Boundaries provide the framework for the therapeutic relationship. They enable clients to feel safely held and promote trust by showing clearly the purpose of the relationship and what the client can expect.
Therapists are in a position of power and need to beware of exploiting or manipulating clients or abusing their trust in any way. What might at first seem like harmless or innocent behaviour can cause untold damage later on. A change in the nature of the relationship can negate any benefits of the therapeutic work previously undertaken.
Complaints about boundaries
Clients have complained about their therapists for:
- unwanted or inappropriate touching
- adding kisses at the end of text messages or emails
- contacting them unnecessarily or unexpectedly聽
- contacting them at inappropriate times, such as late at night
- making contact after the counselling contract has ended
- not keeping to agreed time boundaries
- allowing interruptions to the therapy session
- allowing the therapeutic relationship to turn into friendship
- not maintaining confidentiality
Key considerations for practice
You need to be aware of many different boundaries, such as physical boundaries, social media, the therapeutic space, time-keeping, the professional relationship and confidentiality. It is the therapist鈥檚 responsibility to uphold and model the boundary, and not to blame the client for changing the nature of the relationship (Ethical Framework, Good Practice, point 50).
The personal moral qualities of significance here are candour, care, diligence, integrity, respect, sincerity and wisdom.
Touch
Any intervention involving touch needs to be managed carefully. It's important to talk about touch with the client, ask their permission and discuss the therapeutic purpose and meaning. This helps to avoid misunderstandings and ensure safety.
- Don't touch or hug a client without first checking with them and considering your own motives
Communications
Unless you have agreed otherwise, for example in emergency or high risk situations, you should limit contact between sessions to practical arrangements over appointments.
- Don't contact your clients unnecessarily or at inappropriate times
- Don't allow or encourage contact from your clients between sessions, unless agreed
- Be clear with clients about when the therapy has actually ended
Beware of becoming over familiar with your clients or using language that could be misunderstood. For example, ending a text message with kisses or certain emoticons or emojis can imply a change in the relationship that was never intended.
Social media
Social media is a main area where harmful dual relationships can arise. You should agree the boundaries and protocols in your first meeting (Ethical Framework, Good Practice, point 33c, GPiA 047 Working online)
- Consider having separate social media accounts for professional and personal use
- Check your privacy settings on your social media accounts
Time boundaries
Time boundaries are part of the therapeutic frame that helps a client to feel safe and within which the work can take place. Flexibility may be appropriate in some exceptional occasions, but extending a session may unintentionally make clients feel special, particularly needy or patronised. It can blur that boundary between the professional and the personal.
On the other hand, if the therapist decides to end a session early, without negotiation, the client might assume they have done something wrong and feel as if they're being punished.
- Keep to agreed time boundaries
- Ensure sessions are private and uninterrupted
- Give plenty of notice for breaks and endings
Dual roles
Dual roles and overlapping boundaries are usually best avoided, but where they do exist they need careful consideration, in some cases in discussion with the client but always in consultation with your supervisor (Ethical Framework, Good Practice points 33 to 37 and GPiA 077 Dual roles).
- Where possible, avoid having a dual relationship or conflict of interest
Friendship
The therapeutic relationship must be first and foremost a professional one (Ethical Framework, Good Practice, point 8). Straying away from the professional relationship can lead to clients feeling misled, let down or confused.
- Agree with your clients whether, and if applicable, how you will acknowledge each other if you happen to meet elsewhere
- Discuss any pre-existing relationships or mutual social contacts at the initial assessment, before proceeding with therapy
- Be very careful if considering changing a professional therapeutic relationship to a personal one
- Always take any feelings about a client to supervision - don't keep them to yourself
Confidentiality
Make the boundaries of confidentiality explicit at the outset, so clients understand where the lines are drawn. Many complaints stem from the therapist sharing information unnecessarily with others, from not explaining the circumstances where disclosure might be necessary, or not discussing the need to break confidentiality before actually doing so.聽
- Be clear about who your contract is with and where the boundaries of confidentiality lie
See:
GPiA 014 Managing confidentiality
Confidentiality - what complaints tell us