BOUNDARIES TRAINING

PROFESSIONAL AND PERSONAL CONDUCT IN A CLINICAL SETTING

WHAT ARE BOUNDARIES?

Boundaries
Define personal space. Define limits. Are guidelines between people about suitable behavior and responsibilities. Regulate distance and closeness. Can be protective in nature. For our purposes:

Professional boundaries define effective and appropriate interaction between professionals and the clients we serve. Boundaries protect both the client and the professional.

PURPOSE OF BOUNDARIES TRAINING

To foster and protect a supportive treatment environment. Promote awareness of appropriate and professional client and staff interactions. Share information on how to develop healthy boundaries with clients & staff. Protect yourself.

HEALTHY vs. UNHEALTHY Ask Does this serve the client's therapeutic interests? Is this consistent with clients treatment goals? Am I aware of my own boundaries?
*When in doubt, dont.

WHAT ARE INAPPRORIATE BOUNDARIES?

Sexual contact Sexual behaviors (verbal or nonverbal) or comments (including joking) Violent contact Violent comments (including joking) Giving out personal phone numbers or email to clients. Fraternization Personal Disclosure when there is no therapeutic benefit.

Example of Unhealthy Boundaries

Going against personal values to please others. Accepting food, gifts, or touch that you dont want. Touching a person without asking. Letting others define you. Letting others describe your reality. Believing that others can anticipate your needs or expecting others to fill your needs automatically. Not noticing when someone else displays inappropriate boundaries. Telling all. Manipulative behaviors. Self abuse. Substance abuse.

HEALTHY BOUNDARIES
Emotional it is okay to feel feelings and allow others to be responsible for their own feelings. Physical the individual determines when, how, why, and who touches or gets close to their body. Sexual the individual determines when, how, why, and who touches or gets close to their body. Mental (intellectual) the individual allows their thinking to belong to them. They make a choice to accept or reject what others say about what they think or say. Spiritual the individual defines in his/her own way.

Maintaining a Therapeutic Relationship with Clients

Notify clinical supervisor if a client is admitted to the facility that you may know in any capacity outside the treatment program (any previous social, familial, or any other relationship). Do not give clients personal phone numbers, addresses, e-mail addresses, or any other means of maintaining contact outside the treatment program. Therapeutic boundaries are both implicit and explicit once the client has entered the premises of LVRC. These boundaries should continue for a period of at least two years.

STAFF TO CLIENT BOUNDARIES

Monitor self-disclosure (avoid over sharing). Do not engage in power struggles. Do not touch or speak to a client in a sexual or violent nature -EVEN in a joking manner. Avoid fostering dependent relationships with clients. Maintain open, non-defensive, and non-threatening posture. Do not conduct any interactions behind closed doors unless another staff member is present. Maintain confidentiality. Do not talk to one client about another.

STAFF TO STAFF BOUNDARIES

Be professional and be aware. A staff member cannot touch or speak to another staff member in a sexual nature - EVEN in a joking manner. A staff member cannot touch or speak to another staff member in a violent manner - EVEN in a joking manner. Do not engage in any activity that could be construed as harassing or discriminatory (directly or indirectly). Treat everyone with respect, courtesy, and dignity. Act in an ethical manner.

CLIENT TO CLIENT BOUNDARIES

A client is not allowed in another clients room unless they are assigned to that room. Only clients of the same sex are assigned to room together. Clients will not have one on one contact with clients of the opposite sex (intimate contact or fraternizing between clients is not tolerated). Clients are discouraged from exchanging phone numbers. Any physical violence, threatening gestures, or remarks to clients (or staff) will not be tolerated. Clothing must be appropriate. All personal displays, IE: family pictures, religious material, and any item that can be viewed or heard by other clients must be kept in sleeping rooms.

IF YOU OBSERVE INAPPROPRIATE BOUNDARIES...

Report the situation immediately to your supervisor. Tell the clients primary counselor. Enter the incident into the shift report. Complete an Incident Report (regardless of circumstance or the parties involved).

IF YOU ARE SUBJECTED TO INAPPROPRIATE BOUNDARIES

Re-establish appropriate boundaries instantly by stating to the client that what they have said is inappropriate; and, Advise the client not to make any more comments of that nature to other staff members and/or clients again. Tell the clients primary counselor. Enter the incident into the shift report. Complete an incident report.

ESTABLISHING A BOUNDARY

When you I feel I want

MAINTAINING A NURTURING ENVIRONMENT

One of the goals at LVRC is to provide a safe, compassionate, and healthy environment for all clients

HUGS:
Use good judgment. Ask if a hug is O.K. do not automatically hug someone. If a client wants to hug you and you do not wish to, get someone else involved.

Report the situation to your supervisor immediately.

WHEN A CLIENT LEAVES LVRC

In Public: Do not approach the client or former client. Do not exchange phone numbers. No relationship of any kind with client for years. Phone Calls: Refer to primary counselor.

At NA Meeting:

Relationships: two

POINTS TO KEEP IN MIND

Do not put yourself in situations where you are alone with a client. Do not engage in conversations of sexual or violent nature with clients or staff members (its all about perception). Do not share personal information with clients. Do not talk about one client to another. Communicate boundary issues with your supervisor immediately. ALWAYS FILL OUT AN INCIDENT REPORT!

LVRC HAS A NO TOLERANCE POLICY

Failure to protect our clients and fellow staff members from a hostile environment is unacceptable and will not be tolerated.