Setting Boundaries as a Therapist

Lisa Marie Bobby: Hello, and welcome back to love, happiness, and success for therapists. This is the place where we therapists gather to work through the complexities, the growth opportunities of this challenging yet rewarding career. And today we’re talking about how to know when it’s time to let a client go. Either referring them to another professional or recognizing just that this, this chapter of their journey is ending and that it’s, it’s time to say goodbye with, with grace, courage, and love. 

I wanted to speak about this today because  So, um, I’m the founder of Growing Self Counseling and Coaching, and over the course of my own professional journey, I’ve worked as a therapist for a long time, I’ve also been part of a really meaningful professional consultation group for Gosh, over 13 years now.

Additionally, I have served as a clinical director in my practice. I also provide clinical supervision to early career therapists working towards licensure and also just, you know, day to day being part of my community. This is a question that comes up a lot. Like, should I keep working with this person for a variety of different reasons? 

And so I wanted to talk about this today on the show, because I know that this is just a conundrum that comes up frequently and can be difficult to unpack and get clarity around like, um, Um, should I refer this person? Is this a growth opportunity for me? Is there self of therapist stuff that’s making it feel like an obstacle to me that is actually worth me working through?

Like what is really in the best interests of this person and what is in my best interests as well? Right? Because we cannot leave ourselves out of this equation. So today we are going to be unpacking all of it.  Um, let’s just dive right in. I mean, I think it’s. understood that we are.  have such a position of privilege in people’s lives, right?

We can, are part of their, their journey, right? Their deepest, most important, um, aspects of their life. I mean, they share them with us and with this privilege and. Being a person that they look to to help them, it comes great responsibility, you know, the, the responsibility to really be thinking about our clients well being in a genuine way, and also to separate. 

Our own needs and hopes and rights and feelings, which are valid, but also theirs and understanding when there can be a weird overlap that can obscure the right course of action.  And there are just times when therapists always as practicing ethically need to take a step back and ask that crucial question, is continuing this therapeutic relationship truly in the best interest of my client? 

And I think I’m always so impressed with clinicians who are asking themselves those kinds of questions because  it just conveys this integrity, this love.  Unwavering commitment to the wellbeing of those we serve, but also I think is a doorway into very important self awareness and personal growth that is also part of the deal when we sign up for this career, right?

Um,  and just working through it, I think, um, allows us to be making contact with parts of ourselves, our wisdom, our courage of knowing when to call it quits. So, so today, again, on this episode, we’re talking about what some of these fork in the road moments can look like, what they can be centered around so that it helps you gain that awareness so that you can be confident and self aware in your decision making. 

And the very first thing with us that we should talk about is first related to ethics, upholding ethical integrity in our practice, which is something of course we’re all committed to.  And there are some subtle ways that we can be, um, moving into gray areas with regards to ethics and not even realizing it. 

And continuing to work with a client that you probably shouldn’t be working with anymore is one of those.  And so, you know, just to frame it again, what we do, therapy, it is a sacred space, right? It’s a space of a relationship, a real relationship where trust is built. Vulnerabilities are shared where growth and healing happens. 

And, what happens when we start to sense that we might be We can no longer be the best person to facilitate our client’s  continued forward movement that they are trusting us to create.  And that recognition that, you know what? This person isn’t moving forward  is  an important part of ethical practice.  Um, to just unpack this a little further, I think, um, everybody got the memo that one very important and possibly the most important part of ethics is do no harm, right?

To avoid malfeasance,  but the other side of ethical practice  is related to beneficence.  Is this person benefiting from working with me?  If not. It’s not ethical to continue that taking their money,  you know, keeping them in a relationship where they believe they’re here to get something out of it. And you know that they’re not right.

We need to have those conversations out loud. And that’s one of these fork in the road moments that we have to face, um, when we are providing therapy to someone.  And perhaps over time or, you know, it could, could even be a, an earlier chapter in the relationship where it really is working. They’re making a lot of progress.

Everything’s going. But then we get to a place where it’s. It’s kind of run its course, and that, I think, requires so much healthy humility, first of all, to recognize this, but also to develop an awareness of why it’s kind of stalled,  but also have a lot of courage about it. Thank you. Talking about that because it could mean ending that relationship with a client and then that opens up a whole other can of worms.

Like, how, how is my client going to receive that? Will they feel cared for by me? Will they feel abandoned? Um, but even like personally, you know, it’s easy.  a shame place, if I were a better therapist, I would know what to do. I would be helping them create more progress or, you know, it’s because of some failure on my part.

Like it can shove us into this old, you know, perfectionistic, um,  stuff that, that is our stuff. Right. But. Um, one of the first pieces I think that does need to be recognized is that part of ethical practice is just paying attention to whether or not it’s working for our clients and acknowledging in a healthy and appropriate way, our own limits  in a healthy way,  but sometimes even just related to our own scope of practice, you know, um, And I do think it bears saying that the journey of being a therapist, part of the deal is that it is about continuous learning, growth, reflection, self awareness, um, Developing new skills and abilities, continuing education, right?

And there also needs to be space for this because we’re human and there might not be times when we have all the answers or the right tools or the specific expertise that a client needs. And there could also be growth opportunities in that for us. while maintaining a relationship with a client. Um, I think it’s wonderful.

And, and I’ve done this with a client who is, um, dealing with a presenting issue that maybe I know a bit about, but I’m not, you know, the,  most expert of experts. And yeah, I’ll read a book or get case consultation or, or take a course or, you know, revisit a book that maybe I’ve read in the past or like really thinking about, okay, how do I need to shift what I’m doing in order to support this person’s growth and Um, kind of growing alongside them, behind the scenes so that I can, I can be the therapist that they need me to be.

I think that within reason, that’s absolutely okay. And that is part of how we develop professionally is in response to our client’s needs. And that’s okay.  Um, that’s part of it.  And there might also be situations where.  We’re confronted with the fact that what they need is not like one or two steps up from where we are and how we’re able to serve them, but is like 10, 10 steps away that it would be, it would be difficult for us to, you know, shift into a place where we could help them in the way that we need to help them. 

Embracing these limitations with humility is not a sign of weakness. It is not a sign of failure. I believe that in contrast, it is a sign of strength, of responsibility, of integrity.  It’s really about being self aware and courageous enough to make a thoughtful and loving referral to another therapist who’s better suited to meet that person’s needs and, and having, you know, courageous conversations about that to help them understand why and the fact that  You know, our, our decision is rooted in so much genuine love and care for them and helping them understand that we, we would not be doing right by them if we continued.

Um, and that can be difficult to do, but  I have never had an experience either personally or with a supervisee or somebody else where, where if the, um, Um, reason why was communicated with a lot of,  you know, authenticity and vulnerability, being able to show up with a client and say,  I.  You deserve to work with a therapist who would be better able to help you than I would in this situation.

I care about you so much. I want to help you do that. Um, in a really loving way, but and also acknowledging the attachment that they might have to you. Uh, and, and, you know, there’s a lot of ways to go about doing that before, but  I have never seen anything but positive things come from that when it’s handled well.

So I just wanted to put that out there and highlight the fact that, that sometimes the barriers to our being able to do that with clients can be rooted in our own feelings of shame, perfectionism, self doubt, right? We’re not good enough. Right. Right. Right. We need to hide, right, pretend like we  know all the things, um, and that doesn’t serve anyone.

And it takes a lot of courage to, to lean in and have compassion and respect and appreciation for yourself in those moments. So I just wanted to say that.  There is also another kind of situation. Um, that can be extraordinarily difficult for us when it happens, but that also many times can require us redirecting a client to somebody else.

And that is when we can’t personally create the kind of healing experience  and relationship that our clients need from us and deserve from us. I believe it was Carl Rogers who brought this into the light, right, and started talking about it in overt ways that  empathy is the heartbeat of therapy. Being able to really accurately see, understand  another person’s point of view, see the world through their eyes. 

In a very real way, that is what allows us to connect, to understand, to provide support, the space that our clients really need. Um, that’s, that’s the foundation of any growth and healing that’s going to happen next. And just like in any other relationship, because we’re having real relationships with people.

Yes, it’s a professional relationship. There are different boundaries. We’re here for a different purpose, but it is a relationship.  And just like in any others, they, there may come a time when we find ourselves struggling to have empathy or feel connected to their pain  or even going back to Carl Rogers, have unconditional positive regard for our clients. 

And this can be very difficult for us to recognize in ourselves and acknowledge and own, right? Because  it’s not who we want to be. I think, um,  again, there can be shame around it. If I were a better person, if I were more loving, if I, if I operated in a way that made me feel less burned out, I would probably have more compassion with this person.

Okay. So maybe that’s valid. But. To recognize that, that you, you do not have positive regard for someone and, and that they deserve to have that. And that growth and healing will not really be possible without it  is, is crucial and it’s ethical to be able to say that  to yourself. Um, and acknowledges the fact that all of our clients deserve to have a therapeutic relationship where they feel seen and heard, valued, and if we cannot provide that and if we know we can’t provide that, if there’s not a path forward, it is really our responsibility to help find them somebody who can have that kind of relationship with them. 

And I will say that this can also be a doorways for some very, very rich, um, self of therapist and personal growth work, because of course, you know, it requires radical self honesty, self awareness, but also a ton of emotional maturity, right? Um,  and,  um,  To also, I think, use that as a window  into some of our own triggers, pain points, unfinished emotional business with the past. 

If you are having a, as Herr Freud called it, a strong counter transference experience to a client that, that is truly an obstacle to their, um, productive work with you, to be able to talk through, like, why is that? Oh yeah, they really remind me of my critical father or by whatever, or pushes me into contact with this thing that I don’t.

Like, and, and to be able to unpack that, dig into it and, and use that as a start of a very positive personal growth experience for yourself, whether or not you continue to maintain the relationship with that person. I think there’s space to have gratitude for having had that professional experience that has given you the opportunity to further your, your own growth and personal evolution because of having that relationship and, and bumping up against your own dark emotions.

Um,  but again, um, I, I think. acknowledging that can feel very difficult. And if you’re not managing this well in your own internal process, or I think also too, if you’re in an environment that is not supportive of you, um, you know, if you’re in a environment that has very  perfectionistic. standards or kind of a right wrong culture.

Yeah. That is not emotionally safe for you. Um, or if you don’t have a professional community, a colleague, um, a consultation group where you can show up and say, I’m having feelings about this person, right? That, that can, um, make us vulnerable to shame, self criticism, beating ourselves up for not being better, right?

And again, shifting into this growth oriented mindset where we can acknowledge our own limitations and our own truth without shame or guilt and recognizing that as a sign of enormous wisdom and maturity.  So,  um, And I think also, you know, related to that, the appreciation, um, and the respect for the fact that a client isn’t going to benefit from working with us,  uh, and, and being able to be honest with ourselves about that.

I believe that it is a generous act of care to embrace this truth and to, again, be working with people to find the just right fit for them.  Additionally, so we’ve been talking about  client variables, right? So this person isn’t moving forward, or I am, you know, maybe practicing outside the scope of my practice, or maybe I don’t have unconditional positive regard or empathy for this person.

Those are all challenging enough.  There are also situations where we need to focus on our side of the equation too.  Um, your needs, um, your safety, your comfort, because again,  having a real relationship is what we’re doing. And the therapy room should be a sanctuary, a safe haven for both of us. Of you, and if anything disrupts this, um, for example, you know, a, a client’s actions making you feel scared or uncomfortable, or if there are like multiple boundary violations, inappropriate or,  uh,  intentionally offensive kinds of things coming from the client towards you as a person.

Addressing these issues has got to be a top priority. And so certainly having an open discussion about these concerns and how you are feeling in this relationship might be very important. Um,  not just for you, but also for the client, you know, to get visibility into how they are showing up and, you know, potentially having the opportunity to work through that clinically. 

But it might also be the case that, um, you know, particularly if you’re in an agency environment where you don’t have a lot of power over who you see that, um,  Or, you know, you might be working with somebody who really like actually feels unsafe for you. You might not want to have that conversation, um, and for, for valid reasons,  but to be able to honor, recognize, validate the fact that Um, you deserve to be emotionally safe in your relationships with clients.

You have legitimate rights to have a safe working environment, um, to not experience abuse or trauma from clients,  like to, to have this be okay. And to empower yourself to say no,  just say no to a client. I don’t think I can do this with you anymore.  It might mean saying no to an employer.  And, you know,  as I mentioned in the very first episode of this podcast, there are different environments that we therapists can work in.

And You know, I think we would all love to think that anything related to the therapeutic world would be healthy and of the light, right? There are toxic work environments and there are some toxic practices, toxic agencies where it’s really not okay. To not be okay or to have limits or boundaries, right?

And so if you are existing in a culture where you can’t be setting healthy boundaries in situations like these with, with clients or with your, your leadership or your employer.  That would be a sign to me that not just, you need to release this client, but it may be worth considering what would be a better, healthier, more supportive environment for you to be functioning in long term.

Because I just so genuinely believe, like, this is such a difficult profession.  Therapists need support, nurturing. a safe place. They need understanding. They need, um, you know, not just encouragement, but also opportunities to grow and develop and like to have to have that like active support is so important.

And if you’re not getting that Um, you know, I just wanted to, to illuminate that for a second and just  put that in your mind that it’s, it’s not your short coming, that it could also be part of the system that you’re currently in and that there are also very healthy, validating, emotionally safe and affirming systems that you could align with if you wanted to.

So,  so I’m glad that we, we talked about that.  And then there is one other situation when you may need to let go of a client that is also  I think uncomfortable and can, you know, be a little shame eliciting if we let it, if we let it. Um, but is the fact that, um, Um, going back to this idea that we are having relationships with our clients, real relationships with our clients, and especially long term relationships with our clients that,  you know, perhaps in the beginning began as very intentional.

Therapeutic, um, relationships where, you know, we are working on things and it’s depression and every day we’re talking about cognitive behavioral therapy and how you’re feeling and all the things. Uh, it is also possible to have that evolve into something that feels a lot more like a personal relationship with a client.

Obviously, I mean, it’s still with professional boundaries, um, but you know, if. A client just sort of drops in and downloads about their week and these things happen and maybe you talk a little bit about yourself and it’s kind of like a nice conversation as opposed to something that feels therapeutic, um, we need to be aware of that and talk about that because  going back to ethics, right?

Um, it can be easy to fall into a comfortable Right. Right. Right. Relationship with a client with sort of, you know, under the umbrella of free form talk therapy,  that’s really not,  not therapy anymore. And when our sessions start to feel more like casual conversations with no therapeutic value, it is our duty to bring the focus on that, uh, to have a conversation about that with our client to maybe say, you know,  You’ve made so much progress.

And now I hear, you know, when we talk, you’re telling me about what’s going on in your life and it’s great. I really enjoy talking with you, but we’re not doing therapy anymore. Is there something that I can help you with? Is there something that you would like to work towards? Um, and an opportunity if your client’s like, well, you know,  I just, I don’t have anybody else in my life to talk to the way that I can talk to you. 

That might need to be a goal. Let’s help you develop some emotionally safe, emotionally intimate relationships so that you’re not just relying on me. You’re not dependent on me as your therapist to meet this need in your life that that really should be filled by a personal relationship.  So having this conversation, it can launch a very productive new chapter in your therapeutic work together, or it can also open the door to your client saying, you know what?

You’re right. Our work here is done. And either way, that’s, that’s a victory.  So  I think, um, you know, the, the takeaway here for, for me when I think about this issue and I hope for you too, is that, um,  There also needs to be an awareness  of different modalities that are for the purpose of growth and development that are not therapy at all. 

What do I mean by this? Is it just to add another layer to this conversation? Uh, you know, therapists, it’s important to constantly evaluate what our approach is to what our client really needs. And in therapy, we’re often doing that. Um, thinking about which Modality or theoretical orientation would be most helpful to a client.

So, for example, I’m a marriage and family therapist, as well as as a psychologist. I enjoy, um, using emotionally focused couples therapy with couples. And over the years have realized that this is not always the most helpful path for every client. So have, you know, learned about the Gottman method, other orientations so that I can make informed decisions when I’m working with a couple or, um, the individual, like I, I have, I have different things to pull from.

I always avoid, you know, eclectic to me. That means just, you know, different techniques that aren’t really connected to a model, um, which is never in anybody’s best interest, but, but I have a number of models that I can use.  And one of the things that I have learned a lot about over the years and grown to really appreciate is the model, um,  the method of coaching psychology as being a very different thing from therapy. 

Um, I think that there can be overlap between coaching and therapy and certain phases of the work. But I think many times.  Therapists who have not learned about coaching psychology or how to use a coaching framework with clients does not, um, understand.  all of the means and methods that really important and powerful, not just growth work, but change can happen.

And in my experience, particularly with high functioning clients, maybe they began in therapy. Maybe there was some mental health stuff going on that really needed to be resolved, but to get to a certain point when, you know, in. site is not enough and they’ve talked about everything that they need to talk about and could really genuinely benefit more from a coaching modality than they can from therapy and to recognize that and to let that client go into a new phase of their work where they can, you know, you, you help them fill the hole and heal and now they’re in a good place and now they want to climb a mountain.

Therapy is not built for that, right? Coaching is. Coaching is action oriented, it’s focusing on helping people get clarity around values and goals and outcomes, and really putting plans into place to help them move forward in a very active way, whereas, you know, therapy, um, Again, I mean, it’s, it’s mental health treatment.

Um, it’s, it’s going into the past. It can be helpful for connecting the dots and certainly we need to be going into the past to a degree with coaching to help people understand their internal obstacles. But, but they’re, they’re for different purposes. Therapy is for healing. Coaching is for growth and forward movement.

And understand. understanding that difference, whether or not you practice coaching, um, can be very important because then you can have a conversation with your clients that helps guide them towards the right path, whether it’s continuing therapy or maybe focusing on something different or potentially using a different modality. 

The one that you have been using hasn’t been working, um, but making them aware of coaching as a vehicle that could really help them potentially create outcomes in their life that, that therapy does not always create. And having that conversation, I think it’s just another way to show them how much we care about their true wellbeing, right? 

So, in closing, I mean, making the decision to refer a client or to end a therapeutic relationship or steer them in a different direction.  It is fraught, you know, there’s responsibility, there’s love, care, the deep commitment to the well being of our clients. I think it’s a testament to our dedication to the integrity of the therapeutic process.

Um, we have to navigate these moments with compassion. Honesty, a sense of responsibility, but also a lot of self awareness and a very active management of our own feelings, mindsets, pain points, unfinished business, self therapist issues that can obstruct our ability to do the right thing. So. There’s a lot here.

And I hope that, you know, having this conversation with me was helpful for you today. Um, we have talks like this all the time here at Growing Self. So, um, if you’re not part of a practice or don’t have a good consultation group or a consultation partner in your life, I hope that this gave you some insight.

some of it. And on that note, I have so many other resources for you to support you in this. If you come to my website, growingself. com forward slash therapists, you will find, um, Um, links to these podcast episodes, also articles on a variety of different topics similar to this that I’ve put together for you.

You can also take my How to Flourish and Thrive as a Therapist Assessment. It’s just a free course. quiz that will give you some insight and visibility into what you need in order to reclaim your joy and really feel good about this chosen profession. It might be professional growth opportunities. It could be self care, maybe related to self of therapist.

stuff or, or maybe, you know, not being in the right environment, but taking this assessment will help give you visibility into that so that you can then take action on your own behalf. So come to growingself. com forward slash therapists. And of course you are welcome to join the conversation. Um, jump into the comments, um, on the articles at growingself.

com and also on social media. So on, um, Instagram, on Facebook, you can track me down at growing self, the growing self account, which is where I’m collecting things and putting things out there for therapists. And that’s where we’ll be gathering to have this conversation. And also on LinkedIn, you can hook up with me there too.

So thank you. So much for listening to this or watching it. If we’re hanging out together on YouTube right now, and I’ll be back in touch with you next week with another episode of love, happiness, and success for therapists. See you later.