In therapy, boundaries refer to the limits placed to guide the relationship between the client and his therapist. This means that therapists must always evaluate what they want to say, do or allow from their clients. The boundaries exist to protect the therapeutic experience. They range from the most commonly experienced, the sexual contact with clients to those which may not be easily noticed like giving of gifts.
Types of Boundaries
The various types of boundaries in therapy include such actions as: any kind of sexual contact between the client and the therapist, entering into any business agreement with the client, and failure to respect the client’s sessions. Other boundaries are normally categorized under grey matter. This type of boundaries may at times be allowed in cases where their use can be therapeutic. They include: any form of hugging, therapist lending the client a book, and occasional conducting of sessions over the phone.
Reasons to Cross the Boundary
Even though it is strictly not advisable for the therapist to cross the therapeutic boundaries, there are certain situations in which doing so may be helpful to the clients. Such interventions, though may amount to crossing of the set boundaries, if clinically appropriate can be highly therapeutic. Specific examples may include a case where a therapist may need to accompany a patient who suffers from fear of flying into an airplane. Other therapists can also offer to have amid morning meal with an anorexic patient as well as making home visit to a bed ridden elderly patient.
Ramifications of crossing therapeutic boundary
Even though most boundary crossings are likely to enhance therapeutic alliance and result into the desired therapeutic outcome, caution must be taken. This is because boundary crossing under unclear circumstances can easily lead to extreme cases of boundary violations like sexual relationship with the client. Under such circumstances, the intended result of the therapeutic experience will automatically be impaired.
The difference between crossing boundary and violating boundaries
Boundary violations occur when therapists cross the line of decency. It implies any form of exploitation of the client by the therapist like having a sexual contact of any kind. It may also take the form of entering into an exploitative business relationship with the client (Zur, 2004). On the other hand, boundary crossing majorly involves clinically effective interventions by the therapist. Examples may include self disclosure, home visit and non sexual touch. Boundary crossing is normally done while observing well-defined boundaries of time and space and a clearly structured therapeutic environment. Therefore, contrary to boundary violation which may be very harmful to the clients, boundary crossings are not unethical. They are normal, unavoidable and even expected in small situations.
Ways of ensuring one remains ethical
Different experienced therapists have warned other practitioners on the need to be cautious of the slippery slope effect. They are advised to avoid what may initially seem to be minor boundary crossings as they may graduate into boundary violation like sexual relationships. To remain ethical, therapists are advised to always provide a clearly structured and well-defined therapeutic environment. In case of a dual relationships, any therapist intending to cross the boundary must ensure that the clients’ unique needs and his/her specific situation remain to be the guiding factors. The rationale for the intended boundary crossings should also be clearly articulated and if possible included in the treatment plan.
Further, a therapist planning to enter any dual relationship must give priority to the welfare of the client and the effectiveness of treatment. He/she must also avoid any kind of harm and exploitation as well as any conflict of interest and any form of impairment of clinical judgment. If this is done, any non-exploitative dual relationships can greatly increase trust between the client and the therapist. Such mutual trust enhances the therapeutic alliance yielding the desired therapeutic results.