Strategies for Establishing Boundaries in Counselling Relationships

Introduction

Counsellors are trained therapists who provide a safe, non-judgmental and confidential space for clients experiencing a range of psychological issues and emotional problems. They listen to them talk and help them to explore their thoughts, behaviours and feelings to understand themselves and to cope better. They support their clients in finding their own solutions to enhance their well-being.

One in four people in England will experience some mental health problem each year (Mind), and in 2021/22, there were 1.81 million referrals to NHS Talking Therapies (UK Parliament). The British Association for Counselling and Psychotherapy (BACP) Public Perceptions Survey found that 33% had previous counselling or psychotherapy, and 76% would recommend it to family or friends. These statistics highlight a need for counsellors and their importance.

Counsellors will work closely with many clients, including those with anxiety, depression, addiction, loss, and other issues. They will develop relationships with clients, often known as therapeutic relationships or alliances. However, they must be professional and ethical and maintain clear and appropriate boundaries.

Boundaries are essential for creating a safe, effective and client-centred therapeutic environment. However, there have been regular reports in the media about boundary violations by mental healthcare and other health professionals (Devereux & Hook 2018). Boundary violations, whether intentional or unintentional, can compromise the safety of counsellors and clients and the entire therapeutic relationship.

This blog post aims to provide valuable insights and guidance on establishing and maintaining boundaries in counselling relationships. It will explore potential challenges and practical strategies for both counsellors and clients.

Defining Boundaries in Counselling

The BACP defines boundaries in counselling as:

“Agreed limits or rules which protect both the client and the therapist.”

Counsellors establish, implement and manage boundaries in therapeutic relationships to ensure they work ethically and professionally, maintain standards and provide counselling safely. Boundaries also help them fulfil their responsibility of protecting clients from psychological harm.

Boundaries can cover practical things and interpersonal issues, such as:

• Sessions, e.g. number, duration, location and nature.
• Cancellation of appointments.
• Fees and payment methods.
• Confidentiality.
• Out-of-session contact.
• Behaviour expectations, i.e. consequences of non-attendance.
• Self-disclosure.
• Touching.
• Dual relationships.
• Gifts.
• Counsellor competence.

When a counsellor establishes clear boundaries and a situation of safety, they:

• Make a distinction between a therapeutic relationship and other types of relationships, e.g. friendships.
• Develop trusting relationships and mutual respect with clients.
• Provide a structure, framework and criteria for the therapeutic relationship.
• Provide transparency regarding the nature and purpose of the relationship.
• Give clients an environment where they are autonomous and feel safe, comfortable and confident to explore their thoughts, feelings and behaviours.
• Collaborate with clients within agreed parameters.
• Make therapy client-centred by focusing on them and their concerns.

Boundaries are crucial in establishing trust and maintaining a therapeutic alliance. If clients have healthy relationships with their counsellors and understand boundaries, they are more likely to work with them to achieve their therapy goals. If boundaries are not maintained, or clients are unaware of them, it can lead to boundary violations, which can increase the risk of harm and jeopardise therapy outcomes.

The Dual Role of Boundaries

Boundaries are vital for building trusting relationships, and also protect both the counsellor and the client from physical and emotional harm and are essential in maintaining a safe working environment.

They protect and help counsellors by:

• Ensuring they meet their legal and ethical obligations – counsellors must adhere to standards and ethical practices and act within the best interests of their clients. If they do not, they can find themselves on the wrong side of the law, facing disciplinary action or even removal from accredited registers. Boundaries protect them from unethical and poor practices.
• Preventing compensation claims – if clients are harmed or feel that the counsellor is violating boundaries, they could make formal complaints and even take legal action in serious cases. Boundaries protect counsellors from being negligent and breaching their duty of care.
• Keeping the therapeutic relationship professional – when a counsellor sets boundaries, it lays the foundation for the therapeutic relationship, provides them with a safe framework to follow and helps clients achieve their goals. It also stops counsellors from developing other relationships with clients and prevents them from being manipulated. Boundaries protect the counsellor-client relationship.
• Minimising the risk of boundary violations – if counsellors establish clear boundaries, communicate these to clients and ensure these are understood and mutually agreed on, it will reduce the risk of boundaries being blurred or crossed. Boundaries protect the therapeutic relationship from being damaged.

Boundaries are also important for clients and protect them by:

• Preventing them from being taken advantage of because of their vulnerability – unfortunately, not all counsellors have good intentions, and the profession is unregulated, unlike others, e.g. psychologists. There have been cases where counsellors have taken advantage of vulnerable clients, e.g. fees. Boundaries increase clients’ confidence in counsellors and can demonstrate they are committed to high ethical standards.
• Communicating expectations – clients should know what to expect from counsellors and what counsellors expect of them. If they do not know what to expect, it can make the counselling process more daunting, and they are less likely to engage, making counselling ineffective. Boundaries protect clients by giving them realistic expectations, which can help them meet their therapy goals.
• Preserving their privacy, trust and confidentiality – clients will want assurances that whatever they discuss in therapy remains confidential and their privacy is maintained. If not, it can damage trust, make counselling ineffective and even lead to legal action against counsellors. Boundaries can protect clients from data and confidentiality breaches.

Boundaries also have an essential role in creating a safe space for vulnerability and growth. If clients have healthy boundaries and feel safe within a space, they may be more open with counsellors. They may talk about things they find uncomfortable, embarrassing, frightening or taboo without feeling exposed, judged or overwhelmed.

If clients embrace their vulnerability they can be authentic to themselves, their thoughts, what they have experienced and how they feel. Being vulnerable is not a weakness; it is actually being brave, taking risks and making decisions. It can help clients meet therapy goals and work towards personal growth.

Boundaries can also provide clarity to clients on the practical aspects of therapy, e.g. session times, location and frequency. It can make clients feel less vulnerable and more comfortable and safe about the counselling process. It enables the therapeutic relationship to grow if there is a clear framework.

Setting Clear Expectations

Counsellors must set clear expectations and communicate boundaries to clients. If they do not, boundaries can become blurred or crossed, putting the client and the counsellor at risk and leading to violations. Clients must know what to expect from their counsellor and what the counsellor expects from them.

Boundaries should be discussed, mutually agreed upon and understood by both the counsellor and client before counselling starts. Ideally, they should be specified in a written counselling agreement, which clients should read and sign. The process for this will depend on a counsellor’s approach, but they must inform clients of the nature of the services and role.

Here are some examples of the boundaries counsellors must consider and how they can communicate their expectations effectively.

Confidentiality

Counsellors have a duty to keep client’s data and information confidential. They should inform clients how they will record their personal information and notes from sessions and how they can access them. They should also ensure clients understand the limits of confidentiality and where they may need to break it and inform a third party, e.g.:

• If it is a legal requirement.
• If there is a risk of them harming themselves or others.
• If they need to tell their therapeutic supervisor as part of their training.

Counsellors should be clear to clients that they will only share their information with other professionals for a legitimate reason.

Session length, frequency, method and location

Counsellors should be clear on when and where sessions will take place. Boundaries can be blurred or crossed if there is too much or too little flexibility with sessions, i.e. a client is constantly late.

They may inform clients of the following:

• Whether the work will be open-ended or time-limited.
• The time and length of each session.
• Whether sessions will be face-to-face, over the telephone or online.
• Location of sessions, if face-to-face.
• The level of flexibility for sessions, i.e. if they or their client is running slightly late.
• What they can expect during their first session and how it will differ from subsequent sessions.
• What will happen if they cannot carry on working with a client?

Counsellors may need to make it clear to clients the situations where sessions may need to end, e.g.:

• The counsellor is at risk of harm.
• The client is under the influence of alcohol and/or drugs.

Appointment cancellation

Counsellors should inform clients of their cancellation policy. If either party cancels at the last minute or is continuously cancelling, it can make the client feel unsafe and can break trust, resulting in counselling becoming ineffective.

They may give clients details of the following:

• How to cancel an appointment, and what will happen?
• The notice needed to cancel an appointment, i.e. 24 or 48 hours.
• What happens if they miss an appointment?
• Whether there is a fee charged for missed and uncancelled appointments.
• What happens if the counsellor goes on leave?

Out-of-session contact

If contact between sessions is not agreed upon, it can result in the lines blurring between professional and personal communications and crossed boundaries.

Counsellors should provide clarity to clients on the following:

• Their availability, working hours and when they are contactable.
• The type of contact that will be permissible between counselling sessions, e.g. phone calls, emails or texts.
• Whether they will charge a fee for contact between sessions.
• What happens if there are any changes to out-of-session contact?

Counsellors must record any contact between sessions in their client’s notes.

Fees

Clients may blur or cross boundaries if they are unaware of the cost of sessions or cannot or do not pay. If counsellors put on extra charges without informing clients or are not being honest about fees, it can also be a violation.

Counsellors must be upfront with clients about the cost of sessions when they first contact them, and there should be no hidden fees. They should be clear about:

• The methods of payment.
• When payments have to be made by.
• What happens in the event of non-payment?
• Any charges for missed appointments.
• What will happen if they are struggling to pay, i.e. because of job losses?

Other expectations

Counsellors may also want to cover other boundaries and expectations in their counselling agreements, such as self-disclosure, touching, gifts, dual relationships and complaints. It will depend on the type of counselling they offer and their approach. The BACP has further advice on communicating other expectations on their factsheet here.

Recognising Warning Signs

Despite setting boundaries, there may be instances where they blur or get crossed in counselling relationships. It can be unsettling for counsellors and clients if this occurs, and safety issues may arise. It can also create ethical dilemmas for counsellors as they are responsible for maintaining professional boundaries.

Some common signs of this may include (this list is not exhaustive):

• Developing feelings.
• Showing favouritism.
• Increased and/or inappropriate physical contact.
• Buying and accepting large and/or expensive gifts.
• Inappropriate comments.
• Sexual advances.
• Excessive contact between sessions.
• Social contact outside of appointments, e.g. having coffee or meals together.
• Repeatedly missing appointments or being late.
• Giving personal phone numbers or email addresses.
• Sessions repeatedly running over.
• Discussing personal/intimate issues that are not related or helpful to therapy.
• Others mention that the behaviour is unacceptable or intrusive.
• Joining each other’s social media groups.

Knowing the warning signs can help counsellors avoid blurred or crossed boundaries from becoming boundary violations and is essential for maintaining ethical practice and ensuring counselling is safe for both the counsellor and the client.

Handling Transference and Countertransference

Transference

There may be situations in counselling where a client has feelings for someone, but they project them onto their counsellor or subconsciously associate them with someone else. It is known as transference, and the British Psychological Society (BPS) provides the following definition:

“The client’s experience of the therapist that is shaped by his or her own psychological structures and past’, often involving ‘displacement onto the therapist, of feelings, attitudes and behaviours belonging rightfully to earlier significant relationships’ (Gelso & Hayes, 1998, p.11).”

Transference can result in clients having positive, negative or sexual feelings towards their counsellors, e.g. love, anger, fear, mistrust and erotic fantasies.

Some of the signs to look out for include:

• Clients are overly familiar with their counsellors or very dependent on them.
• Clients have strong emotional and inappropriate reactions, e.g. obsessions, hostility or anger.
• Clients develop feelings and become romantically or sexually attracted to counsellors.
• Clients idealise their counsellors and see them as perfect or infallible.

Transference is completely normal in counselling and is an accepted part of the therapeutic process, as it brings these feelings to light and enhances the therapeutic relationship. It allows counsellors to explore these feelings and work with any underlying conflicts to help their clients resolve the issue.

Countertransference

There may be situations where a counsellor develops strong emotional reactions to a client based on their own unresolved conflicts or plays a part in transference, which is known as countertransference. According to BPS, “countertransference describes the therapist’s reaction to the client in terms of both feelings and behaviour”.

Some signs to look out for include:

• Counsellors offer clients advice.
• Counsellors inappropriately disclose personal information or share too many stories about themselves.
• Counsellors develop romantic or sexual feelings towards their clients.
• Counsellors are overly critical or overly supportive of clients.
• Counsellors try to befriend clients.
• Counsellors ask for personal information that is irrelevant to therapy.

Countertransference does happen. After all, counsellors are humans. They may use it positively to tell a client the effect they are having on their feelings to build trust and understanding. However, they must guard their feelings and manage countertransference to avoid harmful impacts.

Impacts

When transference and countertransference are used by trained and experienced counsellors, they may have positive impacts and help clients grow. To be beneficial, they should always be relevant and helpful to their therapy. However, there are risks associated with these dynamics.

Transference and countertransference are more likely to be harmful and have negative impacts on counselling relationships, for example:

• It can make counsellors and clients feel uneasy, confused and embarrassed.
• It can make it difficult for counsellors to provide effective therapy.
• It can result in boundaries blurred or crossed and even violated.
• It can erode trust and respect developed between counsellors and clients.
• It can damage the therapeutic relationship and the client’s journey.
• It can result in harm in some cases, e.g. a client feels rejected and physically harms a counsellor or themselves.
• It can hinder a client’s progress and result in poor therapy outcomes.

Strategies

It is essential to recognise and manage transference and countertransference, as although they can be beneficial in some circumstances, they are usually harmful in therapy. Some strategies for recognising and managing these dynamics include:

• Establish clear and mutually agreed boundaries to prevent these dynamics, e.g. limiting the disclosure of personal information and no contact outside of sessions.
• Be aware of the warning signs at all times and monitor sessions carefully.
• Ask clients if they remind them of anyone to establish whether transference is an issue.
• If transference is recognised, encourage clients to bring these feelings to light to discuss and explore the underlying conflicts to resolve them.
• Be self-aware, e.g. pay attention to emotions, feelings and reactions during sessions and reflect on the impact they can have. It will help to notice and deal with transference and prevent countertransference.
• Attend regular supervision and talk to managers or other professionals.
• Consider alternative types of therapy, such as group or cognitive-behavioural therapy.

Self-Care for Counsellors

Counsellors must be fit to do their job effectively, as they are responsible for their client’s mental health and well-being, so they must take care of themselves. Self-care means counsellors undertaking activities to maintain their mental, emotional, physical and spiritual well-being. If counsellors do not make time for self-care, they can become stressed, exhausted and eventually burnt out.

Counselling is challenging work. A survey conducted by the BACP in 2022 highlighted that 50% of therapists said the demand for therapy is over capacity. Their report from 2021 stated that nearly half (44%) of therapists felt more stressed and overwhelmed since the beginning of the pandemic. It highlights how busy counsellors are and the importance of practising self-care continuously to protect and preserve themselves.

Self-care is also important for counsellors to maintain healthy boundaries for the following reasons:

• To be good role models – they should lead by example. If they show up to a session stressed and tired, it does not send a positive message to clients, as it demonstrates a lack of boundaries on the counsellor’s part. A counsellor cannot empower clients to set and maintain their own boundaries if they cannot do the same.
• To put the client at the centre of therapy – if a counsellor is not practising self-care, they are more likely to be inattentive, distracted and may even have emotional outbursts. It could negatively impact the therapeutic relationship and result in clients not receiving the help they need, which can reduce the effectiveness of their services. Ethical issues can arise from a lack of self-care.
• To help increase self-awareness – if a counsellor practices self-care, it will help them be more self-aware, which means they can be more in tune with their own limitations and when boundaries are being blurred or crossed.

Here are some self-care tips to prevent burnout and maintain professionalism:

• Make self-care a priority, even if it appears there is no time for it.
• Take regular holidays, even if they are short breaks away.
• Leave work and any issues at the end of the day, and try not to take it home. If work at home is required, have a specific area and regular downtime.
• Learn to say no and not take on too much so it is still possible to have a life outside of work.
• Remember that it is not personal if clients get angry and upset.
• Get plenty of sleep, eat healthily and exercise regularly to improve mental and physical health and to boost well-being.
• Try relaxing activities, such as yoga, meditation or mindfulness, and get outside into nature.
• Have a social support structure, e.g. family, friends, colleagues or peers, to prevent isolation.
• Always ask for help and support, including personal therapy, where needed.
• Be willing to walk away where necessary. Some counsellors may not be the right fit for the client and may need to refer them to someone else.

For further information, please see our blog post on the importance of self-care for counsellors here.

Empowering Clients

According to the World Health Organisation, “empowerment refers to the level of choice, influence and control that users of mental health services can exercise over events in their lives”.

When clients set and have control over boundaries, they are empowered to take more responsibility for their own lives and make decisions that align with their values. It helps them to be more assertive and confident to ensure they meet their own needs and preferences.

Boundaries are important for clients as part of their therapy as it helps them to understand:

• Their own needs and preferences.
• What is acceptable and unacceptable behaviour?
• Other people’s expectations and their expectations of others.
• How the maintenance of boundaries during sessions will help build trusted and respected relationships with counsellors, resulting in better therapeutic outcomes.
• When counsellors are blurring or crossing boundaries.
• The skills needed to be taught and reinforced for their health and well-being.
• Their strengths and abilities.

All clients have different needs and preferences regarding the specific activities and conditions they want in counselling, usually identified in initial meetings. Here are some examples of techniques that counsellors can use to help clients assert their needs and preferences:

Share the available treatment methods and counselling types with clients to give them options and autonomy in decision-making, e.g.

• Cognitive behavioural therapy (CBT).
• Humanistic therapy.
• Person-centred therapy.
• Psychodynamic psychotherapy.
• The BACP has various types of counselling and psychotherapy on its website.

Invite them to express them by asking questions in meetings, e.g.:

• How do you think we can help you in these sessions, and do you have any ideas of what would not help you?
• What would you like to talk about during the sessions?
• What outcomes would you like to achieve from the sessions?
• What are your expectations?
• Do you have any preferences on treatment methods?
• What are the motivations for making changes?

Use client needs and preference assessments and questionnaires, e.g. Cooper – Norcross Inventory of Preferences (C-NIP).

Observe their behaviour, e.g.:

• How they look.
• Their interactions.
• How they communicate verbally and non-verbally, i.e. their body language.
• How they respond to suggestions.

Use active listening and reflection, e.g.:

• Reflecting on what a client says.
• Repeating what they have said to check accuracy.
• Asking questions to check understanding.
• Avoiding distractions when talking to them to show interest.
• Using posture, body language, eye contact, facial expressions and tone of voice to indicate a willingness to listen.
• Summarising to demonstrate that they were heard and understood.

If clients have some control in the decision-making process regarding their therapy, they will feel more empowered and engaged with the counselling process. It will help to create a robust therapeutic relationship and help clients meet their therapy goals.

Handling Boundary Violations

If boundaries become blurred or crossed, it can lead to intentional or unintentional boundary violations. Counsellors can choose to violate boundaries intentionally for therapeutic reasons, e.g. breaking confidentiality if the law requires it or if they suspect a client will harm themselves or someone else. If they do this, they should consider the following:

• The client’s needs.
• If it is appropriate.
• If they can justify their decision to professionals.
• The anticipated effects on the client.

Before counselling starts, counsellors should inform clients about the situations where they may need to violate boundaries and what will happen if this occurs.

There may be instances where counsellors unintentionally violate boundaries, i.e. not realising they have crossed them. If this happens, they should:

• Tell the client of any risk or causes of harm.
• Take immediate action to mitigate any harm where possible and ethical.
• Apologise where appropriate.
• Inform their supervisor about the situation and talk about it in supervision.
• Tell their insurance company and professional membership body (where applicable).

They could also seek advice from a senior counsellor.

If a client feels their counsellor has unintentionally violated boundaries or feels uncomfortable at any time during a session, they could:

• Talk to their counsellor about the situation if they can.
• Talk to another therapist or a friend if they have concerns that their counsellor has violated boundaries.
• Contact a counsellor’s manager if they cannot talk to their counsellor. If a counsellor is in training, they should contact their course provider.
• Contact a counsellor’s professional membership body (if applicable) to discuss the issue.

If a client violates boundaries, counsellors need to address the issue professionally and with compassion. The way to handle the situation will depend on the type of boundary violation and the client’s behaviour. Some general ways of dealing with this may include:

• Telling them assertively why their behaviour is inappropriate and reminding them of the boundaries in place.
• Putting a boundary action plan in place to monitor the violation and take steps to prevent it from recurring.
• Informing them what will happen if the boundary violation occurs again.
• Having a colleague or another professional present in the event of difficult conversations or a risk of harm.
• Discussing the issue in supervision.
• Referring the client to another counsellor in serious cases and if they cannot resolve the issue.

To prevent clients from violating boundaries, counsellors should set clear boundaries so clients understand them and give praise and positive reinforcement when they stick to them. They should also have a plan so they can deal with these types of situations effectively if and when they arise.

The BACP has some boundary violation scenarios that counsellors can reflect on here and also some examples of recent complaints here.

Conclusion

Counsellors have ethical and professional duties to their clients, and establishing and maintaining boundaries is an essential component of counselling, which counsellors must prioritise. Boundaries protect counsellors and clients and are fundamental to providing a safe, secure and confidential space for their well-being.

Good boundaries lay the foundation of therapy and provide a framework for the counselling process. They help build strong therapeutic relationships based on trust, respect and collaboration. They also empower clients to take responsibility for their own lives and have control over their choices.

Boundaries can be blurred, crossed and even violated. Communicating and mutually agreeing on boundaries clearly before counselling starts and having written agreements can prevent boundary issues. If they do occur, having solid procedures and plans can help mitigate any effects that could potentially damage the therapeutic relationship and effectiveness of counselling.

Setting clear boundaries helps clients to know what to expect during counselling so they are more likely to engage in the process and achieve their therapy goals. Please use the comments section to share experiences and insights about boundaries, fostering a supportive and informative dialogue on this crucial topic.