Nobody likes a list of rules. Whether they’re do’s or don'ts. But when it comes to boundary expectations with clients, it’s best to get in the habit of establishing things early. And if necessary going over them often. Many clients are reaching out to you in time of great need. Not only can these boundaries prevent you from losing your license but taking the time to set boundaries will give you and your clients the structure to build a respectful, consistent, and trusted relationship.
Things to DO until they become second nature.
- Remember: the focus of the therapy you’re providing is solely on the client and their progress.
- Any sessions whether in person or via video should take place in a therapist’s office setting; if you are in a home make sure there is no overlap between your office and personal living space.
- Set limits on personal information you disclose to a client
- Maintain transparency about your professional beliefs and practices if a client asks about them.
- Always maintain confidentiality about anything discussed in a therapy session
- If ever the need to consult with another therapist disclose that to the client
- Discuss client progress and revisit their identified goal(s) regularly.
- Stay consistent with appointment times.
- Stay consistent with submitting claims/billing.
- Remember: in treating clients, you are providing a professional service which should be paid for by the client (or their guardian).
- Try to always maintain a courteous and professional attitude with all clients on an equal basis.
Real world lessons you should certainly avoid:
- Discussing any other client’s experiences or sessions.
- Responding to your phone in any way during sessions.
- Eating during a session.
- Allowing any client to perform a service for you (house sitting, baby sitting, etc.)
- Accepting any gifts or money from clients.
- Recommending your client to a spouse or family member for other services.
- Set up clients on dates/meetings with others for social interaction.
- Provide therapy to a client who is also a student in a course you’re teaching.
- Discussing potential shared business opportunities with a client.
- Seeing a client at no cost.
- Treating your sessions as social gatherings or casual meet-ups.
- Having casual conversations, about shared interests as the focal point of your session, for example.
- Sharing personal information about yourself.
- Disclosing professional and/or personal needs/struggles with the client.
- Giving the client money.
- Speaking negatively about other therapists in the community or your other clients.
- Spending time with the client outside of session.
- Using offensive language or making sexual jokes or comments.
- Caring for family and/or friends you are close with.
- Spending time with clients outside of scheduled sessions; on personal time.
It’s important to acknowledge that sometimes you don’t have control over every potential interaction with a client. It's possible that you may run into a client in the community, especially if you live and work in a more rural area. It can be helpful to talk to your client about what you’ll do in that situation before it ever happens. It is an ethical best practice to not acknowledge a client in public, as that would break their confidentiality. However, this may seem rude to clients, which is why it’s helpful to discuss beforehand. A client can come up to you and say hello in the community, as they are responsible for their own health information.
In the event of a dual relationship (more than one kind of relationship with the same person) boundary issues can arise. A boundary violation occurs when a provider exploits the client-provider relationship. For example, if a provider is working with a client who is also an employee at their child’s school, it’s up to the therapist to maintain healthy boundaries and, if necessary, remove him or herself from the professional relationship.
Boundary violations cause serious ethical dilemmas and can possibly result in a loss of licensure. They can also discourage clients from seeking future behavioral health services as well as contribute more stigma surrounding psychiatric care and behavioral health disorders. Find more information on ethical issues and state codes here.
Other important points to consider
- Be aware of compassion fatigue, often described as the “negative cost of caring”, a condition characterized by emotional and physical exhaustion leading to a diminished ability to empathize or feel compassion for others. Maintaining clear boundaries can help to prevent this from happening to you.
- You are the model for demonstrating appropriate boundaries for your clients, so it’s important to respect others’ personal and physical spaces.
- Practice self-care. You can’t put all of your effort into helping others with their emotional issues without taking care of yourself first. Be good to yourself.
Here are some other great resources about drawing lines, and being sure not to cross them.
Rewire article: What Boundaries Should you have with your Therapist?
HPSO article: Clients who Cross the Line
Counseling.org article: Boundaries across borders
Setting boundaries worksheet
Stay up to date with your state’s Laws, Rules, and Policies:
Colorado Addiction Counselors
Missouri Professional Counselors
Missouri Marital & Family Therapists
Ohio Counselor, Social Worker, Marriage & Family Therapist
Ohio Chemical Dependency Professionals
Virginia Laws Governing Counseling
See our article on CE & Other Training Library for information.