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Privacy Issues: Personal Boundaries Between Caregivers and Families

by Kimberly Johnson

In their role of caring for the elderly, caregivers must strike a tricky balance. On the one hand, they often enjoy unparalleled access to a client’s private information. On the other, if they are to be effective (not to mention ethical) in the job of caring for their client’s therapeutic needs, they must maintain clear professional boundaries with the client and family members. Privacy Issues: Personal Boundaries Between Caregivers and Families
Needless to say, it’s not always immediately obvious what constitutes crossing the line in a professional helping relationship with a client and their family. Here are some questions caregivers can ask themselves in order to delineate appropriate personal boundaries in these more ambiguous situations:
Am I over-helping or under-helping in this situation? An example of “over-helping” would be taking on a role or duties that ordinarily would be reserved for a partner or family member, such as helping a client balance their checkbook, giving or receiving special gifts, or (maybe most blatantly) getting romantically involved.
Signs that you may be over-helping—what we in the addiction treatment world often refer to as “codependency”—include: visiting the client when you are off-duty, spending inordinate amounts of time with the client, using family nicknames with the client, a growing self-perception that you are the only person who can help the client, and confusing the needs and feelings of the client with your own. (The latter can happen if you begin to project your emotional needs onto the client, assuming that what you are feeling may be what they also need, or become so invested in their welfare that your own health suffers.)
“Under-helping” manifests itself as neglect of the client’s therapeutic needs. One example might be keeping a personal secret with the client that compromises their health and welfare.
Am I serving the client’s therapeutic needs and interests, or are my actions more about taking care of my own personal needs? Your No. 1 professional obligation as a caregiver is to ensure the client’s therapeutic needs are being met. One good litmus test for any situation is therefore to ask yourself whether you are in fact prioritizing this job duty—or, whether your own need to receive love or care for your emotional needs is actually motivating your actions.
Am I soliciting extraneous private information from a client and their family, or am I sharing extraneous private information about myself with a client and their family? What you choose to talk about can also border on inappropriate boundary-crossing. Invasive questions about a client’s private life, answers to which have nothing to do with the client’s medical care, are inappropriate—but “TMI” (Too Much Information) is a two-way street, meaning that what you share with a client and their family can also fall into this category of extraneous private information.
If, based on your answers to these questions, you believe that you may have crossed a boundary (or may be at risk of doing so), talking to your supervisor or a trusted colleague about the issue may be a wise precaution. They may also help advise you about whether reassignment to another client is necessary. In some cases, it may be appropriate to discuss your concerns with the client and/or family members, so that they can be made aware of the importance of personal boundaries.
By Anna Ciulla
Anna Ciulla is the Vice President of Clinical and Medical Services at Beach House Center for Recovery where she is responsible for designing, implementing and supervising the delivery of the latest evidence-based therapies for treating substance use disorders. Anna has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery.
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Privacy Issues: Personal Boundaries Between Caregivers and Families

Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families

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