Take, for example, the almost universal taboo on "dual relationships," which discourages any connection outside the "boundaries" of the therapeutic relationship. Indeed, during therapy sessions, Lana sometimes found it easier to look at the For example, a client should be able to count on a particular appointment time, That is why some therapists drink tea with their clients during sessions . Often a boundary crossing unleashes the fantasy that deep, childlike. Before describing strategies for dealing with boundary crossing by a client, here's a quick that impinges on the therapeutic relationship between client and counselor. In some cases you may need to refer the client to another counselor .
Psycho therapist John Bradshaw breaks down boundary crossing into five categories: Other areas often covered in codes of ethics include guidelines for accepting gifts.
Establish boundaries from the start of the counseling relationship. Talk to your client about items such as the purpose of the relationship, fees, and appointments, and document your discussion. Have the client sign a form that he or she has received the information.
Sit at an appropriate distance during the appointment and be cautious when touching a client because it can easily be misinterpreted. You should document all gifts received. Perhaps one of the most important ways to deal with boundary crossing is to act promptly. Act promptly How you handle a client who crosses professional boundaries depends on the behavior.
Necessary Boundaries for a Healthy Counseling Relationship
However, some general guidelines can help. If the client makes an inappropriate comment, say so right away. Document your conversations objectively. You can also talk with trusted colleagues, and document the consultation to show that you sought advice. Therapeutic boundaries are of significant importance because it makes the client feel safe. Boundaries are based on good decision making skills. Steps to ethical decision making include some of the following: State the question or concern clearly and simply to avoid confusion Anticipate who will be affected Determine who is the client Assess if you are the right person to do the job Review ethical standards Review research and history relevant to the situation Consider any or all things they may affect ethical judgment Develop plan B to decisions Think through alternative courses of action Document process and results along the way Types of Boundaries There are different types of boundaries including boundary crossings and boundary violations.
Boundary crossings are not harmful to the client or the client therapist relationship. There are many times when a boundary crossing can actually be beneficial. For instance, a drug abuse therapist may want to disclose certain information about their experience with drug abuse in order to help the addict they are counseling feel like they have a competent and knowledgeable counselor who can offer them hope of success.
Boundary violations, however, can be harmful to the client and the therapeutic relationship. Examples of boundary violations include providing more time for one patient than for others; meeting clients in any location other than a professional office; seeing a patient for free or allowing gifts to be exchanged; physical contact of any kind.
Other types of boundaries include physical, emotional and intellectual. In addition, personal boundaries that some clients may have can include rigid, porous and healthy boundaries.
Rigid boundaries are described as being detached and unlikely to ask for help. They can seem anti-social and not have a lot of friends, especially close friends.
Clients who Cross the Line
Porous boundaries of clients appear as overly friendly, finding it hard to say no, over-sharing information about them, fearing rejection and seeking approval from others. Healthy Boundaries Healthy boundaries allow a person to have high self-esteem, be assertive and make good decisions.
Healthy boundaries leave a person feeling good after the session. We all have that nagging feeling or instinct that tells us when something is right or wrong. Listen to your instincts and follow guidelines to make absolutely sure no boundary violations are being made. Healthy boundaries are based on five different principles: Beneficence is where the therapist recognizes the importance of doing what is best for the client and benefits the client the most. It is an action that is done to benefit the client.
Nonmaleficence refers to the therapist who avoids any activities that may do harm to the client. This is compared to the Hippocratic Oath of do no harm to the client.
Autonomy is when the therapist promotes the client being independent from them.
Clients who Cross the Line
Autonomy helps clients make their own decisions. Justice is when the therapist gives counseling that is equal and fair and does not show favor. Justice can involve equity, access, participation and harmony. Fidelity is being honest and committed to helping the client make progress. Unhealthy Boundaries One way to avoid unhealthy boundaries as a professional is to ask yourself the following questions when working with a client: How would this be viewed by colleagues, family members of the client, your family and friends?
Is the client being given special treatment that other clients are not receiving?Professional Boundaries in Nursing- Full Version
Are you comfortable writing about this in progress notes of the client? Does the action benefit the counselor or the client? Examples of major ethical violations in therapy include self-disclosure when it is given too much from the counselor to the client.
Clients do not need to know everything about you in order to have a good therapy session.
Information given should be to help the client in their process of healing, not by giving them additional obstacles to overcome. Other violations include transference, counter-transference, violations of confidentiality, texting or emailing too much, and having a sexual relationship with the client. Self-disclosure i s when you offer the client information about yourself as a counselor that may or may not benefit the therapy process. The context in which the disclosure is made and the intent behind the disclosure are two very important aspects.
Transference refers to the feelings and thoughts a client may have towards a therapist. Counter-transference refers to the feelings and thoughts a therapist may have towards a client. Clients have a right to confidentiality and should be made to feel confident there information will not be shared with anyone else. There are three situations in which a counselor can break confidentiality legally. One is if the client he or she has threatened harm to self. Another is if they have threatened harm to someone else.
And the third is if the counselor is order by a court to supply information. If a client feels their boundaries have been violated, they should be made aware of the legal processes they can take.
In addition, they can file a report with the Better Business Bureau and the Licensing Board with the state of operation. This should always be done in the cases of violations to prevent further violations with other clients.