Mark is a 38 year old patient detained in medium security. He is diagnosed with antisocial and borderline personality disorder. Ward staff have noted that Mark has been hostile towards his allocated nurse and last week he made allegations against her, accusing her of ‘incompetence’. Mark has disengaged from counseling sessions and has stated that the Occupational Therapist has disrespected him and hence he demands an apology before he is able to continue with occupational therapy sessions. Mark has been referred for some initial sessions with a therapist to help manage his behaviour and in particular his hostile and volatile relationships with staff. You have been asked to meet with Mark to explore the possibility of his engaging in such work.
With attention both to practical and ethical issues, outline how you should manage the initial sessions with Mark. Your answer should make specific reference to boundary violations and include examples of how these should and should not be managed.
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