Confidentiality Boundaries

The essay sample on Confidentiality Boundaries dwells on its problems, providing shortened but comprehensive overview of basic facts and arguments related to it. To read the essay, scroll down.

Boundaries not only reflect a need for physical space, but, our core values, self respect and our need for safety and protection. They are invisible lines that differentiate people from each other. The different forms or types of boundaries include physical, emotional, spiritual, financial, and relational. The formation of boundaries in Counselling, or a helping interaction, is very important.

Helping interactions provide people with an opportunity to help deal with their difficulties, whatever they may be. It is a chance to be listened to and understood. As such, the helping relationship is an intimate one.

It is built around trust and support and offers the helpee (client), a place free from judgment. Within a helping interaction where both the helpee and helper (counsellor) are committed to the healing process, the helpee will often divulge information of a very personal nature.

Owing to this, the helper must establish boundaries to maintain a secure working alliance and ensure that the helpee’s needs are met. Without appropriate boundaries problems such as favouritism, exploitation and ineffective counselling may arise. Boundaries in Counselling define the “therapeutic frame. They distinguish helping interactions, from social, familial, sexual, business and many other types of relationships. According to Wosket (1999), they refer to the expectations of how counsellors/helpers should conduct themselves. Professional bodies, training, and literature on good practice shape a counsellor’s/helper’s code of conduct by explicitly or implicitly setting out required and disallowed forms of involvement.

Get quality help now

KarrieWrites

Verified

Proficient in: Human Nature

5 (339)

“ KarrieWrites did such a phenomenal job on this assignment! He completed it prior to its deadline and was thorough and informative. ”

+84 relevant experts are online

Hire writer

Some boundaries are drawn around the therapeutic relationships and include concerns with time and place of sessions, fees and confidentiality or privacy.

What Is A Helping Relationship

Boundaries of another sort are drawn between helpers and helpees rather than around them and include helpers’ self-disclosure, physical contact (i. e. , touch), giving and receiving gifts, contact outside of the normal therapy session and proximity of helper and helpee during sessions. Boundaries should be discussed and agreed upon with a helpee from the onset of therapy. During skills practice, as a trainee counsellor (helpee), I work within a structured framework that is defined by the boundaries I establish.

At the beginning of every session, I establish a contract with my helpee, in which I set out the boundaries of the session. I begin by introducing myself and stating my limits as a trainee counsellor. I then state that I abide by code of ethics set out by the British Association of Counselling and Psychotherapy (BACP), which, dictates my conduct as a helpee. Following this, I set the boundary regarding confidentiality by assuring the helpee that all information will be kept confidential except in instances where self harm or harm to another is mentioned.

I make clear to the helpee that I am bound to report such information. On the issue of confidentiality, I further state that while I take my helpees’ stories to my supervision I do not take their names. Before beginning the session, I also set the boundary regarding the duration of the session. I make the contract user centred by checking whether the helpee agrees to and understands the boundaries set out in the contract. I believe that engaging the helpee in the contracting process is important as it gives a sense of security to the helpee and brings professionalism to the sessions.

Establishing boundaries within a helping interaction can take time and effort, but ultimately I feel that is a significant factor in bringing about therapeutic change in a client. This is because by setting boundaries, particularly concerning confidentiality, the helper creates a space in which the helpee truly feels safe. This allows a helpee to discuss events or problems that he might not have, had the helper not stated that the information would be kept confidential. For example, during skills practice, initially, those taking on the role of helpees would use ‘scenarios’ or ‘made-up’ problems.

However, the repeated emphasis on confidentiality fostered a sense of trust, which in turn has now allowed us to feel comfortable enough to address real/personal issues. Thus, boundaries allow the explorative process to continue. As the helpee may be not used to this kind of framework and unaware of the importance of keeping the limits, it becomes helper’s responsibility to set up and manage the boundaries as well as to recognize the dilemmas that are inherent within them. The agreement on the boundaries concerning therapeutic relationship is beneficial for both the helpee and helper.

Boundaries preserve the therapeutic relationship by ensuring that a helper understands the need to and can keep separate his personal and professional life. Counsellors, or helpers who are able to maintain healthy boundaries do not carry the problems of their clients around with them during leisure hours. They know how to say no, which allows them to keep a balance in their lives. A helper that takes care of himself and knows where to draw the line is in a position to provide a higher standard of service to his helpees, than a helper who blurs the boundaries between personal and professional relationships and feels overwhelmed as a result.

Moreover, by making the distinction between a therapeutic relationship and social relationships, a helper is able to retain a level of objectivity that a friend would struggle with if you went to him with a problem. Your friend may have a stake in the outcome of your problems that a helper will not have. If the boundary is broken or blurred, and for example, the helper and helpee meet for coffee, the relationship is compromised. The helping interaction becomes ineffective because helper will more than likely allow his views and feeling to affect the direction of the session.

Therefore, boundaries are imperative for the counseling to be effective. Maintaining healthy boundaries protects the helper from being overwhelmed and avoiding work because the helper does not know what to do. For example, when I go over the contract with the helpee during skills practice, I state the limits of my capacity by identifying that I am a trainee counsellor. Supervision is also invaluable in supporting a helpee’s work. Sometimes a helpee may be referred to another support agency. This may happen if the helper acknowledges that the client can get better help elsewhere or if boundaries are broken.

Helpers do not have all the answers and they should never imply that they do. Related to the notion of understanding one’s limits, is an understanding and awareness of the role of a helper. Helper’s will work towards self-awareness and help promote change, but cannot tell a helpee what to do. Helpees are regarded as experts in their own life and capable of making decisions. As a helper, during skills practice I use techniques like reflecting, paraphrasing and questioning to broaden a helpee’s perspective and propel the explorative process.

However, I always keep in mind that it is not my role to solve the helpee’s problem for him, and am careful not to overstep my bounds. A helpee should always feel safe in a helping relationship. There should not be any untoward touching, or interaction that the helpee feels is inappropriate. Related to the idea of safety, is the notion of time keeping. Time boundaries relate to the helpee’s knowledge of the precise time and duration of the sessions. During skills practice, I work within a predetermined time frame, and make sure to end the session on time.

Maintaining the time boundary is important because the helper is seen as someone trustworthy and reliable. Being late for a session can give an impression of lack of respect for the helpee, and it can create anxiety in the helpee who may begin to doubt the helper’s reliability and in turn the benefit of the help offered. Time boundaries often give the client a sense of stability and certainty. As the helpee is informed of how much time remains in the session he is able to decide whether to disclose a particular concern at that given time.

Another important issue that requires establishing a boundary within helping interactions is the question of payment for sessions. It is essential to have clear agreement prior to commencing, about the amount and the form of payment. This avoids unnecessary anxiety and misunderstandings. According to Farrell (1999), treating the client as willing and being able to pay for the therapy maintains a ’visible respect’ for the helpee and the counselling process. The helpee is also more likely to attend the sessions, get involved in the threpeutic process, and even challenge the helper.

This is because the fee puts the helpee and helpee on a much more equal footing than would be possible if the sessions were free. As I pointed out earlier, setting up boundaries around confidentiality is important in maintaining trust and respect for the helpee. Confidentiality within a helping interaction cannot be always absolute. The guarantee of confidentiality from the helper has limitations, and these are discussed with the helpee at the beginning of the therapy.

Situations where confidentiality has to be broken include: potential danger to others, physical or sexual abuse of a child, reports presented to legal institutions such as courts, in cases where the helpee is on probation or released on bail, and information which appears crucial to the medical condition of the client, or when information is used for the purpose of ongoing supervision of the counsellor. It is essential to discuss openly and honestly the ongoing aspects of confidentiality and ensuing solutions.

Regardless of the consequences of such openness, the helpee must be treated with respect and trust, and empowered to make his own decisions in light of the helpee sharing such concerns. The quality of therapeutic relationship has an important influence on healing process for the client. Although the therapeutic relationship is characterized by equality, management of the boundaries is a part of counsellor’s responsibility. Wosket (1999) believes that “rules can limit the therapeutic effectiveness even that they also importantly define the boundaries of safe practice” (p. 33). Because of that boundaries are often transgressed by the counsellors, however there is a difference between crossing and violating the boundary. Boundary crossing means departing from the normally accepted therapeutic work conditions which does not have negative effect on the client but can be beneficial for her/him. The violation of the boundaries in counselling process occurs when the counsellor acts to satisfy her/his own needs or wishes (even unconsciously) rather than respecting the client’s needs and providing him/her with secure environment.

It is crucial for the counsellor to be aware of the danger of violating the boundaries as well as of his/her own difficulties in maintaining effective boundaries. These problems can be discussed and closer looked at with another therapist during the supervision. Every boundary which is set up should also be explained and discussed with the client and in certain circumstances can be negotiated (time, payment). Bearing these as an attitude in setting up and maintaining boundaries can bring positive outcome of therapeutic work as well as guarantee safety in counselling work.