地域医療と健康教育

抽象的な

An Investigation of Psychologists’ and Medical Practitioners’ Responses to Overlapping Relationships in the Context of Mental Health Care

Rosemary Anderson* and David Pierce

Aim: The aim of this research was to investigate rural, regional and metropolitan psychologists’ and medical practitioners’ beliefs of ethical appropriateness of overlapping relationships, especially when they are concerned with mental health issues. It was hypothesised that rural practitioners would encounter more overlapping relationships with clients/patients than their urban counterparts and that psychologists would be less accepting of overlapping relationships than medical practitioners. Method: Psychologists (n=439) and medical practitioners (n=478) were recruited by email and mail to respond to 10 scenarios which described a range of overlapping personal/professional relationships in the context of common mental health care provision. Judgements about three scenarios that depicted incidental contact (small talk in the supermarket), a boundary crossing (accepting an invitation by a patient/client to an event) and a boundary violation (taking financial advantage of a patient/client) were measured. Group comparisons were undertaken using nonparametric analyses. Results: Psychologists living in rural areas were less concerned about a colleague’s acceptance of an invitation to a social event than their counterparts living in either a regional or large urban centre (Md=5, n=85), Z=-2.16, p=0.03, r=0.1). For each of the scenarios psychologists were more likely than medical practitioners to express ethical concern about the clinician behaviour. Experiencing previous overlapping relationships significantly influenced attributions of ethical concern for both psychologists and medical practitioners. Conclusions: Overlapping relationships are inevitable for the rural, regional and at times urban psychologist and medical practitioner. Managing overlapping relationships whilst living and working in rural environments creates atypical treatment situations that can be difficult for all health clinicians. Further research is required to understand the specific experience of clinicians whilst living and working in a ‘fish bowl’.