Academic Articles Supplied Subject Website (Articles 1,

¶ … academic articles supplied subject website (Articles 1, 2-3). There are myriad issues regarding the maintaining of professional boundaries and dual relationships for practitioners of natural medicine. Essentially, practitioners are attempting to establish and preserve a relationship with clients that falls between a pair of extremes, best summarized as "a continuum, ranging from disengagement (rigid, inflexible boundaries/guidelines) to enmeshment (flexibility to the point of diffuseness) with a large grey area in between that is notoriously ambiguous and dependent upon the counselor" (No author, 2010).

Their charge, therefore, is to attempt to remain tractable while not becoming too much so. They must attempt to establish clear guidelines for their relationship in which professionalism is maintained. However, they must not do so at the expense of alienating the client -- which can certainly occur without a good deal of temperance on the part of the practitioner. The way to achieving this degree of balance is through establishing clarity in those boundaries.

Practitioners do not want clients to regard them as friends for the simple fact that the former has a certain amount of authority and power as a licensed practitioner. In fact, this degree of authority is another one of the key issues that impact the nature of the boundaries between practitioners and clients. Additionally, because of this perceived authority on the part of the practitioner, there is a degree of trust that each client has which impacts the relationship between the two.

Abusing the perceived authority of the practitioner is effectively violating the trust of the client, which may happen in ways subtle and overt if the desirable professional nature of this relationship were ever transgressed. It is also important to note that the practitioner's power and the client's trust is largely based on the attempted fulfillment of the following five objectives on the part of the former, "Beneficence…Nonmaleficence… Autonomy… Justice…Fidelity" (No author, 2010).

Each of these five concepts indicates that the natural medicine practitioner is supposed to engage in activities that promote these areas of welfare for the patient in order to encourage and foster his or her trust. There are definite aspects of boundary crossing and dual roles that violate these concepts and unerringly favor the practitioner.

The primary end, then of the practitioner, is to adhere to the aforementioned five concepts to induce them in his or her patient -- which is usually best achieved by maintaining boundaries and eschewing dual relationships. In addressing the key issues related to boundaries and dual roles discerned within the case study that this particular assignment is based on, it is critical to note that not all of them are evident with the scant information contained within the case study.

However, some of the more salient ones are definitely addressed, such as the possibility of a dual relationship. It is quite clear in implying that she wants to engage in "catching up" after her session with Michael that Julia is interested in pursuing some sort of a friendship with the male practitioner. Quite possibly she is interested in a romantic relationship or at the very least some sort of friendship.

Regardless of what the specific nature of the dual relationship Julia is alluding to, it is clear that it is one in which Michael is more than simply interacting with her as a medical practitioner. Another fairly eminent aspect of this dual relationship that Julia is attempting to foster with Michael is the fact that she is seeking his company outside of the office.

In certain medical professions, such as mental health or psychiatry, engagement with clients outside of a practitioner's office is strictly forbidden and considered a precursor to boundary crossing (Zur, 2004). Additionally, Julia's inquiries regarding Michael's "personal life" also bring up the issue of "self-disclosure" in a way that is not conducive to modeling, and merely implies that she is seeking a personal relationship with the practitioner. All of the ethical issues relating to boundary crossing and dual relationships therefore apply to this case study.

The articles reviewed for this assignment present varying perspectives on the issue of boundary crossing and dual relationships. One of the facets that is critical to applicable interpretation of Zur's article, "To cross or not to cross: do boundaries in therapy protect or harm" is that it is written for psychologists. These medical professionals have a stricter code of ethics that governs their profession, and also must complete considerably more education and training than natural medical practitioners do.

Therefore, it should be noted that the degree of stringency discussed within this article, which is issued in light of medication prescribing psychologists and therapists is somewhat more severe than that which applies to natural medical practitioners.

Due to this fact, it is somewhat surprising to see that this article spends significantly a significant amount of its text elucidating situations in which dual relationships and boundary crossing is acceptable -- such as in the case in which psychologists take walk with younger patients, or when therapists attend religious ceremonies for those of particular denominations (Zur, 2004). "The role of boundaries in counseling" takes a much more moderate approach to discussing the appropriate boundaries between patients and counselors.

It discusses at length both the virtues and vices of showing patients that the counselor cares without enacting a dual relationship with them. Its concluding case study about a male counselor visiting his female patient in the hospital (No author, 2010) demonstrates these concepts well. Nickel's article is similar to Zur's in that it discusses the ramifications of dual relationships for mental health practitioners. Her article focuses on the ramifications of doing such in small, rural communities, where contact outside the office between practitioners and clients is virtually unavoidable (Nickel, 2004).

Although there are some negative ramifications of such an occurrence, the author focuses more on the positive ones. Regarding the case study for this assignment involving Michael and Julia, it is fairly clear that he needs to formally explicate the boundaries of his relationship with Julia which, since there is no evidence that they are in a small rural community, should ideally remain within the office and professional in nature. More.