Patients and text messaging: a boundary issue.

"Dr. D" is a psychiatrist in private practice. She has treated a patient named "Ann," a woman with borderline personality disorder, for more than 1 year. Ann’s condition has recently worsened. After their latest session, Dr. D received a text message on her cell phone from Ann stating that the session was "useless" and that she feels worse. Unsure of how to respond and, if so, in what way, Dr D. decides she will address the issue at their next meeting.