How to avoid breach of boundaries?

The breaching of boundaries by business professionals and practitioners is one of the most common causes of complaints received by Towergate. Boundaries - time, money, sex, touch, self-disclosure, confidentiality, and contact outside sessions - are there to protect both the client and the practitioner or consultant. The most common types of allegations in complaints and civil actions against professionals relate to seven specific areas:

• Specific boundary violations such as sexual contact, invitations or suggestions of friendship, inappropriate use of touch
• Bullying or disrespect
• Emotional or financial exploitation
• Inappropriate disclosures by the practitioner / consultant or others
• Inappropriate encounters with others such as family members, other clients or workmen
• Giving gifts
• Incompetence

Apart from the more general allegations of incompetence all of the other types of allegations really do fall under the heading of boundary violations.

It is important to note that it’s not just therapists and consultants who breach boundaries. Clients do this too by arriving early, phoning at inappropriate times, bringing gifts, refusing to leave when time is up, forgetting to pay, and so on, and these areas can often be a challenge to the professional framework.

One feature of boundary violations is that the therapist or consultant usually feels real or imagined pressure from the client to do something that he or she would not otherwise do - to write or phone between sessions, to reveal something private, to hold or otherwise touch, to reduce the fee (or agree to work for no fee at all), to change the frequency or number of sessions, to confront, or to give in. Overall our advice is: hold firm! It is easy for a client to become confused or to experience extreme levels of anxiety when the therapist or consultant does something new or unexpected without careful dialogue and contracting.

Professionals who engage in boundary violations with their clients often lose sight of the phenomenon of transference. They begin to emphasise the ‘real’ relationship and feel that their uniqueness as a human being is the therapeutic factor in the treatment or advice - rather than their knowledge or technique.

One definition of a boundary violation is that the therapist or consultant exploits the relationship to meet personal needs. Cooper-White’s ‘spectre of narcissism’ runs through all boundary violations, including those that do not constitute gross failures in good practice but do or may represent departures from accepted good practice.

Towergate Professional Risks therefore offer the following advice to business professionals to ensure that the risk to violating boundaries is kept to a minimum:

• Be interested in and always take to supervision or other professional support any urge you have to bend the rules. Practitioners or consultants who have been complained against often say in hindsight that they responded too quickly rather than exploring these urges with the client to understand them in the context of the client’s presentation and history, rather than step into that history and suffer the consequences.
• Think very carefully and take consultation before using touch in any way with clients. However much you may feel driven by a desire to be warm and kind, touch of any kind can easily be misinterpreted. There are ways to touch and to ‘hold’ a distressed client that don’t involve physical contact.
• Also remember that urges to be kind or to give clients what their mother or father failed to give them may come from your need to be special and not your client’s therapeutic need.
• When it comes to giving - or accepting - gifts always consider the therapeutic or professional value of doing so as opposed to coming from the heart or not wanting to offend
• Likewise when you are considering making a self-disclosures ask yourself - and your supervisor - if this will be of therapeutic value.
• If you find that you have bent or over-stepped a boundary get supervision to help you to discuss it with the client as a way of moving the therapy forward. Therapeutic or business relationships like any other relationship can be put back on track.
• Avoid being drawn into ‘dual relationships’. It is tempting when the client is in training to cross professional boundaries in ways such as also supervising their work or inviting them to a training workshop or seminar. Our experience shows that it is increasingly unwise to take into therapy someone who is in training in an organisation where you have connections - past or present. It is easy to inadvertently cross boundaries of confidentiality or for a fragile client to imagine that you have done so.
• Finally, if you believe that you may have over-stepped a professional boundary - tell your insurer. Even though no complaint has been made by the client, it is always better to notify your insurance provider. Don’t worry - as long as an actual complaint isn’t made, it won’t affect your insurance cover.