Professional Boundaries. Do we need them?
Over the past year I have worked with a number of individuals who have been wounded by counselors who have not maintained good or clear boundaries in the counseling relationships. Licensed counselors have more professional guidelines that they are required to adhere to but many church based counselors as well lay counselor need more help to understand why boundaries are not only important, but act as a safety net for them and their counselee.
The following three areas are where counselors get into the most trouble.
- Informed Consent and Confidentiality: A licensed counselor is required to inform her client (before she opens her mouth) the rules of confidentiality and what would constitute a breach of confidentiality. This is important because most clients assume that everything that is said is confidential. That is not true.
For example, if a counselee came for help with parenting problems and disclosed that in moments of extreme anger, she became abusive, as a licensed professional, you would be required to report her to the Child Protective Services.
If your client didn’t know that ahead of time, things in the counseling relationship could get very messy. Before you ever have a “counseling” conversation with a potential client, usually in the paperwork he or she fills out, you must disclose the limitations of confidentiality which your client reads, agrees, to, and signs.
In addition if you are a licensed counselor you are not allowed to discuss a situation with anyone without the client’s written consent. That means if his or her spouse or pastor or concerned relative calls you, you as his or her counselor are not allowed to disclose any information about your client, not even whether or not they are your client or attending counseling sessions.
If your client uses medical insurance for reimbursement for fees charged, it’s in your client’s best interests to disclose what diagnosis you have put on his or her medical records. That information becomes a part of your clients permanent medical record which can have long term implications for later acquiring life insurance or even adopting a child. Informed consent means you give your client a choice as to whether or not she wants to use her insurance if the given diagnosis may restrict future opportunities.
If you are a church counselor or a non-licensed professional, you are not governed by state licensing rules but that does not mean you should not have your own guidelines on confidentiality to ensure your and your clients well-being.
Your clients will want to know if everything she talks about is totally confidential? If not, what are the exceptions? It would be wise to think about these ahead of time and have your guidelines in place so that you are consistent and can let your counselee know what he or she can expect from you.
A client may also want to know where you keep your written notes of sessions. Who else has access to read or see those records especially if you are in a church setting? (They should be in a locked file).
You should also let your counselee know what your policy is if someone from their family or church contacts you in order to talk about your work them. Can they trust you not to talk about them without their written consent?
Your client would feel safer having these consents and confidentiality guidelines in writing so that there is no misunderstanding.
- Relationship boundaries: Licensed counselors are not allowed to engage in personal relationships with someone who they are professionally helping, even after the counseling relationship is over.
What that means is that the counselor is not supposed to go to lunch with their client or get together on the weekend for a movie, attend an open house holiday party or receive expensive gifts from a client. Counseling is considered a professional relationship and needs to be protected. An exception might be made to attend a funeral if a client had someone close pass away suddenly. If you were instrumental in premarital work, or restoring a broken marriage, you may attend a client’s wedding or a recommitment of vows ceremony (but usually not attend the reception).
This strong boundary sometimes shocks and hurts our clients because the relationship they build with us often starts to feel like a close friendship. It hurts their feelings when we have to say “no” to their invitations. But your client has one counselor, they can have lots of friends and part of good counseling is helping them build other supportive relationships.
Protecting the counseling relationship also means the counselor is clear on the times a counselee comes to the office and how long each session will be. Payment information (if involved) is spelled out ahead of time and the ways and methods of contact are understood.
For example, you may not want your client to e-mail you text you or use your social media to connect. This is to keep the relationship from sliding into a more personal relationship. As the counselor, you are responsible for setting and maintaining these professional boundaries. In addition you should let your counselee know how you want to be contacted in an emergency and when he or she can expect you to respond.
On my informed consent sheet with my counseling clients I spell out what they can “expect” from me if we run into each other at church or other settings. This was important for confidentiality reasons. I didn’t want her child or friend asking, “How do you know her?” or getting hurt because I did not acknowledge I knew her at church. So I put in writing, “I will not approach or acknowledge you if we see each other in settings other than the office to protect your confidentiality.”
With e-mail and internet use so common, the “rules” of engagement between counselor and counselee are being reevaluated by licensing boards and it isn’t always black and white but the main point to keep clear on is that the communication is professional and not personal.
If you are a non-licensed counselor or lay counselor the rules and boundaries are not so clear. You may attend the same church, your kids may be friends, perhaps you are in a small group together.
I don’t think this is always a bad thing, but it does make things murkier and messier. There are many “one-another” passages in scripture that tell us that we are to come along side one another when we are suffering and for a moment, or a season, one “friend” might counsel another. This is a good thing, but understand that the l boundaries are not as clear cut or spelled out and may become confusing to your counselee, who is also your friend.
It may be helpful to set up some temporary boundaries to protect both you and your counselee/friend. For example, will you have regular times to meet? If so where? May she call you when she needs to? What are the boundaries? (How often, what time limits, cell phone versus home phone versus office phone, weekend calls?) May she e-mail you if she needs to and if so, what e-mail address should she use?
If you are in small groups together or have social contacts, talk about how this will be handled and how confidentiality will be maintained.
- Touching Boundaries:
Human touch is important and a counselor must be wise. We are people and feel deep care and compassion for our counselees, especially when we see they are hurting. We often want to hug them or reach out for their hand or put our arm around them but a counselor should never do this without asking for a counselee’s permission and being extremely cautious about any hint of sexual touch.
Sexual relations of any kind are prohibited between a counselor and counselee, even if both give consent. If this happens, a counselor will lose his or her license to practice their profession. This is prohibited even after the counseling relationship is over.
When you work closely with a counselee it’s not uncommon for him or her to develop strong feelings and be sexually attracted to you. Perhaps for the first time she feels cared for and heard. In her confusion she may flirt, be seductive, or even feel like she is falling in love. In her mind the relationship is becoming personal, mutual. It is not or should not. You, the counselor, whether licensed or non licensed, must maintain the boundary.
You can reassure your client that her feelings are not uncommon but will pass. It is your job to remind her that your relationship together is professional and it must always stay that way. She may be disappointed but will feel safe and relieved.
Seeing a damsel in distress, especially when she is attractive and flirtatious, can also be a huge turn on for a man, even if he is a counselor or pastor. It pulls at his hero strings. He wants to rescue her from her awful marriage. He wants to help her feel loved for the first time in her life. Sometimes he lies to himself telling himself that God has asked him to “cross” the professional boundary line in order to help her in a special way that no one else can. I’ve seen it happen too many times and trust me it never, ever, turns out good. The counselor is 100% responsible to hold to the boundary of absolutely no sexual contact, period.
There is much to learn in order to become an effective and safe people helper. If you are having trouble with any of these three areas, please make sure you get some professional supervision so that you do no harm to those God has entrusted to your care.
Posted on February 8, 2016