Boundaries make it possible for the relationship between therapist and client to be professional and safe for the client and set the parameters of the services provided. The primary concern in establishing and managing boundaries with each individual client is to the best interest of the client. While it is difficult for clients to negotiate boundaries or recognize the need for boundaries, or be able to defend themselves about boundaries violations may initiate behavior that could constitute a boundary violation. Here are three areas of boundary issues that can present difficulty in maintaining boundaries. These are: 1)Dual and overlapping relationships, 2) giving or receiving gifts, and 3) physical contact. 1) Dual and overlapping relationships:
In this scenario, the client is a 25 yr. Old lady who is having difficulty with her husband. It is going to the fourth session with her when you see its’ going on to 11:30 and you are hungry. You suggest that you finish talking while grabbing a bite to eat in the restaurant just around the corner and bring it back to the office to eat. All goes well, and the next time you see this client she brings in sandwiches for you and her to eat during the counseling session. If I asked her not to bring in the lunch, the client may ask why we broke the rule of stepping over a boundary that was set earlier.
What can we do in this scenario?
In Corey, Corey & Callanan (2011) p.273. “Youngren and Gottleib recommend that practitioners address these question to make sound decisions about multiple relationships.(pp.256-257). •Is entering into a relationship in addition to the professional one necessary? •Can the multiple relationships potentially cause harm to the client? •Is there a risk that the multiple relationships prove beneficial? •Can I evaluate this matter objectively?
In this case, was there a breach in boundary crossing? Again, in Corey, Corey and Callanan (2011) p.278. Zur,(2007), “The challenge is to find ways to practice ethically with a responsibility, clinical foundation while protecting clients and therapists from risk. Many professionals now agree that flexible boundaries can be clinically helpful when applied ethically and that boundary crossings need to be evaluated on a case-by-case basis. (Herlihy & Corey,2006b, 2008; Knapp & VanderCreek, 2006; Lazurus & Zur,2002; Moleski & Kiselica, 2005; Schank & Skovholt, 2006; Younggren & Gottlieb,2004;Zur,2007,2008).
2)Giving or receiving gifts
In this scenario, a middle aged man from China is coming to therapy to help him with some grief issues he has been experiencing. The client had previously had extended his last session to 10 minutes after the allotted time because he had arrived late. On his following visit, he offers a small gift of appreciation to the therapist. Mistakenly remembering the APA code of ethics which prohibits accepting any gift from a client, who had recently arrived from China, the refusal of a personal gift is a deep insult. While the incident did provide the opportunity to explore cultural differences and explore personal feelings between both parties, it did result in a better understanding of the gift giving. The therapist acknowledged their differences and was alerted to the client’s cultural background and traditions. It is a reminder that we must remain aware of our own cultural, beliefs, and how they influence our values, assumptions, perceptions, interpretations and choices.
In Corey, Corey, and Callanan (2011) p.294 “Few professional codes of ethics specifically address the topic of giving or receiving gifts in the...