Course Code: OCCU 5003
Institution: Dalhousie University
Professional Boundaries: Definition and importance in therapeutic relationships.
Boundary Crossings / Violations: Differentiation between crossing and violation.
Standards for Maintaining Professional Boundaries: Regulations therapists must follow.
Testing / Relaxing Boundaries: Guidelines on approaches to boundaries.
Preventing Boundary Violations: Strategic measures to safeguard against violations.
E1: Adherence to legislative and regulatory requirements.
Accountability for Decisions: E1.7 - Responsibility for actions taken in practice.
Reporting Unprofessional Behavior: E1.8 - Obligation to respond to unethical conduct.
Respect for Boundaries: E1.9 - Commitment to maintaining boundaries.
Boundary Definition: A demarcation that separates professional relationships with clients from personal ones.
Definition: Occurs when a therapist engages in behavior that compromises the therapeutic relationship.
Factors: Client's vulnerability increases the risk of boundary crossing.
Consequences: Such crossings can destabilize the relationship and tilt power balance towards the therapist.
Definition: Transition from a professional to a personal relationship, fundamentally breaching ethical practice.
Transparency and Ethics: Foster client relationships ethically and with respect for diversity.
Responsibility: Therapists must maintain boundaries at all times.
Understanding Transference: Recognize and manage emotional dynamics that can affect relationships.
Anticipation of Relationship Changes: Be vigilant of shifts in dynamics indicating boundary concerns.
Self-Monitoring: Reflect on actions during therapeutic interactions.
Client Consent: Not a shield against boundary violations; violations must be managed regardless of consent.
Family Relations: Avoid treating family members or those with personal relationships to maintain objectivity.
Past Clients: Set time limits before establishing personal ties with former clients to prevent dependency issues.
Relationships with Students and Subordinates: Apply the same boundary principles.
Trust and Authority: Inducement of behavior through abuse of professional trust (Criminal Code of Canada).
Forms of Misconduct:
Sexual intercourse or relations with clients.
Inappropriate touching.
Sexual remarks towards clients.
Awareness: Understand and identify signs of potential misconduct.
Action: Proactively address and prevent situations leading to misconduct.
Roles and Responsibilities: Clear definitions of professional roles.
Cultural Humility: Respect cultural differences within the therapeutic space.
Behavior Monitoring: Address unacceptable behaviors promptly.
Confidentiality and Environment: Maintain confidentiality, pay attention to the context of services.
Timing and Touch: Reflect on practices like self-disclosure and physical touch; use judiciously.
Guiding Questions:
Does altering boundaries breach conduct?
Can this situation be documented?
Am I treating this client preferentially?
Are my motives personal rather than client-focused?
What are the potential consequences?
Would I be comfortable discussing this with colleagues?
Examples Include:
Requesting personal information.
Inappropriate gift-giving.
Inviting interactions beyond therapy (e.g., social activities).
Over-familiar behavior.
Ignoring previously established boundaries.
Utilize Resources: Consult professional guidelines and regulate accordingly.
Create Safe Environments: Ensure the setting counters risks of boundary issues.
Peer Consultation: Discuss boundary dilemmas with colleagues for varied perspectives.
Clear Communication: Avoid ambiguous language and messages.
Scenario 1: OT attending a facility barbecue, contemplating bringing children. Considerations of appropriateness in professional context.
Scenario 2: OT engages with a client’s family during hospital visits amidst sensitive health issues. Caution against overstepping boundary due to personal rapport.
Boundary Management: Vigilance in recognizing and maintaining professional boundaries is crucial.
Responsibility: It is a professional's duty to safeguard against breaches and to address them immediately if they arise.
Protective Framework: Professional boundaries are essential frameworks that serve to protect both therapists and clients, necessitating proactive management to minimize risks.