Boundary violations and sexual misconduct policy
Each physiotherapy practice should maintain a written Policy on professional boundaries and sexual misconduct that clearly defines expected conduct, consent requirements, reporting pathways, and compliance with Ahpra regulatory obligations.
1. Statement of professional boundaries and zero tolerance for sexual misconduct
The Policy should clearly state that:
- Maintaining professional boundaries is a core professional obligation.
- Sexual misconduct with a patient is always unacceptable, regardless of consent.
- The practitioner is responsible for maintaining boundaries due to the inherent power imbalance in the therapeutic relationship.
- Breaches may result in disciplinary action, termination, and notification to Ahpra.
2. Expectations for professional conduct
The Policy should outline expected behaviours, including:
- Maintaining professional, respectful, and therapeutic relationships at all times.
- Ensuring all physical contact is clinically justified and explained.
- Avoiding behaviour that could be perceived as personal, intimate, or exploitative.
- Avoiding dual relationships that may impair professional judgement (eg, treating close friends or engaging socially with patients in ways that blur boundaries).
- Maintaining professional communication, including via SMS, email, and social media.
3. Informed consent and appropriate physical contact
The Policy should require practitioners to:
- Explain the nature and purpose of examinations and treatment.
- Obtain informed consent before touching or examining a patient.
- Ensure examinations are clinically justified.
- Maintain patient dignity and privacy (eg, appropriate draping).
- Respect withdrawal of consent at any time.
4. Communication standards
The Policy should set clear expectations that practitioners must:
- Communicate professionally at all times.
- Avoid flirtatious, sexualised or overly personal communication.
- Use professional communication channels where possible.
- Avoid personal or social media relationships with current patients.
5. Managing boundary crossings and risks
The Policy should explain:
- What constitutes a boundary crossing versus a boundary violation.
- That boundary crossings may be early warning signs requiring reflection and corrective action.
- The importance of seeking advice or supervision if unsure about appropriate conduct.
- The need to prioritise patient safety and professional integrity.
6. Reporting concerns and mandatory notification obligations
The Policy should:
- Require staff to report suspected boundary violations or sexual misconduct internally.
- Identify who concerns should be reported to (eg, Practice Principal or Practice Manager).
- Explain that practitioners have legal obligations under the National Law to make mandatory notifications to Ahpra in certain circumstances.
- Encourage early reporting and escalation of concerns.
7. Response to complaints or concerns
The Policy should outline that the Practice will:
- Take all concerns seriously.
- Respond promptly and appropriately.
- Protect patient safety.
- Maintain confidentiality where appropriate.
- Comply with regulatory reporting requirements.
8. Documentation requirements
The Policy should emphasise the importance of:
- Documenting consent.
- Documenting examinations and treatment appropriately.
- Documenting complaints, incidents, and concerns.
- Maintaining secure and confidential records.
9. Staff awareness and training
The Policy should require:
- Staff awareness of professional boundary requirements.
- Orientation of new staff to boundary expectations.
- Ongoing reinforcement of professional conduct expectations.
10. Reference to Ahpra and regulatory requirements
The Policy should reference relevant regulatory guidance, including:
- Ahpra Shared Code of Conduct.
- Sexual boundaries guidance issued by National Boards.
- Mandatory notification obligations under the National Law.
Further reading and resources available on Boundary violations and sexual misconduct resources.