How Close Is Too Close For Therapists And Clients?

[Rose White]

There are boundaries in the...relationship, but it is more laid back and open. Without the opportunity to have that kind of a relationship with a therapist, I would never be able to develop trust and I likely would be dead by this point.

This is frankly terrifying, but I appreciate your honesty, no matter how vulnerable it makes me feel.

This plays to my fear that somehow I’m not the special one. I’m not the one who gets the extra 20 minutes or the privilege of texting between sessions. That others are getting the special treatment that I feel I need so badly.

My antidote is to challenge the rescue fantasy. Ask myself what do I need that I’m not getting? How can I get it? Am I reaching out to people in my circles? Could I push myself to try something new? Am I telling my T how grateful I am during the time I spend with her?

 

[Stephernovas]

While I agree that all professionals (and not just healthcare professionals) should have boundaries, I disagree that they should all be the same with each patient/client all of the time. I've been a charge nurse on a psychiatric unit. That unit was divided into "secure" - for the patients who needed to be more closely watched - and "open." It was common to spend 30 or more min with a patient on the secure unit and a little less with one on the open unit. The former required more individual time and attention, whereas the latter often engaged in more group activities

Yes, but that is common practice. It is a recognized therapeutically beneficial for the patient/client. Would you text said client while you were out grocery shopping with your kids? Or out to dinner with friends? The answer is no. What you are describing is a requirement of your position. As well, these individuals are on a unit. Of course you are going to spend varying times with each of the patients on under your care - but that is while you are on the clock!

 

[whiteraven]

Yes, but that is common practice. It is a recognized therapeutically beneficial for the patient/cl...

The reason I brought this - specifically - up was because you said:

In a helping profession, you need clear boundaries. There are many risks, including favouritism. If you do something for one client, it’s hypocritical and unprofessional to not treat the other the same. As well, considering the clients state, blurring/crossing boundaries can cause more harm than good. Regardless of what helping profession (nurse, doctor, therapist), you need boundaries

Because of what you say here and because it followed a discussion about nurses, I understood you to mean that it doesn't matter what helping profession you are in; that you have to treat everyone the same. I disagree with that - generally - but specifically here from a nursing standpoint. That's where my comment came in.

I don't believe you can compare a nurse on a psych unit to a psychologist/psychiatrist/or social worker in private practice. It's apples and oranges.

This plays to my fear that somehow I’m not the special one. I’m not the one who gets the extra 20 minutes or the privilege of texting between sessions. That others are getting the special treatment that I feel I need so badly.

Except that I think my therapist likely treats all of his clients this way. He has a very small practice (he does a lot of other stuff) and has the time and inclination to provide that for the people he works with who need or desire it.

Not all therapists do this. And if yours doesn't and you need that, you need more, you owe it to yourself to find someone who does.

Or did I miss your point?

 

[Rose White]

Except that I think my therapist likely treats all of his clients this way.

Ok, I see it now, that’s just his style, and in your original post you were comparing him to the previous T with a much more “walled off” approach.

I think a therapist should have the same boundaries with everyone, and if there are exceptions I would expect them to be well justified.