Maintaining Your Professional Boundaries

by Mark Lockyer | June 12, 2010 8:24 AM EDT

Do any of you ever share your experiences with your clients as a means of showing you too are human and therefore lessening any dissonance your client may have? Whenever you feel uncomfortable remember it has nothing to do with your client, you own your experiences including behaviours and feelings. If being human means saying hello and chatting, then so be it. Don't fight it.

by M mm | June 11, 2010 11:07 AM EDT

Discussion of such possibilities in advance in the office might be essential especially when one expects to run into one's patients like in a small town or a small but dense neighborhood. Giving the patients an option of how they'd like to be greeted or not might be a great professional and therapeutic tool. If this is not discussed, then perhaps letting them acknowledge you first and giving a simple wave or "Hi"and then talking about the encounter at their next visit with you might not be a bad idea. Just because you waved or said "Hi" to someone does not mean you are breaching privacy. And, as embarassing or confusing they may be to handle; these situations happen to all of us, and exploring it with patients before or after is quite meaningful and vital.

by Janice St.Amand | June 11, 2010 9:03 AM EDT

Unbeknownst to my therapist and I, my therapist and my cosmetic surgeon shared the same gym and excercise class together.  I shared with her in sessions about his treatment he performed for my skin cancer and how I was awaiting a follow up appointment with him.

One day in her excercise class she realized who he was and introduced herself as my therapist and told him I was awaiting a call from him.  He immediately called me after his class and told me about this encounter.  I was mortified!  I asked her about it in our next session and she told me she did nothing wrong.  This was the beginning of breach of confidentiality.  Needless to say, I will be seeing her before the board in August.

by Thomas Gutheil | June 10, 2010 12:24 PM EDT

The secret is informed consent of a specific sort. One negotiates in session about how to handle extra-office contact. The therapist may not acknowlegde the patient relationship, but the patient may; nevertheless, one greets briefly and goes on with one's business. Then debriefs the experience in the next session. Much discussion of this matter can be found in my book with A. Brodsky, "Preventing boudary violations in clinical practice" Guilford Press. Thomas G. Gutheil, MD

by Thea Macpherson | May 20, 2010 9:47 PM EDT

The idea of being "on tap" is rather horrifying to me. In my community I have a number of roles - counsellor, mother, wife, friend, gym goer, etc. If my counselling hat is to take precedence every time I go out or am in a social situation I would feel that I am always at work. And counselling is my work - not my life. In my experience boundries have been respected by my clients who understand that I have a life too. In a counrty town people are mindful of privacy, perhaps because it can be fragile at times. Respecting my clients' privacy, and asking them to respect mine, is a part of what makes our relationships respectful and therefore, therapeutic.