Boundary issues involve circumstances in which there are actual or potential conflicts between workers’ professional duties and their social, sexual, religious, or business relationships. These are some of the most challenging issues faced in the mental health profession and typically involve conflicts of interest that occur when a worker assumes a second role with one or more clients. Such conflicts of interest may involve relationships with:
Amanda didn’t think much about a client’s thank- you bouquet, until a week later, at their session, he confessed his strong romantic affection for her. 2. Pursuit of personal benefit : The various forms this may take include monetary gain and receiving goods and services or useful information. For example: Lawrence was surprised to learn that one of his colleagues was receiving stock tips from one of his clients, who ran a very successful brokerage firm. 3. Emotional and dependency needs : The continuum of boundary violations ranges from subtle to glaring and arises from social workers’ need to satisfy their emotional needs. For example: Jeff thought of himself as a father figure to his clients, and encouraged them to contact him at any hour of the day, including during his vacations. 4. Altruistically motivated gestures : These arise out of a mental health practitioner’s desire to be helpful. For example: Sandra felt compelled to give a newly sober client a small loan after the client cried that she didn’t have enough money to feed her children. After Sandra gave her the cash, the client purchased alcohol and got drunk. 5. Responses to unanticipated circumstances : Unplanned situations over which the social worker has little or no control. For example: Jake was uncomfortable when his mother was admitted to the same mental health hospital where he was on staff. Another tricky area involves bartering arrangements, particularly involving the exchange of services. These should be considered carefully and, according to Reamer (2003), limited to the following circumstances when they are: ● An accepted practice among community professionals.
● Current clients. ● Former clients. ● Colleagues. ● Supervisees and students.
With that in mind, the following would be examples of inappropriate boundary violations, and thus unethical, in that workers are involved in a dual relationship that is exploitative, manipulative, deceptive, or coercive in nature: ● Buying property from a disaster client at far below its market level. ● Falsely testifying to support fraudulent actions of clients. ● Imposing religious beliefs on a client. ● Suggesting that a hospice client make you executor of his/her will. ● Referring a client to your brother-in-law, the stockbroker. ● Friendship with the spouse of a client you are treating for marital issues. Five conceptual categories with regard to boundary violations generally occur around five central themes: 1. Intimate relationships : These relationships include physical contact, sexual relations, and gestures such as gift giving, friendship, and affectionate communication. For example : Intimate relationships As discussed earlier, boundary issues involving intimate relationships are the most common violations. Those involving sexual misconduct are clearly prohibited and will be further explored in this course. While most professionals might agree that having other, non-sexual, relationships, such as a friendship with a current clinical client is inappropriate, the rules are not as clear regarding ex-clients and even less so for those clients in case management, community action, or other non-clinical relationships. When a dual relationship results in personal benefit to the practitioner, it also undermines the trusting relationship. Some of the scenarios mentioned earlier (getting property below market value, becoming the executor of the client’s will, and referring clients to a relative) are examples. There are very respectful, sound, and appropriate reasons for encouraging clients to share what they know and to listen to their strengths. Benefiting from information the client has (e.g., stock tips and leads on jobs) is another matter. It is important to remember that this can apply both ways, i.e., the mental health professional needs to avoid offering assistance in areas outside his or her role. According to Reid, 1999: Your usefulness to your patients lies in your clinical skills and separation of your professional role from other roles which would be better filled elsewhere in their lives. Do not suggest, recommend, or even inform the patient about such things as investments, and be cautious about giving direct advice on such topics as employment and relationships. There is a difference between eliciting thoughts and feelings to encourage good decision making and inappropriately influencing those decisions.
● Essential to service provision. ● Negotiated without coercion.
● Entered into at the client’s initiative, and ● Done with the client’s informed consent.
Again, the professional is in the unenviable position of determining whether an action presents the possibility of psychological harm to the client. Kissing on the cheek, for example, may be perfectly correct, and clearly non-sexual, in certain cultures and contexts, but may confuse or intimidate a client in other contexts. Another area fraught with peril is when workers engage in behavior arising from their own emotional needs. Most mental health practitioners are more familiar with examples of intentional and even more egregious examples such as the practitioner who uses undue influence to “convert” the client or takes sides in a custody case in order to foster a relationship with one of the spouses. Many times boundaries are crossed unintentionally, as when a practitioner becomes overly involved in a case with which she personally identifies. Or the worker may be experiencing life issues that make him or her more vulnerable to the attentions of a client. Mental health professionals have a responsibility to maintain competence in both the professional and emotional arenas. Regardless of the circumstances, the worker’s first responsibility is always to the client.
EliteLearning.com/Social-Work
Book Code: SWTX1525
Page 90
Powered by FlippingBook