Maintaining Professional Boundaries in Interpersonal Work

Suffolk County Department of Health Services

Division of Services to Children with Special Needs

Laurie Baumann, M.S., BCBAJoAnn Scanlon, M.S., BCBABarbara FalkmanMichele Gentile, M.A., OTR/LGeorge Heintz, M.S., SDAKathy Junior, Ph.D.Jim Ciaravino, Ph.D. Sue Gerweck, Ph.D.Meryl Zaglin, Ed.D.

A WORKSHOP PRESENTATION – February 2010

Too Much Baggage?

Be aware of what exists

WHY ETHICS?

A Continuum of Professional Behavior Adapted by permission from Kelly Wolf, CASA of Santa Cruz County

ZONE OF HELPFULNESS Where majority of client interactions should occur for effectiveness

and client safety.

UNDER-INVOLVED

DistancingDisinterestNeglect

OVER-INVOLVED

Boundary CrossingBoundary Violations

What Are Professional Boundaries?

Clearly established limits allowing for safe connection between service providers and their clients“Being with” the client, not becoming the clientBeing friendly, not friendsAbility to know where you end and the client beginsA clear understanding of the limits and responsibilities of the role of a service provider

The Importance of Boundaries

Modeling healthy communication & professional relationshipsAvoiding the “rescuer” roleAvoiding burn-out (“compassion fatigue”)

o Stay focused on one’s responsibilities to the client

o Open communication with other team members

o Maintain physical and emotional safety

Creating and Maintaining Healthy Professional Boundaries

Use professional judgment when interacting with client in social settingsSupervisors should not accuse but use open-ended questions regarding clear boundariesPromote and model positive, open communication and respectful sharing of information with team members“Leave work at work”

Creating and Maintaining Healthy Professional Boundaries

Establish clear agreementsAddress warning signs earlySharing personal information only related to goalsFrequently clarify role and boundariesUtilize professional resources when there are questions regarding boundary issues

Signs that Boundary Issues May Be Present

Client and service provider begin referring to each other as friendsService provider receives gifts or gives gifts to clientClient has or is asking for significant personal informationClient asks/expects to socialize outside of professional setting

Signs that Boundary Issues May Be Present

Reveals excessive personal information to clientFeelings of anxiety related to situationOffers assistance outside of role (staying later to watch child or transport family or child)Service provider finds him/herself “venting” with client about other team members

Service Provider:

Signs that Boundary Issues May Be Present

Refers to provider as their friendGives gifts to the providerAsks for personal information, including home phone number.Expects provider to socialize with them outside professional setting

Family:

Unclear Boundaries

Self-DisclosureGifts (greater than token value)Dual or Overlapping relationshipsFriendshipsRomantic Relationships

Difficult to Establish and Maintain Professional Boundaries? Why?Dual relationships the service provider and parent know each other from another setting

Values Conflicts the family choices, history, relationships, feelings, lifestyle, etc. conflict with provider’s values and/or knowledge of best practice

Vicarious trauma the provider experiences trauma symptoms from hearing the family experience. The providers may be triggered due to having a similar circumstance.

Playing the “hero” role the provider may feel the need to “save” the family

Poor teamwork service provider tries to take over for others – loses trust in other team members – wants to be the favorite

Consequences of Having Loose/Poor Boundaries

Compassion fatigue-service provider’s role may not feel sustainablePotential for “splitting” on teamsClient may feel betrayed, abandoned, and/or poorly servedService provider may act unethically

The reputation of agency and/or professional may be compromisedService provider and/or client may be emotionally traumatized or put in physical danger

Some Techniques to Consider

As early as possible, establish clear agreements with the family regarding your role as a service provider, your availability, and best ways to communicate with you.When boundary issues or warning signs appear, address these with the family quickly. Be sensitive to their feelings when doing this, emphasize the importance of and your commitment to maintaining healthy boundaries

Techniques….

If you decide to tell a family something personal about yourself, ensure that the information is related to the family goals. Too much self-disclosure shifts the focus from the family to the service provider and can confuse the family in terms of roles and expectations of the relationship

Techniques…

Realize that how a family interprets your words and actions might not match what you are trying to communicate. You may need to frequently clarify your role and boundaries and ask the family to repeat back what you said to ensure that they understand. This will also give the family an opportunity to ask clarifying questionsUse your supervisor or professional colleagues as a sounding board when you have questions regarding boundaries.