Maintaining Healthy Therapeutic Boundaries: An Ethical Mandate

If you are a therapist or have been in therapy, you know that it is a give and take relationship.

The difference between therapy and other relationships involves the therapist’s mandate to put the client’s needs and well-being ahead of their own.

This does not mean that the therapist’s needs aren’t met. Instead, it means that the therapist is not doing so through work with clients.

Many therapists enter the profession because of something they want to heal in themselves or because of a population they want to serve.

While being a therapist is and should be fulfilling it is not about us; it is about themour clients.

Attending a client’s social or celebratory event (i.e. a boundary crossing) may be beneficial according to Barbara Herlihy and Gerald Corey in their book Boundary Issues in Counseling: Multiple Roles And Responsibilities. However, a boundary crossing should not be undertaken without consideration for the inherent risks.

Clients need to know that they can return to and engage in their world without us. While “good therapy” has many qualities of friendship, the therapist has the responsibility to stay in their lane and not intrude upon a client’s world even if you are invited by them to enter into it.

An invitation from a client is an opportunity to accept the intention and thereby deepen the therapeutic relationship. However, one can accept the intention without accepting the invitation.

The intention is “you matter to me,” the acceptance of it is “you matter to me too.” An expression of gratitude and an acknowledgement of what the relationship means are important and you must trust that it is enough.

The invitation and its intention are a form of respect and regard for the value of the therapeutic relationship; a reaction to the very validating and productive form of intimacy that occurs in “good therapy.”

However, accepting the invitation itself and going outside of the bounds of the therapeutic space risks the independence, the privacy, and the faith that is necessary as it relates to the eventual termination of therapy.

Our communication needs to be:

  • you’re okay” (independence);
  • “you and I know about our work & that is enough to make it real” (privacy/confidentiality); and
  • I believe you can be on this journey with or without me and still have your needs met” (faith).

Not all potential boundary crossings come in the form of invitations. Often they come in the form of gifts.

It is ill-advised to wholly and without consideration reject a gift from a client without consideration for:

  • the timing;
  • the meaning; and/or
  • the purpose.

For example, a client who brings homemade baked goods for her therapist to a session — as part of her fulfillment of a therapeutic task (to distract herself with baking if she feels overwhelming thoughts of self injury) — would be wounded by a therapist rejecting the gift while citing the ethics within our profession.

However, if the client begins to bring food to each subsequent meeting; you should discuss the intent and help to redirect the efforts to those in need or some other solution.

That being said, most client gifts have little or no monetary value, rather the value is personal and the meaning symbolic. The gifts are typically hand-made items or thank you cards.

These gifts come at times of transition, celebration, or endings (termination). There are some clients who never give gifts or offer invitations. That is perfectly fine because it is not an expected or implied part of the relationship.

What we give as therapists should be:

  • our humanity;
  • our attentiveness;
  • our skillful intervention to redirect problematic patterns;
  • noticing and pointing out strengths;
  • our warmth/empathy;
  • our curiosity; and
  • on a more subtle level, our ability to develop a deep conceptual understanding of what is contributing to the client concerns/problems.

What we receive is:

  • the honor and awe of getting to know others in a depth-full way;
  • to admire their courage and commitment to healing and/or growth; and
  • an opportunity to walk alongside and witness personal transformation.

We should not step on their toes…we should not carry them…instead we should stay on our path…and support them on theirsuntil those paths part.

Copyright © 2015 Ruby Blow. All rights reserved.

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