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Post-Polio Health (ISSN 1066-5331)

Vol. 17, No. 3, Summer 2001

Boundary Issues

BASTA! (Boston Associates to Stop Treatment Abuse) has a website ( that addresses treatment abuse. The following information is re-printed with BASTA's permission.

Is There Something Wrong or Questionable in Your Treatment? contains an extensive list of behaviors that could alert you to boundary issues which frequently result in poor or abusive treatment or health care.

Estelle Disch, PhD, explains, "If you are currently in a treatment that doesn't feel right, and/or if several of the items describe your treatment, I suggest that you find a consultant who does not know your current practitioner in order to assess whether or not the treatment is viable. If you have been in a treatment relationship that didn't feel good to you, this list might help you identify what went wrong.

"The list is not exhaustive. It is intended to offer examples of the kinds of behaviors that very often accompany poor treatment. Although most items apply to psychotherapy, some can apply to other kinds of health care, pastoral counseling or clergy relationships. There is a section on touch-based health care (including body work) at the end of the checklist.

"Certain items in the list might not always reflect poor treatment. For example, it might make sense to break ties with abusive people in your life, and a practitioner might support this with your best interests in mind. If, however, the practitioner is encouraging you to break ties with all your close relationships with the sole purpose of making you extremely dependent on him or her, that is very likely to be poor treatment.

"Good, boundaried psychotherapy, pastoral counseling, addiction counseling, bodywork, medical practice, etc. should always be oriented to your emotional and medical needs and not to the emotional needs of the practitioner. Practitioners who are lonely, need attention, have deep unresolved problems and/or who lack good training in boundary issues are apt to do marginal or poor treatment. There are good practitioners, and you have a right to be treated by them."

The site also offers suggestions as to what actions you can take if you suspect abuse in the section called After Sexual (and Other) Malpractice – What Can You Do?

Are You in Trouble with a Client? contains a series of questions for practitioners/physicians to review to determine if they are crossing any boundaries.

These checklists (©1990, 1992) are available at If you do not have access to a computer and would like a printout of the questions to assist you in determining questionable treatment, send a self-addressed stamped envelope to International Polio Network or contact Estelle Disch, PhD, BASTA! (Boston Associates to Stop Treatment Abuse), 528 Franklin Street, Cambridge, MA (Massachusetts) 02139 (617-661-4667).

Basta! is part of AdvocateWeb, P.O. Box 202961, Austin, TX (Texas) 78720 (, 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.