Establishing and embedding professional boundaries

SAFEGUARDING RESPONSE

Decide how you’re going to develop or refresh ‘professional boundaries’ at your place, and then how you’re going to embed them in your culture - as part of having safe and effective policies and practices. This is equally important if you’re a sole practitioner.

Equally, family members and friends who are performing paid support roles as caregivers need to consider and establish agreed professional boundaries, to help keep them and the person they’re supporting safe.

Establish and embed professional boundaries in your ways of working

Take a moment to read this guidance from the Ann Craft Trust in the UK (an organisation widely cited in safeguarding practice):

“… it’s important to be as specific as possible when thinking about professional boundaries. It means setting clear guidelines for what behaviour is and is not allowed when people interact in your organisation.

“These guidelines need to cover the workers and the people they support, but they must also apply to the people who work together in your organisation.

“Professional boundaries can bring a sense of fairness, clarity, consistency, and transparency to professional relationships. When professional boundaries are properly understood and fairly applied, everyone in an organisation can expect the same experience without bias or favouritism.

“Professional boundaries also provide a safe framework for the relationship between the worker and the person they’re supporting, in which all limits and expectations are clear from the start.”

Reference: Ann Craft Trust.

For your action: 

If you’re developing or refreshing your organisation’s professional boundaries:

Use the frameworks in the previous section to understand key concepts.
Consider how you’re going to set clear guidelines for what behaviour is and is not allowed when people interact in your organisation (see guidance from the Ann Craft Trust).
Co-design key content with your team, to shape your principles, policies, guidelines and practice.
Create an action plan and timeline, for when you’ll have these tools in place.

This section provides some examples of health professional boundaries working in practice, and outlines some of the risks when these boundaries aren’t in place or aren’t implemented.

It also includes some tips for professionals and some information for tāngata whaikaha Māori, disabled people, families and whānau

- Using respectful, person-centred communication.
- Asking for consent for interaction, every time when visiting a disabled person.
- Visiting within standard working hours and agreed times.
- Keeping relationships focused on agreed goals and support plans.
- Enabling supported decision-making.
- Maintaining privacy and confidentiality.
- Declining gifts or favours that could create obligation or blurred roles.
- Avoiding personal, romantic, or financial relationships with disabled people or their whānau.
- Using social media responsibly and avoiding personal online contact.
- Using clinical supervision.
Boundary breaches can lead to: 
- Emotional, physical, sexual, or financial harm.
- Loss of trust between disabled people, whānau, and services.
- Increased vulnerability for adults already at risk.
- Professional misconduct investigations by the HDC or regulatory bodies. 
- Harm that affects whole groups of people, particularly those who already experience higher levels of violence, abuse or neglect and discrimination, including tāngata whaikaha Māori, disabled women, and LGBTQ+ disabled people.
In your workplace:
- Become familiar with and follow your organisation’s policies on ‘ethical decision-making’ and ‘professional boundaries’.
- Help shape these boundaries if they’re not in place or not sufficiently clear or robust.
- Make sure you have access to regular clinical / professional supervision.
When providing safeguarding support:
- Clarify your role at the start of the relationship and revisit it regularly.
- Document decisions, concerns, and boundary-related discussions. 
- Seek guidance when unsure about a situation (raise this in professional supervision, and/or with your manager). 
- Avoid dual relationships (e.g. becoming a friend, business partner, or romantic partner).
- Maintain professional distance while still being warm, respectful, and person-centred.
- Follow organisational safeguarding policies and report concerns promptly.
- Reflect on your practice regularly, identifying what went well in your professional interactions and what didn’t go so well, and why – particularly identifying any occasions when boundaries didn’t feel clear to you or easy to maintain.
- Incorporate this learning into your own practice and into informing organisational needs, enabling continuous improvement.
- You have the right to safe, respectful, and culturally appropriate support.
- You can ask for clarity about a worker’s role and what they can or cannot do.
- You can request a different worker if boundaries feel uncomfortable or unsafe.
- You can raise concerns with the service provider or the Health and Disability Commissioner. See https://www.hdc.org.nz/your-rights/about-the-code/code-of-health-and-disability-services-consumers-rights/

It’s important to apply professional boundaries in a way that provides assurance and stability to the working relationship.

Reference: Ann Craft Trust.

VisAble offers interactive training to help you develop a deeper understanding of ethical decision-making and professional boundaries.

The training enables you to apply the information at your place, with your staff (kaimahi) and in your services, to help you develop policies, guidance and practices in both ethical decision-making and professional boundaries, to support effective safeguarding practices.

We can also provide training for tāngata whaikaha Māori, disabled people, families and whānau in understanding your rights, and what to expect from service providers, caregivers and support workersin terms of ethical decision-making and professional boundaries.

Find out more about our training and resources.

Or contact us at info@visable.co.nz