Setting Boundaries In Professional Relationship

A counselling relationship is likened to being on a journey - a beginning, middle and end (Smallwood, 2013). During the beginning phase the client develops sufficient trust in the counsellor and the relationship ‘to explore the previously feared edges of his awareness’ (Mearns and Thorne, 1988, p.126).

As a healthcare professional a therapeutic relationship is fundamental in providing quality patient care. The Nursing and Midwifery Board of Australia (NMBA) National Competency Standards for a Registered Nurse (2006) emphasises Collaborative and Therapeutic relationships as one of the four main domains which make up the standards. The assignment will explore one specific quality on establishing, maintaining and appropriately concluding a therapeutic relationship in relation to a Horizon Hospital and Health Service client, in this case Mary Young. The specific attribute chosen is ‘establishes rapport with individuals/groups that enhances they ability to express feelings, fosters an appropriate context for expression of feeling.’ This attribute is crucial in having the guiding principals for a safe professional practice.

When working with all clients there is a need as a practitioner to use techniques that incorporate, promote a therapeutic relationship. While these may be presented differently with each client the practitioners need to be using three main skills. These are using Unconditional positive regard, being genuine with clients always and while you may not have waked in a similar situation as your client, the use of empathy supports the therapeutic relationship.

At the start of each new counselling session it is important that a contract is set out between the client and counsellor. The BACP states 'good practice involves clarfiying and agreeing to the rights and responsibilities of both the counsellor and the client at appropriate points in their working relationship'.

The social work profession’s Standards of Practice outlines the boundaries in the relationship between social workers and their clients and sets a mandate of their responsibilities as a social worker (Alberta College of Social Workers, 2013, p. 30). In the Code of Ethics, boundaries are also set at a high standard as we must draw metaphysical lines between personal roles or interests and professional (Canadian Association of Social Workers, 2005, p. 7) to prevent forming a dual relationship with clients. Another boundary is to halt the possibility of the social worker from using the time they have to help themselves rather than helping their clients (CASW, 2005, p. 6). In addition to these boundaries, it is crucial for social workers to not share too much of their personal life with clients by placing mental boundaries of how much they feel they can share of their personal life with their clients.

I have been immensely helped by many people, and especially by Deborah Bronnert of the Department of the Environment, to whom I am particularly grateful. But shortcomings or mistakes in this Report are my fault alone. Some recommendations are radical. The participants in the construction process can react in three ways to them. They can refuse to have anything to do with the Report. That would be a pity. The problems would remain, but the goodwill to tackle them, which has been growing dramatically over the last twelve months, would be lost. They can pick out the sections which suit them and reject the rest. If everyone does that, nothing will happen. Or, hopefully, they can try to make the package work, through the implementation structures which the Report recommends. They can set about Constructing the Team. The time to choose has arrived. The construction process cannot wait 30 years for another Banwell or 50 years for another Simon.

As I begin to explore and assess my community, I have chosen Wynnewood, PA, part of The Mainline. Within this community, there’s an OB clinic in a suburban setting that serves the obstetrical patients. With the patients and health care workers all living in this small suburban community, workers may encounter boundaries with knowing their clients personally, and also some of the patient’s friends or family members. The workers will have to deal with how to be professional not to breach any information about other patients. They will also have to deal with personal vs. professional situations that may arise. In certain situations, it would be wise of the practitioner to broach the boundary issues with the client as early in their relationship as possible and discuss reasonable ways of handling potentially awkward circumstances in a manner that both find comfortable and in a way that protects the client’s interests to the greatest extent possible (Frederic G. Reamer, 2012). Social workers should document these conversations to demonstrate their earnest efforts to handle these situations responsibly and

Hi, Janet! I do believe that all boundaries set for yourself as a case manager should be done through professionalism regardless of whatever situation you find yourself with a client. Janet we do have to be careful

Although spite of access to resources practitioners can become habitual, and even burned out in the day- to- day practices of clinical work described two types of habituation such as, being bounded ethnicity, when decisions are made in a setting with limited date, and having ethnical fading, when everyday operational events such as assigning a diagnosis can blind a practitioner from awareness of ethnical practitioners. Overtime, social workers must put a limited to certain boundaries such as ‘crossing the line’ or ‘blurring the boundaries’ with their clients (Ramsay, 2003). There relationships can be managed in a way as to prepare both the social worker and client to professional boundaries. The connection of the social work profession carries many challenges for practitioners. In order for the social work to be effective in their roles, they must have relationships with their clients, built trust and understanding on a professional level. This relationship and approach can be difficult between the social worker, and the client personal and professional boundaries (Compton, Galaway, & Cournoyer,

There is a pressing need for a high level of worker/client boundary identification when working within a client population, however realizing a conflict of interest scenario is vitally important when facing a dual relationship with a client. There are so many issues that are faced by a human service professional, explaining all of them may be difficult. In this field there are issues such as burnout, secondary trauma, compassion satisfaction, dual relationships, and boundary issues. (Reamer, F. (2012). As human services professional or social workers there is a code of ethics. In statement 6 of the code of ethics, it states human services experts must be mindful that in their associations with customers/clients power and status are

Though I like to think that I won’t have any issues concerning boundaries like the ones mentioned in the text such as duel relationships, or attraction for or from the client, I know that this can happen. I would love to say that these will not be an issue for me but then who knows what the future holds. I would like to think that I

In addition, in order to have a healthy professional or non-professional relationship you build trust and confidence with each other. All client’s voluntary or involuntary are entitled to be treated with respect and dignity and to have their choices facilitated (Dean H. Hepworth, 2010, p. 27). A bond of trust must exist before people are willing to risk that difficult human experience of change (Bradford W. Sheafor, 2008, p. 35). Thus, the most fundamental tool of the trade is the use of a professional relationship to help people become open to the possibility of change and actively engaged in the change process (Bradford W. Sheafor, 2008, p. 35).

Dual relationships occur when a practitioner is in a professional role with a client as well as taking on another role outside the clinic with the client. The professional needs to assess the risk in the relationship and whether both the practitioner and the client can differentiate between a boundary crossing and a boundary violation. In rural area’s a dual relationship may be unavoidable, the article discuses that the practitioner may have been chosen because of the prior relationship, and that some form of prior relationship may even be a prerequisite for the development of trust and respect in a small community. However, Zur also writes about the “Slippery Slope Effect” in which that all boundary crossings eventually lead to sexual relationships and boundary violations. The author then notes that the slippery slope effect is an unreasonable link and adds that when thinking of crossing a boundary the professional needs to consider the welfare of the client and benefits to treatments, whilst avoiding harm or exploitation and to respect the client’s autonomy (Zur 2004, pp27-32).

Equalize the power relationship between you as the professional worker and the client as the vulnerable individual so that you both become persons in the eyes of the other.

As everybody is different and comes from different backgrounds, therefore give us all different values and beliefs, it is important to have an effective client-counsellor relationship based on four main areas of duty of care 1. Helper competence, 2. Client autonomy, 3. Confidentiality, 4. Client protection (Nelson-Jones, 2008). There will be times throughout the sessions with clients that your own values and belief creep in, and you do make judgement, therefore you as a counsellor have to know and acknowledge this happen and understand why it is happening.