Setting Boundaries (Chapter 6)

Leaving It At The Office

Boundary / Therapeutic frame	A limit or territory that is not to be violated; the safe and predictable environment set for the patient to work and for the therapist to render effective care that is put in place through boundary setting
Overwork	Working beyond our capacity; often driven by our need for appreciate, and a desire to be liked and admired; a curse and a badge of honor
Therapist self-abuse	Short-lived boundary commitments by a therapist. Devising boundary limitations that are difficult to implement and breaking them. Examples are scheduling too many clients in one day or letting clients consistently run over the allotted session time

Define your role as the therapist and the role of the client. A psychotherapist must utilize self-awareness in order to understand one’s own strengths and weaknesses. This self-awareness allows each of us the ability to set our own boundaries, such as how many hours we will work. We are socialized to work beyond capacity, to the point that we aren’t doing the work well. The authors suggest we aim for under capacity in order to accommodate for self-care and the unexpected. Understanding and defining your role as the therapist and the role of the client allows for better decision-making and adherence to boundaries. Are you overworking already?

Setting boundaries allows us to prevent work life from creeping into our personal life. This is necessary to prevent burnout. If we constantly let appointments go over, work outside of scheduled hours, skip lunch to see a client, or allow patients to call you outside of working hours for non-emergencies, then burnout is much more likely. Very interesting research about boundaries with healthcare workers during the pandemic has also been published.
Establishing and communicating boundaries will help both the therapist and the client. Embrace boundaries that are easy to implement. Devise measurable, attainable, and reasonable goals.

Decline to treat certain clients and learn to say no to clients, referral sources, agencies, and administrators. Allow yourself to become a responsible assertive therapist. How have you been able to practice saying no/being assertive within your practicum settings?

Although we are unable to share the specifics of our day to day work with family and friends due to confidentiality, we can still engage with them in other ways throughout the day. Scheduling lunch appointments or visits with family and friends during the work day or having telephone conversations with them can bridge the gap. These relationships can help ground us when we are facing challenges with our work.

Clarifying the relationships that exist among colleagues is also an important aspect of boundary setting. Maintaining boundaries with colleagues and avoiding the blurring of relationships can help us to avoid the complexities related to boundaries and expectations.

Keep clinical work at the office. Avoid bringing work home or talking about what’s happening with clinical work with family or other people outside of work. This can be essential in maintaining distance between personal and professional life. How realistic is this? Do you think you would adopt this easily or face challenges with this?

When unable to completely delineate between personal and professional lives, boundaries will play a huge role in maintaining balance. By embracing personal activities that are outside of the psychotherapist role, there can be a better distinction between the two roles. This includes trying to have friends outside of the profession.