Question

Describe the difference between boundary crossing and boundary violations in a counseling relationship. How do the ACA and the NAADAC address these concepts?

*Please answer it precisely and support your answer with references.   

Answer 1

A boundary crossing is defined as counseling behavior which does not in theory or practice comply with standard methods of counseling. It may defy standard practitioner logic in the eyes of the patient, however, the same devoids harm, is not exploitative and in many circumstances a part of therapy or a technique that aids the therapeutic process. On the other hand, a boundary violation can be or is harmful to the patient.

The ACA and now NAADAC have a set of rules that they can compare a therapist’s behavior to in case of complaints pertaining to violations from patients. Here is a look at what those rules are and if they are crossings or violations.

No knowledge of the Ethical Standard (Boundary Crossing): Often patients may not be fully aware of what the norm is for conducting therapy. They may later realize the same and can complain about it.

Trying to treat patients outside the counselor's scope of knowledge (Boundary Crossing or Boundary Violation or both): Such instances may create further trauma for the patient or can even cause the patient’s death.

Insensitive nature (Boundary Crossing): If the caretaker does not want to interact with the patient in times of patient crises that is insensitive on the caregiver’s part.

If the caregiver is selfish (Boundary Crossing): A counselor's temperament is all that matters when counseling patients with mental or emotional trauma. A pushy counselor will not help the patient but will make matters worse.

Lack of responsibility (Boundary crossing or boundary violation or both): Such behavior from a counselor may be alarmingly dangerous for the patient.

Revenge against client (Boundary crossing or boundary violation or both): A counselor's false perception about a client that the client is a probable threat to the counselor.

Emotional problems with a counselor (Boundary crossing): This will definitely make the counselor give the patient incorrect advice

Interpersonal relationships (Boundary crossing): A counselor may make an unneeded advance towards the patient.

These rules remain more or less the same but can be slightly different depending on the nature of the doctor-patient relationship and the time and the pace of such a meeting between both the parties.