Establishing clear and healthy boundaries can be vital in developing a healthy therapist-client relationship in a therapeutic setting. These boundaries can form the foundation of a safe, trusting, and professional environment that enables appropriate collaboration.
Without boundaries, the risk of overstepping personal and professional lines increases, which may increase the risk of ethical concerns that can compromise the therapeutic relationship and lead to malpractice claims. A clear understanding and consistent practice of maintaining proper boundaries is crucial for therapists to maintain a high quality of care throughout their careers.
Understanding Professional Boundaries
According to the basics of the training many therapists receive, one of the primary responsibilities of mental health professionals is to act in the client’s best interest. However, this process may not be straightforward. Because each client is unique, it can be crucial for therapists to apply their knowledge of boundaries and proper client interactions individually to each client’s unique situation and treatment plan.
The therapist sets professional boundaries to maintain ethical distance between them and the client while offering evidence-based and applicable support. Boundaries can also be rules for one’s office space, scheduling, and communication outside of sessions.
Types Of Professional Boundaries
According to one study, establishing clear boundaries early in the therapeutic process can create a solid foundation for a client’s treatment journey and ensure trust and empathy between the two parties. This study illustrates the value of understanding professional boundaries and how to apply them to your practice effectively. Below are various types of professional boundaries to consider.
Boundaries Of Competence
Boundaries of competence are the ethical responsibility of mental health professionals to practice within the limits of their skills, training, and experience in each therapy session. It is crucial that mental health professionals recognize their limitations and refer clients to the proper treatment professional when the therapeutic relationship becomes compromised or if they are confronted with issues outside their area of expertise.
This principle highlights the value of therapists recognizing and acknowledging their professional limitations when working with a diverse client population. It’s incumbent upon therapists to ensure they have the appropriate knowledge and ability to handle the complexities of a patient’s situation as more information comes to light in the early stages of treatment.
Therapists often have the ability and expertise to offer a proper treatment regimen and provide relevant and effective services. However, it can be vital for therapists of all experience levels to be unbiased and honest about whether they are the most suitable provider for each case. For example, a depression specialist working with adolescents may not be the best option for an adult client experiencing psychosis.
Multiple Relationships
Multiple relationships occur when a therapist interacts with a client beyond the confines of the therapeutic setting, such as being their friend, romantic interest, or business partner. Comprehending and abiding by the Code of Ethics by the American Psychological Association (APA) is crucial in understanding what these relationships are and how to avoid them.
Therapists often become aware of intimate details of a client’s life. While some of this information may inform the treatment process, it can also be crucial for therapists to set boundaries clearly and compassionately. There may be instances where a therapist’s effectiveness could be compromised due to the depth of knowledge they hold about a client’s personal life or the feelings they develop throughout treatment.
When such situations arise, it may be in the best interest of the therapist and the client to consider ceasing treatment. This decision can be made with utmost compassion and empathy, prioritizing the client’s welfare. By being empathetic, therapists can work toward maintaining self-awareness and an unbiased focus on acting professionally despite possible personal temptations in this role.
The APA stresses the importance of maintaining professional boundaries to prevent conflicts of interest that may impair the therapist’s objectivity, competency, or effectiveness in performing their functions as a mental health professional. A clear understanding of these ethical guidelines ensures the therapeutic relationship remains focused on the client’s well-being, preserves the essential trust-based nature of the relationship, and avoids potential harm to the client.
Self-Disclosure
In psychotherapy, self-disclosure is a tool that can bolster the therapeutic relationship and aid in establishing trust and rapport between therapist and client. Providing clients with some information about your treatment experience, life experiences, or other relevant information could foster a sense of relatability. Disclosure in this format can make the therapeutic space seem more genuine and less hierarchical. However, the key to effective self-disclosure lies in its judicious use. When using this technique, ensure it is client-focused, relevant to the client’s experience, and serves the client’s therapeutic goals and best interests.
Excessive self-disclosure can be counterproductive and potentially jeopardize the therapeutic alliance. When the therapist overshadows the client’s experience with their own, it can shift the focus away from the client, causing a sense of imbalance within the therapeutic relationship. It may also blur professional boundaries crucial to maintaining a safe and beneficial therapeutic environment. While self-disclosure can be a potent tool in therapy, consider being mindful of oversharing and potentially compromising the therapeutic alliance.
Therapists may consider what types of self-disclosure are beneficial and which may not support the progression of treatment. For instance, a therapist might inform the client about a shared identity, such as being a part of the same minority group. Studies have shown that there are various reactions, both positive and negative, that clients take away from what therapists share with them. For this reason, it can be vital to consider if self-disclosure will ultimately benefit the patient’s well-being and to what degree it is necessary in the context of their treatment goals.
How To Establish Healthy Boundaries
As a mental health professional, you may benefit from consistent methods to establish clear boundaries with your clients. Below are several considerations for setting healthy boundaries.
Remain Mindful Of Personal Feelings
As much as they are professionals, therapists are also human and experience personal feelings that may arise concerning certain facets of the therapeutic relationship. It can be vital for therapists to maintain a mindful awareness of these feelings. A therapist’s personal feelings, when not considered, have the potential to affect their objectivity, thereby influencing the trajectory of therapy.
Bias can lead to a phenomenon known as countertransference, where a therapist unconsciously redirects their personal feelings onto the client. Hence, therapists can benefit from regular self-reflection to ensure their personal feelings do not seep into or potentially hinder the therapeutic relationship. A therapist’s self-awareness and ability to delineate their personal life and personal mental tendencies from their professional role can be integral to maintaining a healthy and effective therapeutic alliance.
Consider engaging in a consultation or discussion with a fellow professional to explore any personal feelings that arise during treatment or to explore the role of being a therapist. This process can expose you to differing perspectives that may shed light on the reality of the situation.
Understand How To Approach Uncooperative Clients
Some counseling professionals may encounter instances where clients struggle to respect established boundaries. Below are tips on how to effectively handle such situations:
- Reassert Boundaries: Politely but firmly remind your client of the boundaries that have been discussed. Redefining these guidelines can reinforce their importance and remind the client of the need for respect.
- Practice Empathy and Understanding: It can be vital to approach uncooperative clients with empathy. Understand they may be dealing with complex issues and that their actions could reflect their situation rather than a deliberate boundary violation.
- Consistent Enforcement: Consistency can be critical when establishing healthy boundaries. Counseling professionals may benefit from being unwavering in maintaining the rules of engagement, ensuring exceptions are minimized.
- Seek Supervision: If a client routinely violates boundaries, it may be helpful to seek advice from a supervisor, colleague, or more experienced therapist. Peer support can provide fresh insights and strategies to handle the situation.
Use Consent And Agreement Forms
Designing consent and agreement forms may be a valuable consideration for counseling professionals to establish clear boundaries early in the therapeutic relationship. These documents serve as legal tools and comprehensive guides about the counseling process and what clients can expect from the relationship.
Consent forms provide clients with an understanding of what to expect, creating an environment of trust, respect, and transparency. By outlining the ethical practice norms, including confidentiality, the nature and length of therapy, and any potential risks, these forms help set client expectations at the outset.
Furthermore, consent and agreement forms are essential tools for therapists to proactively address any potential boundary-related issues. These forms can specify the rules regarding communication outside therapy hours, the therapeutic frame, dual relationships, and financial matters. By making clients aware of these boundaries early on, therapists may prevent future misunderstandings, ensuring the therapeutic relationship remains safe, professional, and beneficial for the client’s emotional well-being. It can also be vital to consider the role of any physical touch that may occur throughout treatment.
According to ethical standards, engaging in physical touch is not inherently unethical; in some cases, treatment strategies may benefit from using physical contact. However, this touch is professional, non-sexual, and platonic. According to one study on this topic, researchers found that professionals may be fearful to employ touch in case of repercussions. For this reason, it may be helpful for therapists to include this topic in initial discussions and initial consent forms. To learn about techniques that involve the positive use of physical touch, reviewing studies on the matter could offer valuable insights.
Support Options
In some cases, therapists may also benefit from the support of a therapist to address their own mental health and the feelings that arise throughout the course of therapy with various clients. However, in-person treatment may not be accessible for working professionals. In these cases, online therapy through a platform like BetterHelp may benefit therapists seeking assistance.
Online therapy offers a uniquely flexible, accessible, and tailored approach to therapy. Many individuals seeking treatment avoid doing so due to a fear of in-person interaction and the presence of mental health conditions such as depression and anxiety. Online therapy provides a comfortable and discreet environment where individuals may perceive themselves as safer when sharing their thoughts and feelings, potentially leading to more open communication and positive progress.
In one study, researchers looked into the utility of online therapy for therapists and its ability to offer the same level of effectiveness as in-person treatment. In their study, researchers found that online therapy is as effective as in-person sessions. Additionally, researchers found that therapists often require additional training on setting boundaries and addressing unique ethical concerns related to the digital setting. This study further illustrates the importance of regularly considering the role of boundaries.
Takeaway
Maintaining the therapeutic relationship can be a delicate task that requires counseling professionals to navigate a complex web of ethical considerations. Boundaries serve as crucial guidelines, delineating the scope of this relationship, ensuring its professional nature, and protecting the client and therapist.
It can be incumbent upon therapists to understand and consider the factors influencing their ability to set healthy boundaries, from the client’s specific circumstances to societal norms and legal constraints. By doing so, therapists can foster ethical practice and create a safe, trusting environment that best serves their client’s well-being.
