TY - JOUR

T1 - Psychiatrists’ attitudes to professional boundaries concerning spirituality and religion: mixed-methods study

AU - Poole, Rob

AU - Cook, Christopher C.H.

AU - Robinson, Catherine

PY - 2023/8/23

Y1 - 2023/8/23

N2 - Aims and methodCalls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists’ attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered.ResultsIn 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants’ opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common.Clinical implicationsMental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice.

AB - Aims and methodCalls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists’ attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered.ResultsIn 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants’ opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common.Clinical implicationsMental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice.

U2 - 10.1192/bjb.2023.66

DO - 10.1192/bjb.2023.66

M3 - Article

JO - BJPsych Bulletin

JF - BJPsych Bulletin

SN - 2056-4694

ER -