Substance abuse counselors are in a unique position to offer their services in both in-person and digital settings. The rise of virtual visits as a standard of care and service within the mental health field brings exponential benefits and new challenges. Today’s blog post will discuss professional boundaries in telehealth and cover how to ensure you maintain professional boundaries in the digital landscape.
What Are Professional Boundaries?
Professional boundaries are the ethical guidelines and expectations that substance abuse professionals use to guide their everyday interactions with the clients and families that they serve and their colleagues. Boundaries are essential. They support creating and maintaining professional relationships that keep everyone safe.
Substance abuse counselors face daily scenarios where boundaries influence how they interact with clients. For example, it’s not uncommon for a counselor to work with a grateful client who wants to give gifts as a show of appreciation or for a client to flirt with their counselor. Professional boundaries help counselors navigate situations like these in a balanced way that keeps interactions clean and professional.
Your ability to uphold professional and ethical boundaries will determine your competency as a substance abuse counselor.
Navigating Professional Boundaries in Telehealth
The digital landscape can be tricky to navigate. Identifying when a professional boundary is potentially at risk can look and feel different. Let’s consider a multi-faceted scenario and discuss how to handle it ethically.
Scenario: The Emergency Session
Telehealth offers flexibility. Many counselors have direct messaging for their clients, allowing them to reach out anytime. Consider the following scenario that may arise from this virtual feature:
Kya is a substance abuse counselor. She’s working with a client who is a straight, single male. During their online sessions, he notices photos of her with her children on the wall behind her. He also notices no photographs except those of her and her children. He assumes she is single and begins to flirt with Kya during sessions, which she deflects by changing the subject and shifting the conversation.
When his advances fail, he contacts her outside of office hours through direct messaging. He calls for an emergency session, saying he’s struggling and needs immediate support.
Kya receives the message late in the evening. She considers referring him to the emergency line or another more appropriate resource, but his message is insistent, so she decides to meet virtually that evening. When the virtual visit starts, he admits that his motives for calling the emergency sessions are because he “misses her: and “needs to see her.” Kya realizes there is no crisis, so she reminds him that she is his counselor and is responding to the situation he has conveyed. He gets angry, accuses her of “coming on” to him, and leaves the session.
Could Kya have avoided this situation? How could she have handled it better? Let’s discuss some telehealth tips that apply to this scenario.
Prepare For Virtual Client Encounters
Before meeting with a client online, educate them. Here are some suggestions on how to achieve this:
- Create a “Client Rights and Responsibilities” document. It should lay out the rights and responsibilities of the client. This can include expectations of conduct, clear dos and don’ts during sessions, and how all virtual services will be used (and not used). Make common violations clear and cover how they will be addressed.
- Ask for a Virtual Visit Consent Form. When a client signs this form, it will indicate that they have read, understand, and agree to the Client Rights and Responsibilities.
- Promote trust and safety. Make it clear that the client or counselor can terminate a virtual interaction at any time if they feel safety, ethics, or professionalism are at risk. Ensure there is a clear policy regarding how sudden termination will be handled.
Maintain a Structured Schedule
The flexibility of telehealth services can destabilize the work-life balance. You can regain balance as a counselor by creating and maintaining a structured schedule. This looks like:
- Conducting virtual visits during regular business hours
- Maintaining a clear boundary between professional and personal time
- Avoiding sessions of any kind during personal time, such as after hours, during vacation, or while sick
Stage Professionally and Ethically
Think about the space you will be using for virtual visits. Pay attention to what is in the camera frame, and avoid allowing the space to be overly personal.
In Kya’s situation, she could have staged better by ensuring her space didn’t show personal photographs. Remember, what you show on camera gives your client a glimpse into your world—ensure it’s your professional world they see, not your personal world.
Openly Address Inappropriate Behavior
When a client behaves inappropriately, it becomes the counselor’s responsibility to address the behavior. This is where education becomes crucial. It lays the groundwork for potentially challenging conversations.
If Kya had laid the groundwork for expectations with the abovementioned tools, addressing her client’s unwanted advances could have been easier.
When a professional boundary is crossed, it’s critical to address it openly. For example, she could have initiated a professional conversation instead of ignoring her client’s flirtation behaviors. If addressing her client’s behavior became too uncomfortable or challenging, she could contact her colleagues for supervision and support.
Resources For Professional Boundaries
Virtual visits can make honoring professional boundaries a challenge. Remember, as a substance abuse counselor, you have access to many supportive resources.
You aren’t a solo professional; you’re part of a team.
As you navigate the virtual world of substance abuse counseling, keep these resources handy:
- Professional Boundaries for Substance Abuse Counselors – Part 1
- Professional Boundaries for Substance Abuse Counselors – Part 2
Via Our Blog
- Training and Education for substance abuse professionals
- Clinical Supervision for substance abuse counselors
- Substance Abuse Counseling and Online Counseling
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