Good book on boundaries (how-to and why)?

[DrGachet]

---

Members don't see this ad.

I'm trying to brush up on my boundaries. Have an old book, probably from the Genghis Khan period, and some notes I usually refer to but anything new out there? I'm an emotionally receptive guy and like to go deep into the other person's psyche, so I'm looking for a book that is more flexible with boundaries as opposed to one saturated with dumbed down rules and absolutes that take away the spontaneity and freedom to rely on one's own intuition/discretion, specially when you are naturally good at picking up the nonverbal stuff. In other words, I am not looking for APA ethics codes, but more of a how-to...though some explanations and justifications aside from "APA will kick your ass" and "client will sue your ass off", may be a nice addition.

 

[DrGachet]

Please Delete, double post.

 

[DrGachet]

Hmmm, the mods deleted my other post instead of this one labeled "double post." Oh well. Just to let you guys know I am still interested in suggestions if you have any. 🙂

 

[FuturePhD2]

I'm trying to brush up on my boundaries. Have an old book, probably from the Genghis Khan period, and some notes I usually refer to but anything new out there? I'm an emotionally receptive guy and like to go deep into the other person's psyche, so I'm looking for a book that is more flexible with boundaries as opposed to one saturated with dumbed down rules and absolutes that take away the spontaneity and freedom to rely on one's own intuition/discretion, specially when you are naturally good at picking up the nonverbal stuff. In other words, I am not looking for APA ethics codes, but more of a how-to...though some explanations and justifications aside from "APA will kick your ass" and "client will sue your ass off", may be a nice addition.

"Flexible boundaries" as you put it, to me, sounds like a slippery slope that could lead to boundary violations. Most of the absolutes should be absolute regardless of the situation.

 

[FuturePhD2]

- keep contacts to normal business hours

Agreed, although I would add the caveat of except if the client is suicidal. The standard of care would be for you to be on-call, even after business hours.

 

[starsinnight]

Agreed, although I would add the caveat of except if the client is suicidal. The standard of care would be for you to be on-call, even after business hours.

No not always. The rule of thumb is you set this boundary before you start with a client. You let them know that 911 is to be used if they are feeling suicidal or you give them another hotline, etc. If they admit to you their suicidal thoughts in person, then commiting them to a hospital might be necessary. Anyways, I am NOT on call and NEVER will be! LOL I refuse to give out my phone # except during business hours. That's just my preference.... and boundary. 😉

I wish I had an excellent book on boundaries too Dr Gachet, if you find one, please let me know. I have a handout I use but so often this line gets crossed, by the client/patient, and it'd be helpful to have more information and solutions and preventions.

 

[FuturePhD2]

No not always. The rule of thumb is you set this boundary before you start with a client. You let them know that 911 is to be used if they are feeling suicidal or you give them another hotline, etc. If they admit to you their suicidal thoughts in person, then commiting them to a hospital might be necessary. Anyways, I am NOT on call and NEVER will be! LOL I refuse to give out my phone # except during business hours. That's just my preference.... and boundary. 😉

I wish I had an excellent book on boundaries too Dr Gachet, if you find one, please let me know. I have a handout I use but so often this line gets crossed, by the client/patient, and it'd be helpful to have more information and solutions and preventions.

This is not what is recommended by evidence-based treatments for suicidal individuals, and I would argue that this is unethical and negligent practice for such clients. The standard of care is that the client has a way to contact either you, a member of their treatment team, or someone that is covering after hours in a crisis situation. I've never worked in a location where I did not either carry a pager or there was an answering service number that clients could call to have their treatment provider contacted.

Obviously, if the situation absolutely cannot wait for the treatment provider to return the client's call, they should have a safety plan in place to call 911. There are also boundaries and limit-setting involved with some clients (e.g., BPD) regarding the format of calls. But the standard of care is that the treatment provider should be involved in managing crises, whenever they occur. It's much better if you can help someone effectively manage their suicidality in the moment rather than have them admitted to a hospital, which is not an effective treatment for suicide (only a way to ensure safety in the short-term).

 

[sunlioness]

I agree with FuturePhD2. It's one of the reasons why solo practice was totally not for me. I couldn't deal with the 24/7 being on call. Even though I was rarely called outside of hours, I didn't like being tied to it all the time. I know a lot of people (psychiatrists and psychologists both) who do the "Call 911" thing, but it's not good practice and has a high likelihood of being indefensible if you are ever sued.

Anyway, I'm all about maintaining good boundaries. Anything less is genuinely detrimental to the patient. Even if they don't realize it at the time and, indeed, are asking for it. It's our jobs to know better and to maintain an appropriate professional relationship. Unfortunately, I don't know any good texts off the top of my head either.