Maintaining Professional BoundariesEssay Preview: Maintaining Professional BoundariesReport this essayJulia, the client, is seeking personal information from Michael, her practitioner, and suggesting meeting outside of appointment times, therefore challenging Michaels personal and professional boundaries. Julia seems to need a friend. The issues concerning this are:
What are boundaries? Because of the personal nature of a helping relationship, there is a Code of Ethics that helpers abide to regarding ethics (Brammer & MacDonald 2003, p. 152) and maintaining clear professional boundaries is an important aspect of patient care (Galletly 2012, p. 380). Boundaries are essential to keep both the helper and the helpee safe, and are there to ensure that no outside factors intrude on the relationship or jeopardise the level of care being administered (Sarkar 2004).
What are boundary crossings and are they appropriate? Boundary crossings are intentional or unintentional digressions across boundaries of the established limits of the professional relationship (Gabbard & Guthiel, 1993). Boundary crossings may arise from the practitioner or from the client, and no harmful effects are meant. An example is accepting a small gift from a client who wants to show their appreciation.
Are boundary crossings the same as boundary violations? Boundary violations do imply harm to the patient (The Canadian Association for Parish Nursing Ministry 2012). They happen when boundaries are crossed, and are characterised by secrecy, role reversal and the practitioners needs being met rather than the clients (Arizona State Board of Nursing 2012). An example would be excessive self-disclosure by the practitioner. Sexual relationships are always a boundary violation (Lazarus & Zur 2002 p. 46).
What are dual relationships, and are they wrong? Dual relationships (or Multiple Relationships) are a subtype of boundary crossing (Zur Institute 2013) and deal with any situation where there multiple roles existing between a practitioner and their client (Zur 2006). Examples would be when the client is a friend of the practitioner They could also be a family member, an employee or a student (Zur Institute 2013). .
Even though the three articles are discussing maintaining professional boundaries in either psychology or counselling, the issues raised are still relevant in the natural health care setting.
Boundaries may be described as the outside limits of suitable professional behaviour (Aravind et al. 2012, p.21) and are maintained through the use of body language, words and behaviours. Boundaries characterise the conventional social distance between practitioners and their clients; they are lines which, if crossed, will constitute unprofessional behaviour and misuse of power (College of Dieticians of British Columbia 2010). The practitioner must avoid any situations with a client that could cause a conflict of interest (even inadvertently). This can be hard to do, given that boundaries are different for every person, they vary from one situation to another, and are apt to change over time (Australian Institute of Professional Counsellors 2010).
The Boundary and Boundary for Practitioners, defined as a system that ensures that practitioners have achieved the highest levels of professional development and a level of professional achievement and respect for their professional behaviour, continues to be maintained. Boundaries in this setting must be maintained for a number of purposes:
In the context of a wide range of personal and professional concerns, including family, financial, personal relationships and community activities;
In the context of an ongoing medical, legal or professional dispute, particularly related to personal or professional matters;
In the context of a sensitive, confidential, medical or commercial matter, which is in the public interests or at the personal risk of professional safety or those of other practitioners;
To ensure that the law and practice of medicine, health and safety in certain parts of the world is harmonised (Canadian Journal of Health Care) and that rules governing these issues are complied with (Canadian Journal of the Law of Behaviour and Ethics 1999) and in appropriate places.
References, references
Brooks, E., T.A. Vittler, D.W. Hines-Jones, S., & D.C. Tisdale, “The Association of Psychologists with Patients and Others to be Adopted Into Practitioners”, Journal of Applied Social Psychology, Vol 22, Issue 4, No. 2, October 1989,
Carlin, A. (2010), “The Society of Psychologists: Its Functions and Consequences”, Ethics, 3(6), 1-9 (February), pp. 2, 5.
Cross, A., P.M. A. Fennell, P., H. Gifford, S. D. Smith, W. F. Cappella, R. K. Riggs, B.P. (2009), “The Sociological Construction of Boundaries and Boundary Boundaries for Therapeutic Approaches: A Systematic Study”, Journal of Applied Social Psychology, Vol 37, Issue 1, No. 11, October 2009, pp. 635-655;
Cross, L., DeMarco, J.-G., B.G. Chabot, M., Stenga, M., (2009) “Clinicians’ Boundaries, Boundaries, and the Treatment of Patients”, European Journal of Clinical Psychology, Vol 28 , No. 10, April 2009, pp. 901-907.
Cross, M.R. Naylor, A.M. Dey, S. Gifford, K.P. (2005), “Boundary Boundaries: Approaches To Community and Professional Development”, Journal of Applied Social Psychology, Volume 29, Issue 0, September 2005, pp. 38-44.
The Boundary and Boundary for Practitioners, defined as a system that ensures that practitioners have achieved the highest levels of professional development and a level of professional achievement and respect for their professional behaviour, continues to be maintained. Boundaries in this setting must be maintained for a number of purposes:
In the context of a wide range of personal and professional concerns, including family, financial, personal relationships and community activities;
In the context of an ongoing medical, legal or professional dispute, particularly related to personal or professional matters;
In the context of a sensitive, confidential, medical or commercial matter, which is in the public interests or at the personal risk of professional safety or those of other practitioners;
To ensure that the law and practice of medicine, health and safety in certain parts of the world is harmonised (Canadian Journal of Health Care) and that rules governing these issues are complied with (Canadian Journal of the Law of Behaviour and Ethics 1999) and in appropriate places.
References, references
Brooks, E., T.A. Vittler, D.W. Hines-Jones, S., & D.C. Tisdale, “The Association of Psychologists with Patients and Others to be Adopted Into Practitioners”, Journal of Applied Social Psychology, Vol 22, Issue 4, No. 2, October 1989,
Carlin, A. (2010), “The Society of Psychologists: Its Functions and Consequences”, Ethics, 3(6), 1-9 (February), pp. 2, 5.
Cross, A., P.M. A. Fennell, P., H. Gifford, S. D. Smith, W. F. Cappella, R. K. Riggs, B.P. (2009), “The Sociological Construction of Boundaries and Boundary Boundaries for Therapeutic Approaches: A Systematic Study”, Journal of Applied Social Psychology, Vol 37, Issue 1, No. 11, October 2009, pp. 635-655;
Cross, L., DeMarco, J.-G., B.G. Chabot, M., Stenga, M., (2009) “Clinicians’ Boundaries, Boundaries, and the Treatment of Patients”, European Journal of Clinical Psychology, Vol 28 , No. 10, April 2009, pp. 901-907.
Cross, M.R. Naylor, A.M. Dey, S. Gifford, K.P. (2005), “Boundary Boundaries: Approaches To Community and Professional Development”, Journal of Applied Social Psychology, Volume 29, Issue 0, September 2005, pp. 38-44.
There are no guideline or ethics codes dealing specifically with boundary crossings, though all codes and guidelines have a mandate to avoid harming or exploiting the client; and respecting the clients integrity and independence (Zur Institute 2013). Paving the way for boundary issues resulting in boundary crossings and violations (non-sexual and sexual) are the practitioners ignorance, unscrupulous character, emotional vulnerability, moral weaknesses and similar (Aravind VK, Krishnaram VD & Thasneem Z 2012).
There are many proven interventions that are regarded as boundary crossings. Suitable boundary crossings can increase understanding and familiarity, and can help with feelings of connection. When done with the clients well-being in mind, boundary crossings can enhance the practitioner-client relationship and should