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2012 OCASI
Professional Development Conference

Professional and Ethical Practice:
Boundaries




JUNE 15, 2012
(E9)
FACILITATED BY:
DEBORAH G. HEADLEY



                        Email: nta@ca.inter.net Telephone: 416-691-1411
       Shoppers World Postal Outlet 3003 Danforth Ave. Box 93590 Toronto, Ontario M4C 5R4
   Copyright © 2012 Deborah G. Headley, Network for Therapeutic Alliances. All rights reserved. No part of this work may be
 reproduced, used in any form, or distributed by any means without the written permission of Network for Therapeutic Alliances.
Professional and Ethical Practice: Boundaries



Goals
Define boundaries as part of ethical practice and professional responsibility
Distinguish between boundary blurring, crossings and violations
Describe various types of boundaries and boundary breaches
Identify strategies for establishing and maintaining appropriate boundaries




Guidelines
Confidentiality
Respect & Sensitivity
Saying No/Participation
Making Mistakes/Compassion
Having Fun




Agenda
Welcome and Overview
Goals/Guidelines/Agenda
Professional and Ethical Practice
Blurring, Crossings and Violations
Addressing and preventing boundary breaches
Closing and Evaluation




                                                                                2
Professional and Ethical Practice: Boundaries



Overview
Professional boundaries are the lines of separation that distinguish clients from
counsellors in the helping relationship. They include the concrete contractual aspects of
the working relationship. They define the nature of the relationship between counselor
and client. They address those areas of judgment that have the potential to do harm.




Rationale
Professional boundaries are essential in the workplace, because they are meant to
prevent problems such as unfair treatment, law suits, exploitation, etc, within the
company and with business.

Each counsellor at various points in her/his profession will be faced with defining and
maintaining appropriate boundaries with clients.

Boundaries exist as part of the helping relationship. They provide for a safe therapeutic
connection and therefore should not left to chance.




Types
A boundary is a dynamic line which, if crossed, may constitute unprofessional behaviour
and misuse of power.



There are three types of breaches: blurring, crossing and violation.




                                                                                          3
Professional and Ethical Practice: Boundaries



Boundary Breaches
Blurring
There are grey areas around professional boundaries that require the use of good
judgment and careful consideration of the context (e.g. the appropriateness of hugging
a client, attending a client function, giving a client a lift, giving a colleague advice about
their family member, etc.).
While each situation may appear harmless, when put together they may form a pattern
indicating that a boundary has been crossed or is likely to be crossed in the future.

Crossing
Behaviours that raise the need to be cautious are considered crossings, because they
may distort the professional boundaries that are in place to protect the client.

However, while lack of clarity may occur, these types of breaches may also be used in a
therapeutic manner. Therapeutic use can only happen if the counsellor is conscientious
about potential for harm and has the client’s best interest in mind. Some of these
behaviours include:

   Gift giving
   Dual/multiple relationships
   Bartering/use of personal money
   Social contact/out of office contact
   Non-sexual touch/attractions
   Workplace friendships
   Excess counselling time
   Personal disclosure

Violation
Boundary violation is a deliberate behaviour by a counsellor or helping professional that
is recognizably inappropriate and in violation of the nature of therapeutic relationships,
ethics and/or legal statutes. These types of breaches are those that lead to abuse,
sexual relations or romantic encounters, inappropriate contact or relationship and abuse
of power. They are never appropriate and are prohibited. They cross the line of decency
and violate or exploit clients.




                                                                                             4
Professional and Ethical Practice: Boundaries



Prevention
Codes of ethics on their own cannot prevent counselors from acting in unethical ways.

Good judgment is nurtured and borne out of a willingness to be conscious of and reflect
upon one’s competences, to critically analyze, to challenge personal motivations and to
heed the warning signs that may lead from a boundary crossing to a violation.




Principles
Boundaries are guidelines that are based on the basic principles of
counsellor/practitioner codes of ethics and standards of practice. Corey (1996) briefly
outlines five principles in which therapeutic boundaries are based upon:



•   Beneficence: a counsellor must accept responsibility for promoting what is good for
    the client with the expectation that the client will benefit from the counselling
    sessions.

•   Nonmaleficence: “doing no harm”. The counsellor must avoid at all times, (even
    inadvertently) any activities or situations with the client that could cause a conflict of
    interest.

•   Autonomy: the counsellor’s ethical responsibility to encourage client independent
    thinking and decision-making, and to deter all forms of client dependency.

•   Justice: the counsellor’s commitment to provide an equal and fair service to all
    clients regardless of age, gender, race, ethnicity, culture, disability and socio-
    economic status.

• Fidelity: being honest with clients and faithfully honouring the counsellor’s
    commitment to the client’s progress.




                                                                                             5
Professional and Ethical Practice: Boundaries



Strategies
Effective and diligent counsellors recognize that the intense feelings can arise in the
counselling relationship and how these can challenge personal and professional
boundaries.

Understanding the serious effects of one’s own power and how the relationship can be
misinterpreted by the client is a necessary caution that comes with understanding the
need to continually establish and maintain safe and respectful relationships with clients.

Steps:

1. Set the stage with appropriate boundaries from the initial contact.

2. Use judgment that puts the client’s well being and safety first.

3. Interrupt or address these breaches immediately, seemingly harmless comments
   that can evolve into the uncomfortable territory of boundary crossings.

4. Report and/or seek help for questions or lack of clarity about a potential boundary
   breach.

5. It is the counsellor’s responsibility to re-establish the professional boundaries,
   regardless of who crossed the line.

6. Document inappropriate behaviour as well as the measures taken to re-establish the
   professional boundaries.




Action Plan
What is a next step I will take as a result of this workshop?



What are the resources I can access to achieve my next step?




                                                                                          6
References & Resources
Books
Linzer, N. (1999). Resolving ethical dilemmas in social work practice. Toronto: Allyn
and Bacon.
Murphy B.C. & Dillon, C. (2011) Interviewing In Action In A Multicultural World. 5th
ed. California: Brooks/Cole Cenage Learning.
Schneider-Corey, M. (2007) Becoming a Helper. 5th ed. California: Thomson
Brooks/Cole.

Websites
Pope, K. S. & Keith-Spiegel P. (2008). A practical approach to boundaries in
psychotherapy: making decisions, bypassing blunders, and mending fences. Journal
Of Clinical Psychology, 64, 638-652. Retrieved from:
http://kspope.com/ethics/boundary.php.

Pope, K. S. & Vasquez, M. (2011). Steps in ethical decision-making in Ethics in
psychotherapy and counseling: a practical guide. 4th ed. Toronto: John Wiley.
Retrieved from: http://kspope.com/memory/ethics/boundary.php.

Zur, O. (2011). Dual Relationships, Multiple Relationships & Boundaries In
Psychotherapy, Counseling & Mental Health. Retrieved from
http://www.zurinstitute.com/dualrelationships.html.

Resources
Ontario College of Social Workers and Social Service Workers (2008) Code of Ethics
& Standards of Practice. http://www.ocswssw.org/en/code_of_ethics.htm.

Pope, K. S. Dual relationships, multiple relationships, & boundary decisions.
Resources http://kspope.com/dual/index.php.


Zur Institute. Ethics Codes of the Major Psychotherapy Professional Associations
Retrieved from http://www.zurinstitute.com/codesofethics.html.
                                                                                        7
TRAINING & EDUCATION

Network for Therapeutic Alliances: For more information, call 416-691-1411 or email
nta@ca.inter.net


 Courses: Clinical                     Workshops: Clinical
 Cross Cultural Counselling for        Understanding violence Against Women by
    Counsellors: Introduction;             Intimate Partners
    Individuals & Family; Groups;      Working with Abused Women: Overview
    Communities; Documentation;        Working with Children Exposed to Violence
    Supervision                        The Impact of Violence on Child Development
                                       Feminist Group Development and Group
 Counselling Skills: Interviewing;         Process
     Assessment, Community Services    Values, Ethics & Professionalism
     and Referral; Theory, Methods &   Working with Families and Children with
     Documentation                         Special Needs
 Workshops: Organizational             Working with Youth/Transitional
 Understanding Identity and Workplace      Aged/Newcomer Youth
     Dynamics                          Understanding Identity, Diversity and
 Inclusive Conflict Resolution             Workplace Dynamics
 Principles, Policies and Practices in Welcoming Diversity in the Classroom
     Inclusive Organizational Change   Cross Cultural Counselling: Competencies &
 Board Governance: Overview, ARAO          Practice
     101, Leading for Inclusive        Documentation through a Cross Cultural Lens
     Organizational Change             Inclusive Supervision Practices
 Staff Hiring and Recruitment
 Establishing Inclusive Group Norms
 Planning for Inclusive Organizational
     Development
 Leading Inclusive Organizational
     Development
 Strategies for setting up a Diversity
     Committee



                                                                                      8

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E9 professional and ethical practice boundaries

  • 1. 2012 OCASI Professional Development Conference Professional and Ethical Practice: Boundaries JUNE 15, 2012 (E9) FACILITATED BY: DEBORAH G. HEADLEY Email: nta@ca.inter.net Telephone: 416-691-1411 Shoppers World Postal Outlet 3003 Danforth Ave. Box 93590 Toronto, Ontario M4C 5R4 Copyright © 2012 Deborah G. Headley, Network for Therapeutic Alliances. All rights reserved. No part of this work may be reproduced, used in any form, or distributed by any means without the written permission of Network for Therapeutic Alliances.
  • 2. Professional and Ethical Practice: Boundaries Goals Define boundaries as part of ethical practice and professional responsibility Distinguish between boundary blurring, crossings and violations Describe various types of boundaries and boundary breaches Identify strategies for establishing and maintaining appropriate boundaries Guidelines Confidentiality Respect & Sensitivity Saying No/Participation Making Mistakes/Compassion Having Fun Agenda Welcome and Overview Goals/Guidelines/Agenda Professional and Ethical Practice Blurring, Crossings and Violations Addressing and preventing boundary breaches Closing and Evaluation 2
  • 3. Professional and Ethical Practice: Boundaries Overview Professional boundaries are the lines of separation that distinguish clients from counsellors in the helping relationship. They include the concrete contractual aspects of the working relationship. They define the nature of the relationship between counselor and client. They address those areas of judgment that have the potential to do harm. Rationale Professional boundaries are essential in the workplace, because they are meant to prevent problems such as unfair treatment, law suits, exploitation, etc, within the company and with business. Each counsellor at various points in her/his profession will be faced with defining and maintaining appropriate boundaries with clients. Boundaries exist as part of the helping relationship. They provide for a safe therapeutic connection and therefore should not left to chance. Types A boundary is a dynamic line which, if crossed, may constitute unprofessional behaviour and misuse of power. There are three types of breaches: blurring, crossing and violation. 3
  • 4. Professional and Ethical Practice: Boundaries Boundary Breaches Blurring There are grey areas around professional boundaries that require the use of good judgment and careful consideration of the context (e.g. the appropriateness of hugging a client, attending a client function, giving a client a lift, giving a colleague advice about their family member, etc.). While each situation may appear harmless, when put together they may form a pattern indicating that a boundary has been crossed or is likely to be crossed in the future. Crossing Behaviours that raise the need to be cautious are considered crossings, because they may distort the professional boundaries that are in place to protect the client. However, while lack of clarity may occur, these types of breaches may also be used in a therapeutic manner. Therapeutic use can only happen if the counsellor is conscientious about potential for harm and has the client’s best interest in mind. Some of these behaviours include: Gift giving Dual/multiple relationships Bartering/use of personal money Social contact/out of office contact Non-sexual touch/attractions Workplace friendships Excess counselling time Personal disclosure Violation Boundary violation is a deliberate behaviour by a counsellor or helping professional that is recognizably inappropriate and in violation of the nature of therapeutic relationships, ethics and/or legal statutes. These types of breaches are those that lead to abuse, sexual relations or romantic encounters, inappropriate contact or relationship and abuse of power. They are never appropriate and are prohibited. They cross the line of decency and violate or exploit clients. 4
  • 5. Professional and Ethical Practice: Boundaries Prevention Codes of ethics on their own cannot prevent counselors from acting in unethical ways. Good judgment is nurtured and borne out of a willingness to be conscious of and reflect upon one’s competences, to critically analyze, to challenge personal motivations and to heed the warning signs that may lead from a boundary crossing to a violation. Principles Boundaries are guidelines that are based on the basic principles of counsellor/practitioner codes of ethics and standards of practice. Corey (1996) briefly outlines five principles in which therapeutic boundaries are based upon: • Beneficence: a counsellor must accept responsibility for promoting what is good for the client with the expectation that the client will benefit from the counselling sessions. • Nonmaleficence: “doing no harm”. The counsellor must avoid at all times, (even inadvertently) any activities or situations with the client that could cause a conflict of interest. • Autonomy: the counsellor’s ethical responsibility to encourage client independent thinking and decision-making, and to deter all forms of client dependency. • Justice: the counsellor’s commitment to provide an equal and fair service to all clients regardless of age, gender, race, ethnicity, culture, disability and socio- economic status. • Fidelity: being honest with clients and faithfully honouring the counsellor’s commitment to the client’s progress. 5
  • 6. Professional and Ethical Practice: Boundaries Strategies Effective and diligent counsellors recognize that the intense feelings can arise in the counselling relationship and how these can challenge personal and professional boundaries. Understanding the serious effects of one’s own power and how the relationship can be misinterpreted by the client is a necessary caution that comes with understanding the need to continually establish and maintain safe and respectful relationships with clients. Steps: 1. Set the stage with appropriate boundaries from the initial contact. 2. Use judgment that puts the client’s well being and safety first. 3. Interrupt or address these breaches immediately, seemingly harmless comments that can evolve into the uncomfortable territory of boundary crossings. 4. Report and/or seek help for questions or lack of clarity about a potential boundary breach. 5. It is the counsellor’s responsibility to re-establish the professional boundaries, regardless of who crossed the line. 6. Document inappropriate behaviour as well as the measures taken to re-establish the professional boundaries. Action Plan What is a next step I will take as a result of this workshop? What are the resources I can access to achieve my next step? 6
  • 7. References & Resources Books Linzer, N. (1999). Resolving ethical dilemmas in social work practice. Toronto: Allyn and Bacon. Murphy B.C. & Dillon, C. (2011) Interviewing In Action In A Multicultural World. 5th ed. California: Brooks/Cole Cenage Learning. Schneider-Corey, M. (2007) Becoming a Helper. 5th ed. California: Thomson Brooks/Cole. Websites Pope, K. S. & Keith-Spiegel P. (2008). A practical approach to boundaries in psychotherapy: making decisions, bypassing blunders, and mending fences. Journal Of Clinical Psychology, 64, 638-652. Retrieved from: http://kspope.com/ethics/boundary.php. Pope, K. S. & Vasquez, M. (2011). Steps in ethical decision-making in Ethics in psychotherapy and counseling: a practical guide. 4th ed. Toronto: John Wiley. Retrieved from: http://kspope.com/memory/ethics/boundary.php. Zur, O. (2011). Dual Relationships, Multiple Relationships & Boundaries In Psychotherapy, Counseling & Mental Health. Retrieved from http://www.zurinstitute.com/dualrelationships.html. Resources Ontario College of Social Workers and Social Service Workers (2008) Code of Ethics & Standards of Practice. http://www.ocswssw.org/en/code_of_ethics.htm. Pope, K. S. Dual relationships, multiple relationships, & boundary decisions. Resources http://kspope.com/dual/index.php. Zur Institute. Ethics Codes of the Major Psychotherapy Professional Associations Retrieved from http://www.zurinstitute.com/codesofethics.html. 7
  • 8. TRAINING & EDUCATION Network for Therapeutic Alliances: For more information, call 416-691-1411 or email nta@ca.inter.net Courses: Clinical Workshops: Clinical Cross Cultural Counselling for Understanding violence Against Women by Counsellors: Introduction; Intimate Partners Individuals & Family; Groups; Working with Abused Women: Overview Communities; Documentation; Working with Children Exposed to Violence Supervision The Impact of Violence on Child Development Feminist Group Development and Group Counselling Skills: Interviewing; Process Assessment, Community Services Values, Ethics & Professionalism and Referral; Theory, Methods & Working with Families and Children with Documentation Special Needs Workshops: Organizational Working with Youth/Transitional Understanding Identity and Workplace Aged/Newcomer Youth Dynamics Understanding Identity, Diversity and Inclusive Conflict Resolution Workplace Dynamics Principles, Policies and Practices in Welcoming Diversity in the Classroom Inclusive Organizational Change Cross Cultural Counselling: Competencies & Board Governance: Overview, ARAO Practice 101, Leading for Inclusive Documentation through a Cross Cultural Lens Organizational Change Inclusive Supervision Practices Staff Hiring and Recruitment Establishing Inclusive Group Norms Planning for Inclusive Organizational Development Leading Inclusive Organizational Development Strategies for setting up a Diversity Committee 8