Setting Limits: Understanding Boundaries in Therapy

Looking for a great therapist? Expert patient and online forum moderator Deborah Gray explains the do's and don'ts of therapy.

Most of us recognize and respect boundaries in our day to day life. We don't stand too close to other individuals in a line, we don't call a friend in the middle of the night unless there's an emergency and we don't walk in on someone when they're in the bathroom. These types of social boundaries exist to make us feel comfortable with other people.

In therapy, boundaries exist to protect the therapeutic experience. Some of these are obvious. The boundary violation we hear about the most often is therapists having sexual contact with clients (patients). However, there are other boundaries that, when violated in the therapeutic relationship, are also extremely damaging.

Your therapist should always be asking himself/herself whether something they are doing, saying or allowing serves your interests therapeutically. The answer might vary depending on what type of therapist they are – psychoanalytic, humanistic or somewhere in between. Some things are taboo no matter what type of therapy your therapist practices:

• Sexual contact of any kind

• Asking the client to invest money in a venture or enter into a business partnership of any kind

• Borrowing anything from the client – money, vacation home

• Not respecting the client's session – being late, canceling frequently, taking non-essential phone calls

• Calling client to talk about his or her own life (this actually happened to someone I know)

• Regular social contact such as a book club

The following limits fall into more of a gray area:

• Hugging at the beginning or end of a session

• Therapist attending an important life event of a client's such as a wedding or graduation

• Therapist lends the client a book

• Client sees the same individual therapist as family or friends

• Sessions are occasionally conducted over the phone when client cannot attend in person

A therapist should always explain why something is not permitted in the therapeutic relationship. In other words, instead of rejecting a hug from a client by stating that it's not appropriate, he or she should explain why it would be harmful and ask the client to talk about what it would mean to them.

When you are interviewing a therapist, you want to ask them how strict their therapeutic boundaries are. You might be less comfortable with a psychoanalytic therapist if you would prefer that a hug is permitted occasionally, or you might be less comfortable with a humanistic therapist if you prefer a formal therapeutic frame.

To prevent a potentially awkward situation, you might want to ask your therapist what they do if they see a client in a store or at a social event. What does he or she prefer you to do in that situation?

You may figure that once you have ended therapy with someone, these restrictions no longe