Professional Boundaries & Issues for Natural Medicine Practitioners

Medicinal herbs are common in natural medicine.
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Natural medicine or naturopathy is a form of complementary and alternative medicine practiced by medical doctors with training in Western medical science and alternative practices such as herbal medicine, ayurvedic medicine and therapeutic massage. The professional boundary requirements for a naturopath are similar to those for other types of doctors.

Personal Ethics, Professional Boundaries

    The American Association of Naturopathic Physicians published a new set of ethics guidelines in 2012, establishing the standards of professional conduct for natural medicine practitioners. The guidelines identify types of boundary violations considered unethical behavior by the AANP. The first is unethical behavior in the practitioner's private life. Even when she isn't at the office or in session with a client, the naturopath must uphold high ethical standards of behavior due to the trust society places in all doctors. For instance, a naturopath in a sexual relationship with a minor would be in violation even if the minor wasn't a client.

Boundaries at Work

    Some behaviors normally considered private business can be boundary violations in the workplace. The AANP code of ethics lists inappropriate use of work computers and inappropriate interactions with co-workers, subordinates or vendors. For instance, using the office computer to browse a dating website could be a boundary violation, and asking an intern out on a date certainly would be. The AANP bans all romantic or sexual relationships between supervisors and subordinates.

Therapeutic Boundaries

    The most serious boundary violation recognized by the AANP is improper sexual behavior toward or with a client. This can be an inappropriate comment or off-color joke, improper physical contact, going on a date or having a sexual encounter. The authors of "Perspectives on Complementary and Alternative Medicine," edited by Tom Heller, note that incidents of this type are always counter-therapeutic even if both the client and the practitioner believe the relationship is healthy. Patients can become emotionally confused by a phenomenon called transference, in which they develop strong feelings for the doctor because she's taking care of them. Natural medicine practitioners can also experience counter-transference.

Staying Within the Boundaries

    Sometimes a natural medicine practitioner treats a client she would have been romantically interested in anyway if she'd met him socially, without transference or countertransference as factors. But the AANP always considers dating a current client a serious boundary violation. The AANP permits practitioners to date former clients one year or longer after the end of the therapeutic relationship, and only if both parties signed a document at the time to show that they both considered treatment to have ended.

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