Boundaries in Counselling
Boundaries are a crucial aspect of any effective client-counsellor relationship. They set the structure for the relationship and provide a consistent framework for the counselling process. Some boundary lines are clear. Most counsellors would acknowledge that it is ethically problematic, for example, to counsel your ex-partner because the pre-existing relationship impairs objectivity and serves to undermine the professional relationship.
Whilst situations such as these are clearly problematic, outside of such elementary confines are numerous situations where the delineation of boundaries is less clear. These situations fall outside of the formal code of ethics and lie instead in an ambiguous grey area. Boundaries are guidelines that are based on the basic principles of the counsellor/practitioner code of ethics.
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.
The confusion caused by boundaries is best described by Corey (1996) as a continuum, ranging from disengagement (rigid, inflexible boundaries/guidelines) to enmeshment (flexibility to the point of diffusement) with a large grey area in between that is notoriously ambiguous and dependent upon the counsellor, the situation and the client’s changing needs and circumstances.
To be an effective counsellor, one cannot disengage from the client to the extent that the counsellor cannot empathise with the client. That is not the purpose of counselling and is counterproductive to the therapeutic relationship.
However, the counsellor does not want to empathise with the client to the extent that they hug the client upon meeting them or rant and rave with their client in a mutual expression of anger. Nor would the counsellor pop in to visit at the client’s home on their own way home from the office. This is the behaviour of a friend, not a counsellor. Hence, boundary violation has occurred.
Ambiguous boundaries often arise in counselling, but strict responsibilities do apply to the counsellor in relation to their duty to inform clients of the limitations on client confidentiality. Such information forms a large part of informed consent and informed consent is a fundamental client right.
A Short Case Study
Jenny had been seeing her counsellor, David, for two years when she was rushed to hospital for emergency surgery. As she was extremely stressed and upset on the phone, David visited her at the hospital the following day. Jenny was in horrific pain, and David sat in a chair beside her bed and took her hand when she held it out to him. David offered some words of comfort, and after ensuring that the family would be visiting Jenny soon, he left the hospital.
Jenny was aware that this was an exception to her usual counselling sessions with David and it would not be repeated. David’s visit to the hospital simply meant that he cared for her and could appreciate the depth of her pain and vulnerability.
At the first counselling session with Jenny after her discharge from hospital, David took the first few minutes of the session to discuss his visit to the hospital to ensure that Jenny understood fully its place in the context of the therapeutic relationship.
While some counsellors would not have visited Jenny at the hospital, arguing that it took the therapeutic relationship outside of the confines of the office and that the counsellor’s behaviour could have been misinterpreted by the client, many other practitioners believe that a decision must be based on the individual circumstances and the uniqueness of each relationship with each individual client.
The professional manner in which David conducted himself during the hospital visit and later at the first counselling session allowed David to move the boundaries in all good conscience. He was not cavalier about his visit to the hospital, rather he carefully thought out his decision; considering the ramifications and benefits for his client.
His behaviour was appropriate as a professional, in a professional setting, he did not make the mistake of thinking his visit was equal to that of a friend and neither did he behave as a friend. Also, as soon as he was able, he spoke to the client to clarify the visit and remove any possibility of ambiguity or innuendo.
Efficient counsellors recognise that the intense feelings that can rise in the counselling session can often challenge a counsellor’s personal and professional boundaries. Counsellors who understand the serious effects of their own personal power, and how that can be misinterpreted by the client, also take the boundaries of the counselling profession seriously. When counsellors choose to be flexible regarding boundaries, they do so carefully, having taken into account the ramifications of their flexibility for their client.