This toolkit on professional boundaries provides information about professional boundaries and tools to support maintaining professional boundaries in the provision of care. (A printable copy of this page can be found below.)
Establishing and maintaining professional boundaries is fundamental to a safe and therapeutic environment for people receiving services.[i] While boundary crossing is clear when acts of an aggressive, sexual or verbally abusive nature occur, other behaviors that may be perceived as “helpful” and “supportive” may also cross professional boundaries and contradict the goals of the care environment.
Relationships between staff and people receiving services are complex. Staff are often relied upon to assist people in their care in many personal areas of their life including activities of daily living, personal development, learning life skills and medical care. Staff may also have access to sensitive and personal information about people receiving services. Training on professional boundaries and ongoing coaching and support can help staff understand the vulnerabilities of people in care, and to effectively manage their care giving relationships for the good of both parties.[ii]
Establishing agency culture and conditions that promote appropriate workplace boundaries reduces the risk of mistreatment and improves quality of care. Maintaining professional relationships requires being person-centered, self-aware and following professional ethical standards.
The information provided in this toolkit will help educate people receiving services, self-advocates, direct care providers, agency administrators, friends and family members on the importance of professional boundaries in the provision of care.
Additional information including a continuum of professional behavior, best practices, red flag behaviors, and tips on reporting misconduct are available for download. Look for the Protecting Professional Boundaries article in the toolkit below.
These case studies, involving fictitious victims, represent a collection of facts identified from multiple Justice Center investigations and are used for illustrative purposes only to aid in staff training. The case studies below present a variety of examples of boundary problems with a range in severity of actions and potential consequences.
A 16-year-old boy, Brandon, has recently been discharged from a residential treatment facility. Brandon’s parents are very grateful for the work the clinician, Matt, did to help stabilize their son and return him to their care. Matt went above and beyond for Brandon on more than one occasion, spending extra time with Brandon to help him feel comfortable attending groups and providing additional one-to-one support during transitions. When Brandon was discharged, his parents brought Matt cupcakes and a card. After they leave, Matt finds a $50 gift card was included in the envelope. Matt does not report this to his supervisor and uses the gift card. Later, Brandon has another crisis and his parents reach out to Matt directly to see if Matt can help get Brandon re-admitted. Matt explains that he cannot help in this situation because he is not in charge of admissions. Brandon’s parents are upset about Matt’s response and repeatedly call Matt and leave him voicemails at all times of the day and night.
- Matt spent extra time with Brandon
- Matt received a monetary gift and did not report it to his supervisor
- Matt accepted the gift and did not return it to the family
- The family became upset when they were not given preferential treatment
Potential Risks and Harmful Outcomes
- Trust is damaged
- Compromised clinical ethical standards and agency policy
- Compromised care of other individuals receiving services
Additional case studies are available for download in the Toolkit below. Look for Could This Happen In Your Program.
What You Can Do
Partners in Prevention: What You Can Do
Remember: We all play a role in establishing and maintaining healthy boundaries.
|People receiving services, Advocates, Families & Friends
|Establish a mission statement that emphasizes a commitment to a safe and therapeutic environment.
|Demonstrate that your position includes being a role model by maintaining professional boundaries with co-workers and people in care.
|Learn the agency’s policies and practices on how staff are to develop and sustain professional boundaries.
|Ensure that informed consent for treatment has been obtained.
|Always remain aware of your profession’s code of ethics and the Justice Center Code of Conduct.
|Participate in programming and treatment to learn how to use healthy boundaries in a variety of situations.
|Provide training to all staff on professional and therapeutic relationships and trauma informed care.
|Build a strong personal support system that includes professionals, supervisors and others who share your ethical standards of maintaining healthy boundaries.
|Where possible, request and review agency policies regarding the use of social media and how social media can impact boundaries.
|Provide clear policies and direction to all staff on the use of social media at or about work.
|Attend training on trauma informed care.
|Become educated about personal boundaries regarding your relationships with staff.
|Provide training for people in care on professional boundaries.
|Be aware of warning signs of crossing boundaries.
|Speak up or ask someone to speak for you if you feel someone has crossed your boundaries.
|Set clear expectations that it is always staffs’ responsibility to use professional boundaries.
|Do not allow personal bias to interfere with a person in care practicing their religion, faith, spiritual and cultural beliefs.
|Develop policies and practices to address violations of professional boundaries.
Printable resources for individuals receiving services, guardians, agencies, staff members, and advocates.
Tips for providers in establishing a professional boundary policy.
Tips for providers in establishing a social media policy and establishing training for social media use.
Protecting Professional Boundaries Fact Sheet for People Receiving Services, Advocates, Families and Friends
A fact sheet for people receiving services, advocates, families and friends.
A fact sheet for provider agencies.
A fact sheet for staff.