1 Boundaries Highly personal translations of moral codes in our - PDF document

Up Close and Personal Navigating Personal Boundaries in Day to Day Support Presentation developed by Marianne Simpson, Community Consultant Regional Support Associates Up Close and Personal, Marianne Simpson DSW, BA Up Close and Personal, Marianne Simpson DSW, BA Goals for Today  Stimulate thought and discussion about boundary issues.  Promote improved ethical practice. Up Close and Personal, Marianne Simpson DSW, BA 1

Boundaries  Highly personal translations of moral codes in our relationships with each other.  They are intrinsically neither negative or positive.  They exist in all relationships expressed overtly or covertly by symbols and behaviour. – Bervera & Harper, 1992 Up Close and Personal, Marianne Simpson DSW, BA Boundaries  Boundaries define formally and informally how professionals are to exercise their power inside the relationship. - Peterson 1992  Two staff may subscribe to the same ethical codes yet have very different boundaries in their relationships. The very nature of some community support work demands shifting relationship boundaries and constant evaluation of the appropriateness of established boundaries. – Curtis & Hodge 1994 Up Close and Personal, Marianne Simpson DSW, BA Violating Boundaries  Serious deviation from professional behaviour is a Boundary Violation. Boundary violations are actions that could bring significant harm to patients, staff or the agency as a whole. – Morton 2004 Up Close and Personal, Marianne Simpson DSW, BA 2

Crossing Boundaries  Grey areas of decision making are recognized, and non-therapeutic behaviours, which are sometimes immediately evident, are considered boundary crossings. – Morton 2004 Up Close and Personal, Marianne Simpson DSW, BA Situations  Why I am interested in this?  Situations I have encountered.  Situate yourself.  Acknowledge, accept, consider, learn and change. Up Close and Personal, Marianne Simpson DSW, BA Considerations  Remembering perceptions of power  Reciprocity  Liability  We come and go in people’s lives  We are paid  Cultural Up Close and Personal, Marianne Simpson DSW, BA 3

Free Hugs Up Close and Personal, Marianne Simpson DSW, BA Complications  Age of technology  Societal expectations  Employer expectations  Community connections  Work/Life Balance  Generosity of the human spirit Up Close and Personal, Marianne Simpson DSW, BA Our Roles  We care.  The work that we do.  How do the people we support understand the relationship?  What does your employer expect?  Teacher? Counsellor? Parent? Confidante? Advocate?  Intimate, personal support.  We are paid. Up Close and Personal, Marianne Simpson DSW, BA 4

“The relationship is as primal as that between a mother and infant, and as complex as that between spouses. It is intimate but professional. It has protocols and serendipity, involves serious reciprocal responsibilities and is premised upon values of warmth, respect and humanity.” Catherine Frazee, 1998 Up Close and Personal, Marianne Simpson DSW, BA Recognizing a Boundary Violation Reversal of roles 1. A Secret is involved 2. A Double Bind exists 3. The indulgence of personal privilege 4. Marilyn Peterson, 1992 Up Close and Personal, Marianne Simpson DSW, BA What can you do?  Ethical principles  Do no harm. Do good. Autonomy. Fidelity.  Training  Recognize the power in your position  Educate and involve the people you support about boundaries  Be open about uncertain situations Up Close and Personal, Marianne Simpson DSW, BA 5

Questions to Ask Yourself  Is this in the person’s best interest?  How does the person receiving support perceive this action/our relationship?  Am I creating a dependency?  Will the person feel obligated to me?  Will I feel obligated to the person?  Whose needs am I serving?  Do I benefit from this? Is there a conflict of interest? Up Close and Personal, Marianne Simpson DSW, BA Questions to Ask Yourself  Will this have an impact on the service I am providing?  How would this be viewed by the individual’s family?  How would I feel about telling a colleague about this?  Am I treating the person differently?  Does this person mean something “special” to me?  Am I comfortable documenting this? Up Close and Personal, Marianne Simpson DSW, BA Where Does Your Agency Stand?  Mission, Vision, Values  Behaviour Support Policy  Rules of Conduct  Confidentiality  Ethical codes  Abuse and Neglect  Human Rights  Conflict of Interest Up Close and Personal, Marianne Simpson DSW, BA 6

What Next?  Keep it alive  Be open and honest about it  Talk, talk, talk – Consult, consult consult  Ask questions  Examine your motives  More questions than answers Up Close and Personal, Marianne Simpson DSW, BA Resources Curtis, L.C., Hodge, M. (1994). Old standards, new dilemmas: Ethics and boundaries in community support services. Psychosocial Rehabilitation Journal, 18 (2), 15-33. Frazee, C. (1998). Balance and Movement. In M.A. McCol & J.E. Bichenbach (eds.). Introduction to Disability. London: W.B. Saunders Company Ltd. 59-72 Morton, S. B. (2004). Revitalizing professional boundaries policy into meaningful practice improvement. Home Health Care Management & Practice 16 (4), 255- 260. Newman, C. (2004). Too close for comfort: Boundary issues in the professional/client relationship – Training Workbook. NCA Associates : Ottawa. Peterson, M. (1992). At personal risk; Boundary violations in the professional-client relationship. New York: W.W. Norton & Co. Up Close and Personal, Marianne Simpson DSW, BA Contact Information  For more information or a comprehensive list of resources contact: Marianne Simpson, Community Consultant Regional Support Associates Phone: 519-354-2156 ext 2322 Email: msimpson@wgh.on.ca Up Close and Personal, Marianne Simpson DSW, BA 7