Author | Thomas G. Gutheil, MD


9 Tips to Maintain Boundaries in Clinical Practice

March 31, 2017


The points summarized in this pocket guide-drawn from actual cases-recur repeatedly as problems for practitioners.

Breaking Up Is Hard to Do: Terminating Therapy Before Things Get Out of Hand

June 29, 2012


Cases that come to our attention as malpractice claims, ethics claims, or Board of Registration complaints raise the question: why did the treating clinician not terminate the treatment before things got so out of hand?

Grand Rounds-Boundary Issues in Clinical Practice

May 08, 2012


Psychotherapists have fiduciary power and-from a risk management perspective-the clinician must act in a manner in which misconduct cannot be inferred. In terms of boundary violations, some preventative measures (like psychodynamic education) can be taken.

Empty Words in Psychiatric Records: Where Has Clinical Narrative Gone?

December 16, 2011


Here we address some of these problems of meaningless phrasing, empty shells, and template-distorted recording in an attempt to improve clinical documentation for both clinical care and risk management.

Podcast: Psychiatric Records-Careful of Those Empty Words

December 14, 2011


In this podcast, Dr Thomas Gutheil talks about a key challenge facing psychiatrists. . . valid medical record keeping. Here: important tips from an expert based on an article he coathored with Dr Robert Simon.

A “Pocket Guide” to Avoiding the Most Common Boundary Pitfalls

March 03, 2011


Here is a “pocket guide” for clinicians drawn from actual cases. With some modification, the list could become a patient information sheet or office policy.

A Letter To the APA Leadership and Membership Committee

February 04, 2011


This letter constitutes my formal resignation from the American Psychiatric Association.

Ethical Aspects of Self-Disclosure in Psychotherapy

May 18, 2010


The issue of self-disclosure in psychotherapy is one of complexity and some evolution.1-16 Most discussions about the practice refer to boundary questions because self-disclosure by the therapist to the patient is a boundary issue. Self-disclosure has, of course, a number of dimensions, including clinical, therapeutic, technical and-in some cases-legal or regulatory. Despite the rich and interesting clinical issues relating to self-disclosure (outlined in Gutheil and Brodsky1), the focus of this article is on the ethical aspects of self-disclosure.1,15,16 Of necessity, the discussion centers on the more exploratory forms of psychotherapy, such as dynamic therapy, rather than on behavioral therapies, co-counseling, substance abuse treatment, or pharmacological treatment.

Detainee Interrogations: American Psychological Association Counters, but Questions Remain

September 02, 2008


I am writing to correct several inaccurate assertions in the essay, “The American Psychological Association and Detainee Interrogations: Unanswered Questions” (Psychiatric Times, July 2008, page 16), by Kenneth S. Pope, PhD, and Thomas G. Gutheil, MD.

The American Psychological Association and Detainee Interrogations: Unanswered Questions

July 01, 2008


News accounts and court records of detainee interrogations in such settings as the Guantnamo Bay detainment camp and the Abu Ghraib prison have sparked controversy over involvement of mental health professionals and behavioral scientists. Authors of articles in medical, psychological, legal, and scientific journals have struggled with complex ethical questions about psychiatrists and psychologists who participate in planning or implementing detainee interrogations.