Boundary Violations By Evelyn Stone, RN., BSN., M.Ed.

Countertransference  Reaction of staff loving, caring, hostility, hatred or anxiety  Reflect problems experienced in the past with clients from the past

Forms of Countertransference  Trying to help a client with matter that does not relate to the goals  Personal or social involvement with client  Trying to “Push” a client before he/she is ready  Dreaming about client  Preoccupied with client

What Is Boundary  Going outside the line of a therapeutic relationship  Doing something special for a client  Doing something different for a client

Boundary Violations  Taking a client to lunch or dinner  Professional relationship turning into a social relationship  Revealing personal information to a client  Client introduces staff member to family for the purpose of a social relationship  Client gives staff an expensive gift  Staff does business or purchase services from client

Violations (continued)  Staff routinely hugs a client  Has physical contact with client  Staff accepts free gifts from client’s business  Sexual contact with a client  Staff attends social functions of the client

(continued)  Need to defend actions with client

Therapeutic Alliance  Staff assume responsibility of behavior  The reason behind this behavior  Know the laws  Client exploitation  Sexual exploitation

Conclusion  Do not cross the “line”  Know the goals of the client  Focus on the treatment  Know the consequences for crossing the line

SERVICES  Nurse Assistant Course  Mental Health Hab Tech Course  Medication Aide  Medication Administration  Clients’ Rights  Confidentiality  Documentation

SERVICES (continued)  Medication Administration  Care of the Behaviorally Challenged  Developmental Disabilities  Client Admission  Blood Borne Pathogens  Policy Manuals