How To Set Healthy Therapeutic Boundaries With Clients

Across a variety of interpersonal situations, boundaries can help protect the well-being of all parties and contribute to the positive health of a relationship. This is true in professional scenarios too, including during sessions between a therapist and their client(s). Clear, appropriate boundaries in this type of setting can not only help establish the best possible environment for client care but also safeguard the well-being of the mental health professional administering it. See below for information on why boundaries are important in therapy plus advice on what kinds of healthy limits to set with your clients.

Sometimes, boundaries aren’t enough to prevent burnout

Get emotional support in therapy

Why are boundaries important in therapy?

As a mental health care provider, you know that boundaries are parameters an individual sets for how they prefer others to interact with them. While you may routinely help support clients in setting boundaries in their own personal lives, remember that setting some with the client yourself is usually important as well.

Psychological literature emphasizes that boundaries can serve as a way to clearly define the roles of participants in the therapeutic process. When applied effectively, therapeutic boundaries can foster a sense of safety for clients, ensuring that practitioners act in the best interests of those they treat. Well-established boundaries can also help therapists feel more comfortable and lower the risks of certain challenges associated with this type of work, such as burnout.

Three tips for creating healthy therapeutic boundaries

There are various angles to consider when setting boundaries with your clients. The following are a few important tips that could help you in this process.

1. Set clear guidelines for care

It can be beneficial to establish rules around your counseling relationship and services early on with clients. Some guidelines will involve filling out forms, such as those related to informed consent regarding the type of treatment the client is to receive.

Outside of those set by law or governing bodies, the rules you create will be entirely up to you (or the organization you are affiliated with). Some potential areas to cover may include:

• How and when clients can reach you. Setting your hours can be an effective way to maintain a healthy work-life balance. First, let clients know when it is appropriate to contact you. You may also want to let them know how you do and do not prefer to be contacted, especially outside of normal business hours—such as emails versus texts or phone calls, or contacting the receptionist at your office instead of your direct line.
• Session duration. How long therapeutic sessions will be is another essential guideline to set ahead of time. A single therapy session will typically last anywhere from 45 minutes to one hour, though it can vary depending on the type of therapy. Letting clients know that these time frames are fixed and then enforcing that boundary can help ensure everyone knows what to expect from a session.
• Cost and payment methods. It's important to clearly communicate the cost of sessions with clients before they begin treatment. If you offer a sliding scale or discounts or accept health insurance, be clear about the parameters and procedures for these ahead of time as well. 

2. Maintain an appropriate therapist-client relationship

Another vital type of boundary to set is around your relationship with your clients. In general, it should remain professional and consensual at all times. For example, one area to handle very carefully is the topic of physical touch. While some may appreciate occasional gestures like a hug or a touch on the shoulder from their therapist during particularly challenging sessions, you should not assume that any type of touch will be welcomed by your client. Gaining explicit consent before any type of physical interaction (and consenting to it yourself as well) is a must.

Note also that some types of contact are never appropriate between therapists and clients, even with consent. The most prominent example of this is touch associated with a romantic or sexual relationship. The American Psychological Association (APA) ethics code prohibits providers from engaging in romantic or sexual intimacy with current clients or patients or their client’s close relatives, guardians, or significant others. Violating these guidelines can result in the loss of inclusion in the APA organization and sanctions on the offending party. 

In general, the APA warns against the formation of any multiple relationships between therapist and client—for example, when the psychologist is in a professional role while simultaneously:

1. Occupying another role with a client
2. Being in a relationship with a person closely associated with or related to a client
3. Promising to enter into another relationship in the future with a client or a person closely associated with a client

These relationships—which could be anything from a romantic connection to a business partnership—can impair a therapist’s ability to be objective and can make it difficult for them to effectively provide care. Multiple relationships also carry a risk of exploitation or harm for clients.

3. Avoid excessive self-d*sclosure

In relation to the mental health field, self-d*sclosure is when a provider gives out personal details about themselves with their patients or clients. Of course, a certain amount of self-d*sclosure may be unavoidable and could even promote trust in a therapeutic relationship. However, sharing too many details could be harmful. It may damage the professional relationship between you and your client, distract the client from their own challenges, and reduce the efficacy of therapeutic sessions. It could also lead a client to ask further questions, which might make you uncomfortable.

To reap the benefits and avoid the risks, it may be helpful to keep self-d*sclosure instances brief and relevant to the subject at hand. If you believe that certain, limited information may help your client and you are comfortable sharing it, you may decide to do so. Just make sure to have clear boundaries set on this topic ahead of time and be ready to respectfully say so when you don’t feel comfortable discussing a particular subject. 

Find emotional support for professional challenges

Even with the right boundaries in place, working as a therapist can come with a variety of challenges that may be difficult to manage alone. Demand for mental health care is increasing, and the APA reports that burnout among mental health professionals is high. Left unchecked, the stress associated with overwork may make it difficult to provide effective care and could also negatively impact your own health and well-being. Meeting with a therapist yourself is one way to address the challenges you may be facing, as they can help you find effective ways to establish boundaries at work and support you in developing healthy coping skills for stress. 

Sometimes, boundaries aren’t enough to prevent burnout

Get emotional support in therapy

However, if you’re feeling overwhelmed and stressed with your job, finding time to commute to and from in-person therapy appointments for yourself might seem impossible. That’s where an online therapy platform like BetterHelp can be an especially helpful option. You can get matched with a licensed provider who you can meet with via phone, video call, and/or in-app messaging from anywhere you have an internet connection. Research suggests that there’s generally no difference in efficacy between in-person and online therapy in most situations, so you can typically choose the format that works best for you.

Takeaway

Creating therapeutic boundaries can help mental health care providers maintain their personal well-being while ensuring their clients receive the best support possible. Examples of therapeutic boundaries include setting clear guidelines for care and staying within the definitions of a professional therapist-client relationship. If you're looking for support in establishing boundaries, coping with burnout, or addressing other mental health challenges of your own, meeting with a therapist yourself could be helpful.