Importance Of Boundary Boundaries

A boundary is defined as “the edge of appropriate, professional conduct” that differentiates between behaviour that is appropriate in a professional capacity, and behaviour that is not (Guthiel, 2005, p. 89; Allen, 2001). Boundary issues may arise around the professional external boundaries that are set including role issues, time, place, money, and physical and sexual contact, among other things which may result in boundary crossing (Guthiel, 2005). For most clients, a customary therapeutic relationship developed around these boundaries is all that is required; but others, mostly the more disturbed clients, require engagement that goes beyond the standard model (Waldinger, 1994). Boundaries then become difficult to define as it is not possible

Boundary crossings are deviations from the traditional framework of therapy that can be neutral in nature, potentially support therapy, or potentially harmful (Pope & Keith-Spiegel, 2008). A boundary violation is a deviation from the framework that is clearly harmful to the client (Waldinger, 1994). While from an analytical point of view all boundary crossings are detrimental, cases have demonstrated that not all behaviour that crosses traditional psychotherapy boundaries necessarily represents misuse of therapeutic techniques or misconduct in the therapeutic setting (Zur, 2004; Allen, 2001). The distinction between a boundary crossing and a boundary violation is difficult to make in a conceptual vacuum and may only be evident when an intervention is understood within the context of an ongoing treatment relationship and the clinical judgement made by the therapist in arriving at that intervention is understood (Waldinger, 1994; Pope & Keith-Spiegel, 2008). Consequently, boundary issues should always be considered within context. While one cannot finitely predict the eventual outcome of a boundary crossing, if it is implemented with the welfare of the client and therapeutic effectiveness in mind, it can in fact support therapy (Allen, 2001; Zur,

Boundaries are fundamental in providing a safe foundation for the therapeutic alliance that is critical to, and the best predictor of, the successful outcome of therapy (Speight, 2011; Smith & Fitzpatrick, 1995). Boundary crossing evokes potential for misalliance. There is a one-way power dynamic that naturally develops in favour of the therapist as a result of how the therapeutic relationship functions which denotes more serious consequences for the client should the therapist engage in negligent practice and harmful boundary crossing (Smith & Fitzpatrick, 1995; Simon, 1992). This includes anger, loss of self-esteem, depression, and other psychological distress experienced by the emotionally vulnerable client; and can also result in distrust of professionals when the integrity of a relationship is not preserved (Schoener, 1998; Aravind, Krishnaram & Thasneem, 2012). The result of a harmful boundary crossing could be a missed diagnosis, the use of an inappropriate technique, or the worsening of the original psychiatric condition; all of which could lead to premature termination which of course is far from beneficial for the client and