You likely learned a lot about setting therapist boundaries during your formal mental health education. But the real world can be much different from the classroom. You may be experiencing some unique challenges now that you’re in practice. Issues now and those that may arise in the future are why it’s essential to think about how you want to set boundaries as a therapist.
The Importance of Maintaining Boundaries in Therapy
Your clients aren’t perfect, and neither are you. They may push boundaries or ask you to do unethical or unprofessional things, even unintentionally. That’s where your therapist boundaries come in. These boundaries dictate how you respond in these situations. They help you know what to do to continue an appropriate professional relationship with your clients. They also keep you and your clients safe.
Boundaries you set with clients may include:
- Maintaining therapist confidentiality unless you legally or ethically can’t
- Setting clear expectations of the therapeutic process
- Limiting physical contact with clients
- Not accepting gifts from clients
- Avoiding friendships, or dual relationships, with clients
- Engaging with clients on social media or in public places
- Limiting self-disclosure
Boundaries are vital to help the client and therapist feel secure in your professional working relationship. They help both of you feel emotionally and physically safe with one another and keep your sessions focused on the client and their needs. You’re less likely to question how to engage with clients with strong boundaries in place. They help you know how to respond to various issues that may arise, like a client requesting you meet in a local coffee shop instead of at your office or what to do when you see a client at the grocery store.
Understanding Boundary Violations
Sometimes, clients may try to push or violate your therapist boundaries. These boundary violations can happen for various reasons. Perhaps the client doesn’t realize what they’re asking of you isn’t acceptable. Or, maybe they do and just want to see what they can get away with. Either way, clients will test your boundaries, and that’s when you must stay firm in your beliefs and ethics.
Types of boundary violations include:
- Physical Boundary Violation. This consists of any type of unwanted physical contact. In general, it’s best if you don’t touch your clients, as it can be triggering in many situations. If a client tries to touch you, like by giving you a hug, for example, it may be best to try to shake their hand or pat them on the arm instead. If you feel comfortable accepting a hug, it’s probably best not to make it a regular occurrence.
- Emotional Boundary Violation. This boundary is breached when a client tries to manipulate or control your emotions. For example, a client may try to play on your feelings to get you to prescribe them a medication that you aren’t comfortable prescribing or don’t think they need. In this situation, saying “no” is a critical boundary. Offer an alternative solution instead.
- Financial Boundary Violation. A client may even attempt to take advantage of you financially. For example, a client may try to call you repeatedly when they aren’t in crisis to get your advice or help without having to pay for a session. If this happens, it’s best to tell the client you think you should schedule a time to talk and have a more regular session schedule, then explain that calls between sessions are for mental health emergencies only.
Establishing and Maintaining Boundaries
How do you set therapist boundaries with clients? It’s a bit like playing a game of “what if….” You consider what you know and what other mental health professionals say about how clients may violate your boundaries and develop your responses for these scenarios.
To maintain boundaries:
- Establish Boundaries From the Beginning. You don’t want to seem like you’re constantly changing the rules on your clients. So, it’s essential to establish and address as many boundaries as you can right from the beginning of your relationship. For example, you may want to address policies for things like prescriptions, after-hours contact, and social media or public engagement in your new client paperwork. Laying out the rules as best you can from the beginning starts your relationship on the right foot.
- Create a Professional Environment. Be sure your office is conducive to a professional relationship. This could mean having a waiting room and some office staff always present. Or simply ensuring that where your clients are encouraged to sit and where you sit are facing one another but not touching or on the same piece of furniture.
- Consider What You Want to Disclose. How much of your life are you willing to share with clients? Decide in advance what you want them to know. For example, you may relate better to a client if they know you have children, but that doesn’t mean you have to provide your children’s names. Your client may see that you’re married because you wear a wedding ring, but that does require you to tell stories about your spouse in sessions.
- Have a Gift Policy. Many clients don’t mean anything by gifts. They’re trying to show you their appreciation with homemade chocolate chip cookies or a candle at Christmas. Unfortunately, gifts put you in an uncomfortable position. You don’t want to seem ungrateful, but you also don’t want to give even a hint that your integrity may be compromised. If a client brings a small gift, like flowers, it may be simplest to graciously accept, tell them gifts are unnecessary, and display them for the office to enjoy. But if a client tries to give a large or personal gift, it’s best to politely decline and explain why it’s necessary for you to avoid accepting gifts.
- Keep Personal Space. Use your words to show clients how much empathy you have for their situation, but don’t touch them. It’s best not to blur these lines. If a client tries to touch you in an innocent way, try to give them an alternative, like a handshake or a smile. If a client touches you in a way that makes you uncomfortable or compromises your safety, address it immediately. Explain to them why it’s unacceptable and that you’ll be forced to discontinue your professional relationship if it happens again.
- Acknowledge and Move On. If you see a client in public, you might acknowledge them with a smile, nod, or even a hello, depending on if they are alone or how they choose to engage with you. However, remember that it’s not like running into a friend at the coffee shop. It’s best to acknowledge them and move on.
Dealing With Boundary Violations
Unfortunately, clients will test your boundaries. It’s not a matter of if; it’s about when. So, it’s good to have a clear plan for responding when it happens.
When dealing with boundary violations:
- Recognize What Happened. You may be surprised when a boundary violation occurs, but it’s important to recognize it for what it is. Name it. This client just violated your boundaries in this way. Acknowledging it helps you enact your plan.
- Address It Immediately. Tell the client immediately what they’ve done and why it’s unacceptable. How you word this may depend on the severity of the violation. For example, if a client requests your friendship on Facebook, you may address it in your next session by saying you saw the request but you couldn’t accept it because it’s against your policies. If a client grabs your arm during a session, you should firmly tell them to remove their hands from you and explain that it’s unacceptable for them to touch you in any way.
- Provide Consequences. If a client continues to violate your boundaries or does something especially egregious, address the steps you’ll take if it happens again. In the example above where the client grabs your arm, you may explain at the end of the session that it’s inappropriate for them to touch you and it made you extremely uncomfortable. Then, explain that if it happens again, you’ll be forced to discontinue your professional relationship.
- Enforce Consequences. Many boundary violations are small and easily addressed. Then, it never happens again. However, this isn’t always the case. If a client continues violating boundaries or simply isn’t a good fit, you may need to refer them to another mental health professional who is willing to accept them or simply discontinue your services. If you take this route, you’ll want to address why you’re making that decision. Your goal is to help the client understand why you can’t work together and what options you’re providing for them.
Turn to All Counseling
Even with tons of advance planning, unexpected boundary violations can arise and leave you wondering how best to handle the situation. That’s when it’s vital to have a group of trusted mental health professionals to guide you. All Counseling’s Insider Group is just that. It’s a free private group for licensed professionals to share and learn from each other. Claim your All Counseling profile and join our community today!
