidence, displaying a lack of integrity
and so forth; but they are not necessarily displaying lack of fitness to practise.
The professional who gossips on Facebook, or who takes Ecstasy tablets
occasionally at parties, might be an example of this. Perhaps it is this outer
circle that represents the grey area for which it is difficult to be prescriptive.
Discussion
Various key themes emerged from the findings, which are discussed in turn.
Crossing the line or entering the shadows?
The very word ‘boundary’ is full of ambiguities. For some, a boundary is a
clear demarcation between x and y. This is consistent with strong views that
Figure 1 Competence and confidence.
Page 14 of 24 Mark Doel et al.
there are right and wrong, and universal moral principles that can prescribe
correct and incorrect behaviours (Figure 2).
For others, the idea of ‘boundary’ is not so clearcut. Boundaries are more
like a no-man’s land, or a disputed piece of territory that is capable of being
claimed by many sides. Moreover, the rules that are used to determine who
might claim what part of the territory are also changing and negotiable.
From this perspective, crossing a boundary is not necessarily a violation
or a transgression, since the boundary areas are fluid (Austin et al., 2006).
Indeed, many practitioners might cross these boundaries trying to be
helpful; they could drift incrementally into one of the indeterminate
areas. From this perspective, boundaries are shadow areas where two or
more systems overlap (Figure 3).
Those individuals or agencies that see boundaries as lines—and therefore
every crossing as a violation—are more likely to see the need for a highly
prescribed code of conduct. Those who view boundaries as shifting areas
of shadow, where flexibility can become transgression, will be more inclined
to a set of guidance based on general principles that require interpretation
in the light of the particular circumstances. Of course, these different para-
digms can have serious consequences: a social worker who came from one
agency where gift acceptance was the norm and part of the agency’s thera-
peutic approach to mutual help would be exceptionally vulnerable moving
Figure 2 Crossing the line.
Figure 3 Entering the shadows.
Professional Boundaries Page 15 of 24
to an agency where gift acceptance was viewed as tantamount to grooming.
Perhaps the existence of these sharply at-odds paradigms explains the wide
differences noted in the scenarios about the action that different informants
would take.
Reference points
Two contrasting reference points are evident. For some, the key question
was ‘how does this affect the service user?’ (Figure 4). That, in turn, can
be from an empowering point of view or a paternalistic, protective one of
a ‘vulnerable person’. Those on the other side of the line ask themselves,
‘how does this affect the agency?’ The two are not mutually exclusive,
nor are they necessarily always compatible.
These reference points are linked to notions of social distance, with some
scenario informants clearly seeing service users as a different caste, ‘others’
from whom professionals must be resolutely separate. This might be seen as
defensive self-preservation from a hostile public or as a failure to see people
who use services as fellow citizens. The patriarchal distance model of social
worker–client relationships identified by Dietz and Thompson (2004)
emerged as perhaps dominant over the feminist ‘relational’ model they
describe. It seems clear that service users are not routinely involved in
developing codes of practice or in discussions about professional bound-
aries, though what evidence we have suggests they prefer professionals
who are able to be flexible and ‘human’ (Browne and Russell, 2005; Doel
and Best, 2008; Lord Nelson et al., 2004).
Only occasionally was the possibility that professionals and service users
might be one and the same person considered:
The [scenario] implies that service users and staff are completely separate
rather than overlapping groups. Any policy or approach to managing
these issues needs to address the possibility that staff may also use services
(Scenario 6, Informant 18).
Contextual issues
We have highlighted the significance of case-specific contexts, but it is clear
that there are wider socio-political influences. Differences in the ways that
Figure 4 Reference points.
Page 16 of 24 Mark Doel et al.
professional boundaries are drawn and conceived are probably at their most
pronounced if one considers the contrasts between collectivist and individu-
alist societies (Rossiter et al., 2002) and societies that have strong religious
beliefs (Dobrowolska et al., 2007).
Figure 5 attempts to capture the wider influences and to illustrate the
many potential ‘pinch-points’ for boundary quandaries (the intersections
between the circles).
Personal and professional moralities
Because personal moral codes are developed incrementally throughout our
lives and drawn from personal experiences, it should not surprise us that
these codes seem more likely to influence us than professional standards
(Asquith and Cheers, 2001), though religiosity has also been found to
have a strong influence (Landau, 1999). This must lead us to the conclusion
that a professional or regulatory code of ethics is unlikely to have as strong
an impact on the behaviour of the individual professional as the creators of
the code might hope.
Sliding scales and hierarchies of principles
‘Slippery slope’ is a term mentioned in two of the scenarios’ responses and
present in the literature. For some, even a penny overclaimed (Scenario 2)
Figure 5 Boundary zones.
Professional Boundaries Page 17 of 24
was a dismissible offence because, once crossed, this breach could lead to
much more serious transgressions, namely larger sums of money.
Lowenberg and Dolgoff (1996) propose a hierarchy of principles in which
financial probity sits below, for example, distributive justice. However, the
response to the mileage over-claim (Scenario 2) suggests that financial
probity is rated highly and far outweighs any support for redistributive
justice implied by the motivation for the over-claim. In contrast, a commit-
ment to anti-discriminatory practice, which relates to one of the highest of
Lowenberg and Dolgoff’’s principles, was evident in only some of the
responses to Scenario 3, in which a social worker refuses to work with a
same-sex couple. Whilst not viewing it as right per se, a significant minority
of informants were prepared to accommodate this discriminatory behaviour
and would favour transferring the case quietly to another worker. The refer-
ence to ‘religious beliefs’ seemed to be important to many informants.
Identification and investigation
As we noted in the literature review, the prevalence of boundary transgres-
sions is difficult to estimate, not least because of the discrepancies in what is
considered to be a transgression (Pope and Vettner, 1992). What evidence
we have suggests that boundary violations, certainly as reported to pro-
fessional bodies, are steady (Phelan, 2007; Stromm-Gottfried, 2003). Preva-
lence is important because it relates to the ways in which codes of practice
are developed: do they arise because there are recurring patterns of miscon-
duct or do they arise from highly unusual one-off situations?
The question of prevalence begs those of detection and reporting. The
most likely people to be aware of boundary issues are colleagues but
what likelihood is there of whistle-blowing? Of course, it is difficult to
research what is not reported, but the responses to the scenarios elicited
only two instances of the informant declaring that they knew of a similar
instance happening; and there were a number of ‘sympathy’ responses:
‘Action would probably be taken against the social worker by the council
[for publicising a client’s plight, scenario §6] but again as people may
have sympathy with the situation who would report the social worker?’
(Scenario 6, Informant 38).
One informant recognised that the manner in which a possible transgres-
sion is detected has an impact on the subsequent investigation: ‘The type of
action [taken] depends on whether this formed a part of a complaint or
came to light in a different way’ (Scenario 7, Informant 31). When there
was concern about a possible transgression, who would decide whether
further action was taken? ‘It would be down to the agency to interpret
[the code of practice]’ (Scenario 1, Informant 13); and how wide would
the investigation go? ‘[We] would want to know a lot more about the
Page 18 of 24 Mark Doel et al.
member of staff and service user’s possible use of cannabis’ (Scenario 7,
Informant 28).
Positive boundary crossing
Because complaints come to light in the way that compliments do not, it is
very difficult to estimate how much good and effective practice is taking
place in the shadow areas, where some social workers are prepared to
cross hard and fast lines and to ‘go the extra mile’, but there is evidence
that boundary crossing can be something to celebrate rather than suppress
(Boland-Prom and Anderson, 2005; Turbett, 2009) and more research into
service users’ opinions about professional boundaries is needed.
Conclusions
The relative absence of grey areas, the shadows, in agency policy documen-
tation about professional conduct is in stark contrast to the reality of every-
day practice (as exposed by the responses to the scenarios). Furthermore,
the task of providing bullet-point lists to steer professionals away from
the shadows, or through them, is near impossible. It is highly unlikely
that a breach of professional boundary was caused by the absence of a
bullet point in a code of practice.
Our research suggests that the best way to help professionals avoid trans-
gressions is to provide them with opportunities for regular ethical exercise.
Informants commented how invigorating they found the ‘ethical hill climb’
of considering the scenarios, and how this could aid team-building. At
present, agency codes of conduct seem to be rather like insurance policies
that are only brought out from the bottom drawer when the front-room
carpet has been spoiled to see whether a claim can be made or not.
Ethical engagement is more than that, and much more than an occasional
audit; it is an active and regular engagement with ethical issues in order
to inform everyday practice and to remain ethically alert (Khele et al.,
2008).
Codes of practice should be developed by an ethically engaged workforce
in concert with service users, bottom-up rather than top-down. The first
step is a recognition that a code of practice, whilst a useful starting point,
can never fill every contingency and is not an algorithm of conduct in a
morally difficult situation. A more strategic approach should embed pro-
fessional boundary issues in the daily reality of good practice. Concrete
scenarios can engage with these realities and tease out the personal moral
codes and belief systems that are so much more significant than objective
codes. It is important to ensure that agencies are open to learning and
that boundary issues are not forced underground. Workers and supervisors
Professional Boundaries Page 19 of 24
need to be able to recognise ‘red flags’ of potential misconduct or proble-
matic behaviours. If codes are seen as hostile rules that must be
managed, they are likely to fail in their intent. Moreover, boundaries
should not always be seen as problematic; some service users appreciate
professionals who can cross boundaries, but this must be in a transparent
and considered manner.
A long list of principles or standards risks losing sight of the wood for the
trees. For example, NASW (the National Association of Social Workers in
the USA) upped its list from eighty to 155 in 1999. Would it not be better to
learn how to navigate through the wood rather than to count, map and
identify all 155 trees? Is it at all likely that a 156th principle or standard
would actually have prevented this professional from breaching that bound-
ary? Though we need more research to know why individuals breach pro-
fessional boundaries, the findings from this research suggest that a broad
strategy that develops the ethical engagement of the professional workforce
is likely to be the most effective way forward.
Accepted: August 2009
Acknowledgements
We would like to acknowledge the General Social Care Council, who com-
missioned the research on which this article is based and, in particular, the
GSCC team, Rachel Newman, Yvonne Rogan and Kerrin Clapton for their
support and encouragement. Our thanks, too, to the many people who
responded to the scenarios and to those who gave their time for the tele-
phone interviews.
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Appendix: The scenarios
Would your agency take action if the following information came to light?
What policies and procedures would come into play?
If it is likely that action would be taken, what would the action be?
(If you are answering this as a social work educator please consider how
your course might address each of these scenarios with students).
Do please attach electronic copies of any agency policies and procedures
that you feel are relevant to any of the scenarios below.
These same trigger questions were asked of each scenario:
Action would be taken: NO /YES
If ‘IT DEPENDS’ what might it depend on?
If YES, what codes of practice or agency policies would be relevant?
How are they likely to be used?
The term ‘social worker’ was replaced by the appropriate profession depend-
ing on the informant’s own profession.
§1 A social worker becomes engaged to a person who until two months ago
was a user of the agency that employs the social worker.
§2 A social worker overclaims mileage allowance in order to fund a group for
services users.
§3 A social worker refuses to work with a same-sex couple because it contra-
venes his/her religious beliefs.
Professional Boundaries Page 23 of 24
§4 A social worker invites a service user to pray with him/her.
§5 A social worker masturbates a 25 year old man who has lost use of his arms.
§6 A social worker appears on local television with a service user to publicise
the service user’s plight.
§7 A social worker gives advice about where a service user can purchase
cannabis.
§8 A social worker becomes aware that a colleague has borrowed money from
a service user
§9 A social worker uses hypnosis with a service user
§10 A social worker invites a homeless service user back to his/her home to
stay
§11 A social worker discusses the details of a service user (without using their
name), to complain about their boss to other friends on Facebook.
§12 A social worker constantly fails to attend in-house and external training
and makes it know that they do not need any further training and have
no interest in professional development.
in a few snowballs, the twelfth scenario above was replaced by this one:
§12a A social worker is working as a dancer in a lap dancing club in their own
time.
Page 24 of 24 Mark Doel et al.
