Welcome to Shaping Success, a series where we introduce and explain the importance of a work-related topic that helps promote success at Circle of Care.
In this edition, we’re going to cover the topic of Therapeutic Boundaries.
Knowing Where to Draw the Line
Note that the names have been changed in this story.
Karen has been Benjamin’s PSW for five years. Over time, they have built a close relationship. Benjamin, who often feels lonely, really appreciates Karen’s visits. After a difficult hospital stay, he handed her an envelope with $300, saying it was a thank you gift for her support during his recovery. Karen wasn’t sure what to do, but accepted the money so she wouldn’t offend him.
Later, Benjamin gave her more gifts—jewelry, gift cards, and even a tablet. He also invited her to his 79th birthday party. Karen felt honoured and went to the party on her day off.
Even though Karen meant well, she crossed professional boundaries. PSWs should not accept gifts or attend personal events with clients. This can lead to problems, such as feeling pressured to say yes to future client requests, showing favouritism, or making other clients feel like they’re being treated differently. It can also make it harder to stay professional and objective.
Keeping clear boundaries helps protect both the client and the PSW—and makes sure care stays fair and respectful for everyone.
Expectations for You
It is important that you maintain a professional therapeutic relationship with each of your clients and ensure that no boundaries are crossed. A therapeutic relationship is the professional relationship that is established and maintained between a healthcare professional (i.e. PSW) and the client. It is NOT a social or personal relationship.
At no point in an employee-client relationship should you engage in any of the following activities:
- Physical, emotional, sexual, or financial abuse or harassment
- Exploit the employee-client relationship
- Use intimidation tactics and/or making threats
- Invite, accept or offer gifts (refer to the no gift policy for details)
- Spend off-duty time with the client
- Use of photography, video recording, voice recordings etc. without client consent and manager permission
- Perform services that are not outlined in the plan of care without manager permission.
- Ignore agency policies and procedures when working with a client.
When to Reach out to Your CSS
If you experience any of these signs or see them with other colleagues, please seek assistance from your CSS:
- Spending extra time/off duty with client beyond therapeutic needs
- Feeling other team members do not understand the client as well as you do
- Disclosing your personal information/Giving client your personal contact information
- Dressing differently when seeing a client
- Frequently thinking about the client when away from work
- Feeling guarded or defensive when someone questions your interactions with the client
- Ignoring Circle of Care’s policies when working with the client
- Keeping secrets with the client
- If client is only willing to speak/work with you and refuse to speak/work with other PSWs.
Please refer to our Therapeutic Relationships Policy for more information.
What Should Karen Have Done?
In the situation above, Karen should have politely declined the money and gifts and explained her professional boundaries. She could have thanked Benjamin for the kind gesture and respectfully explained that Circle of Care’s policy and professional ethics do not allow her to accept gifts or financial tokens from clients. Karen should have informed her CSS as soon as Benjamin offered her money or invited her to his birthday party. Her CSS would have been able to provide guidance and intervene early to prevent boundary issues. It is likely that Karen would need to consistently reinforce the professional role she plays in Benjamin’s life, to make sure that they both avoid behaviour that blurs personal and professional lines.