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Professional Boundaries
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Okay, so we're going to get started, because we have quite a bit of info to cover. And I just want to make sure I create space and hold space for folks who may have questions, who may want to process some things, etc. And so we're going to get moving. Okay, so good morning, everyone. I am so happy to see you all. My name is Dr. Dolores Blackwell, and I am a consultant, consultant for ORN, and do some other work for RODA, which is our Rural Opioid Technical Assistance Program. And so today, I'm going to be talking with you about professional boundaries with a smathering of ethics. And so this particular conversation is not the end-all be-all, because we know that with anything, that we need to continue to expand our knowledge around it, continue to lean into it in a variety of different ways, not just for the purposes of this webinar today, but also the purposes of supervision, etc., any interaction that you're having with clients and folks on a regular basis. It's something that when we talk about professional boundaries and ethics, it's really connected to every type of setting that we can find ourselves in, whether it's working in a recovery space, whether it's working in an outpatient space, etc. Because our professional boundaries, the things that we kind of hold space for in regards to relating to clients in a professional sense, that transcends everywhere. And I use that word for a particular reason, because I am talking with you today, Transcend New York. So welcome. And I am going to share my slide deck, and then we're going to start chipping away at some of this information. Okay. In two seconds, I am going to turn the mic over to Katie, who will be talking you through our ORN portion, because that's an important part of what we're doing today as well, because ORN received a request to bring this training to you. So you should see my slide deck. Can you see it? Everyone sees it? We see it. Yeah. Okay. Awesome sauce. So professional boundaries, Transcend New York, and I introduced who I am, Dr. Dolores Blackwell, licensed clinical social worker here in New York and a few other spaces and places. Also, Master Addiction Counselor, whole bunch of initials after my name. I actually counted it the other day, and it's 25. So I really need to stop at this point. But today, we're coming through ORN. So Katie, would you like to walk us through ORN and what that looks like and who ORN is? I can just speak for a minute or so. And I'm sorry that I messed up this ORN slide and pasted. Let's do that. The ORN is a SAMHSA-funded organization. So we are present in every state and U.S. territory, but we are organized into regions. We are in Region 2 that covers New York, New Jersey, the U.S. Virgin Islands, and Puerto Rico. And then I specifically work in New York, and we receive TA requests from organizations in New York like you all who are interested in training or technical assistance or anything related to substance use, really. So all of our services are free. We have training consultants, just resources for anyone who's looking for a particular guide or information. And yeah, we just accept requests from every kind of organization, anyone who is interested in learning anything about substance use. And there's a version of me in every other state who's responsible for their local TA response. So yeah, if you want to learn more about the ORN, we can put our website in the chat. And yeah, I hope you enjoy this training. Yes. So when we talk about the connective tissue between ORN and or actually substance use, there's a variety of different topic areas that we could lean into. Because when we talk about substance use, there is so much connected to substance use. So we could talk about the social determinants of health, we can talk about trauma, we can talk about mental health, all of that is interconnected. And so it's super helpful to have a resource such as this because we're working with communities across the country to really help to provide training, experience, you know, in regards to prevention, treatment, etc. that impact communities impacted by the opioid crisis. So today, I'm going to be leaning into professional ethics and boundaries. And again, this is a broad strokes conversation, because there are multiple connective pieces to this additional training, knowing your organization's policies and procedures, etc. All of that is key. So you'll have access to the slide deck in a bit, I think, right after or in soon after our conversation finishes today. And this is very much a conversation. Okay, this is very much a conversation. While I'll be sharing information with you, there will be times I might ask an open question, etc. Or you might unmute yourself and say, Hey, Dr. Blackwell, I wanted to ask a question about this. Okay. So we're going to be talking about professional ethics and boundaries, explore the various types of professional boundaries and ethics. I literally or we literally could spend hours and actually weeks or even a semester or a year talking about professional boundaries and ethics. So we're going to try to cover some major ones in this two hours that we are together. But with the recognition that you will continue to explore this ongoing and ongoing in your supervision and other opportunities. Okay, so we're going to learn some of the common boundaries, issues and challenges that can lead to ethical dilemmas when serving clients. Okay. And so this, again, is something that is transient transcends all settings. And so I want to lean into some of this basic information. Some of this will feel like reminder for some folks, this may be brand new information. But this is something that we all have to lean into. Many of us have to complete a training every year in regards to professional boundaries and ethics, because it's not something that's a one time conversation, because there's so many things that happen. Anything or any space where we have to interact with other human beings, other folks in a professional capacity, we need to be mindful of our boundaries and ethics. Okay. So hold on one second, because I'm having something weird happen with my screen here. Let me just get myself sorted out. Okay, because some of this looks a little weird, not sure what's happening. Okay. So I don't know why my toolbar is so high, but it's blocking some of the information. Ah, there we go. All right. So a boundary is anything that marks a limit, and it defines where something or someone starts or stop. And it's an invisible line. Of course, we don't see most boundaries, particularly when we're working with clients, but a physical boundary can be present, let's say boundary of property, et cetera. But we're going to be leaning into the invisible line that is experienced in human relationships. It can be flexible, it can be rigid, present, not present, strong, weak, all of those are potential things that can identify a boundary. So just kind of leaning into the different types of boundaries. And as you're hearing this and leaning into it, thinking about in your work with clients or connecting to folks in the space, what are some of the potential boundaries that you have in place, may need to have in place, et cetera. And you don't necessarily have to answer that question, but to begin to think about it, because I frame every context or every conversation around food for thought. Okay. So we have material boundaries determining whether or not you give or lend things such as your money, car, books, food, anything, right? Those material boundaries and thinking about what are your material boundaries? Are you clear about what they are? And if you're not kind of thinking that through, physical boundaries feel very, very organic to us. So those are the physical space, privacy and boundaries or privacy and body, right? So for example, when you see someone, do you give them a hug? Do you allow them to hug, a handshake, et cetera, whom and when. While we're talking about this in the space of working with clients, this is across the board, these types of boundaries connecting to anyone or being present in our society. There's also mental boundaries as well, which apply to your thoughts, your values. Are you easily suggestible? Do you know what you believe? Can you hold onto your opinions when they are contradicted, when there's pushback on your opinions, et cetera? And can you listen with an open mind to someone else's opinion? Okay. And this is incredibly important in the work that we do with clients, because we may have interactions with folks and I'm using the word clients, but we have interactions with folks that they may express something that's very different to your thoughts and ideas and opinions about how something should happen, be done, et cetera. And so we want to lean into the premise of when we talk about mental boundaries, yes, it's important to have your own kind of thoughts and ideas and opinions, et cetera, but also a part of this is, can you respect the differing potential ideas and thoughts that someone else may express? Okay. So the other type of boundaries that we're talking about or leaning into just for today is the emotional boundaries. And that's really leaning into distinguishing between your emotions and your responsibility from them for somebody else's. So it's really about healthy boundaries when we lean into this. So we're talking about the potential of giving advice, blaming or accepting blame, et cetera, accepting guilt or feeling guilty for someone else's negative feelings, or taking other's comments personally, right? These are the emotional boundaries that we need to lean into no matter where we find ourselves, because when we're working with folk who have a variety of different challenges, such as substance use, mental health, et cetera, things may be said, things may be said in the heat of the moment, maybe not in the heat of moment, et cetera, that can feel very personal. That can feel very personal, feel like a personal attack, et cetera, kind of lending itself to, you know what? This is not personal. This person does not know me, right? They know me in this capacity, but they don't know me personally. And I need to just take a breath before I interact, right? One of the biggest challenges that folks generally tend to have is that in those moments where it feels very intense, that we don't stop and take a breath before we respond. Take a breath, maybe ask for peer advice, et cetera, or connect with a supervisor, et cetera, before we handle particular challenges that come up. This is very, very important in regards to boundaries and ethics, taking a breath, stopping, right? Just stopping. Even if there is something happening, an urgent, emerging crisis, et cetera, stopping and taking a breath and get all of the information as much as you can gather, and then figuring out how to respond. Okay? Boundaries are not meant to harm or hurt or to shut out others. And so when we talk about this whole premise of boundaries, it's not meant to interfere with your relationship with the folks that you are working with or serving, right? It's meant to establish healthy relationships with folks. Okay? Healthy relationships. So sometimes when we hear about that, okay, I need to maintain a physical boundary. I need to maintain an emotional boundary, et cetera. We may connect that to, I am not going to be connecting to people, or I can't connect to people the way that I would like. You can connect to people. You can have those interactions with folks, but maintaining healthy boundaries can be very much a context of that. Okay? It's not stopping you from having relationships with folks. It's about healthy relationships that are healthy for you and the folks that you are connecting with. Okay? Anybody have any thoughts about that? What I've discussed so far? Oh, yeah. My experience in working at Transcend, and my boundaries are much better. In terms of clients expressing political views that are not my own, I have learned how to be magnanimous and just, you know, I mean, it's been a real learning experience, you know, but I get my, you know, in my private life, I'm very political, but professionally, I have learned, you know, I'm here to serve the client. So that's been a learning experience. And there's other things. And there's other things. We have Transcend in this setting. It's a fine line, boundary-wise, because most of the employees here are in 12-step groups. And, you know, we can't sponsor other clients as, you know, in our guys. And so, there's some navigation that has to happen there. And, yeah. Absolutely. And thank you for bringing that to the forefront. Because, again, while this is something that is present in every setting, it looks different in every setting. So, for example, this may be very challenging for times with, for folks who have lived experience and who are connecting with other folks with lived experience. There's a conversation, there's that connection, that's that, you know, that's there. But yet, how do you maintain healthy boundaries while still having those conversations is going to be key. Okay. And it's something, it's not a one-size-fits-all. It's really constant work to figure out what this is going to look like. And it may look like for different, for different clients, right? Some clients need more of that interaction, some may not. And so, the clients that need that interaction, navigating that is going to be something that you really need to talk about in supervision, connecting with peers, et cetera, right? Because boundaries are incredibly important regardless as to where you land. Okay. But it does become a bit more of a navigational challenge if you are connecting with folks just based upon their lived experience and having those conversations and in groups, et cetera. It can be very challenging. Okay. So, this is constant, constant diligence. Other folks, anyone else have any response to what I mentioned? Yeah. Can everybody hear okay? Yes. Okay, cool. Yeah, I really appreciate the breakdown, especially the distinction between mental and emotional boundaries. The mental ones, I'm just noticing some immediate things. I hope I'm not getting too far ahead here by just noticing some things that I personally have difficulty with. You brought up the idea of suggestibility in this slide, right? Can we maintain open to opinions without being overly suggestible? And I think that one is extremely difficult to do in an environment where somebody maybe has an ulterior motive, wants you to be suggestible for something. And so, maintaining openness, like, sure, maybe it's possible that I'm trying to think of a not entirely relevant and some particular brand of bottled water made you blow positive for breathalyzer. Sure, I can entertain that possibility, but it didn't. And then the other one is not taking things personally. That one is extremely difficult for me. I've had that happen a few times recently where I can look at it, understand intellectually, I did not do anything wrong. And the reaction that I'm getting is not about me as a person, it's the role that I'm filling in a professional setting. And so, doing exactly what you said, taking that extra breath, talking with some peers about this to help kind of ground and understand that, yeah, I don't need to give advice, blame or accept blame. So, those are the things that stand out to me. Excellent. And thank you for sharing that because it is difficult when in the midst, like, depending upon your standing, like, your position there, depending upon the type of interaction, et cetera, this can get pretty challenging when someone is saying something directly that feels very much like a personal attack. And we're human, you know, when we think about boundaries and ethics, et cetera, this also is us being human beings and connecting to human beings and the navigation of relationships that happen on a day-to-day basis. Hi, if I may, sorry, I was late. I'm Vicks. Thank you so much for coming and doing this training, Dr. Blackwell. I just, picking up on what Ned and Simon said about this, I think that what's really key for me to have good boundaries is to know myself, is to be really, really honest about who I am. As Simon just said, you know, if I'm someone who takes things personally, for me, that's not it. For me, it's more like what Ned's talking about. Like, if we get the politics talk going and, you know, I love to argue. I know that. I know that I love to argue. And so, in a professional setting, I, you know, put a tamper on that and have pretty strong boundaries around conversations regarding politics, religion, ethics, et cetera, that we can get into and kind of get off track of what we're trying to do. And, you know, it's a fine line. And this is where, this is so important for us to define a lot because talking about things like your, you know, ethics and moral sense about the world are really important in recovery. Like, that's crucial for people to be defining those things for themselves, but it can go off in a dangerous direction if we let it. So, I know who I am, and that helps me to set good boundaries. And you mentioned something key there. Thank you for sharing that information. Self-awareness is key here. Reflection on what you're doing, how you're interacting with folks. That's where that breath comes in. Like, wait a minute. Am I about? Let me just take a second because this feels like an attack or this feels like I may be crossing a line here. I would like to say that the majority of the time, if something raises a flag for you, you need to pay attention to that flag. Because most of us know when we're crossing a line, like, it just doesn't feel right. Right? It just doesn't feel right. And if it doesn't feel right, you may not be clear on what doesn't feel right, but that's when you can kind of take a breath, stop, and like, you know what? Let's revisit this. Let's come back to this, et cetera. And then you can talk it over with your supervisor, a peer, whatever it is that you're a supervisor, a peer, et cetera. One of the things around boundaries and ethics is that you do not have to navigate this alone. You don't. In the professional setting, it's about connecting to your supervisor, connecting to your peer, connecting to whomever to help you process this. Because nine times out of 10, when you process it, that person who you're connecting with will give you maybe one perspective that you didn't think about, maybe help you to process it and think about it and think about, okay, maybe I should take a step back from this. Maybe I'm not the person to deal with this particular situation. All of these different things are possibilities. Okay. Dr. Blackwell, I think Abraham has a question here. Sure. I just wanted to chime in and say that one of the things that stood out to me is that there's kind of like these two roads. There's like these overall ethical standards and then also like very much like case by case. I've encountered things that for one client would be like massive transgressions of boundaries that for another client, it's just like everyday communication. So both of those at the same time, the standards and then the case by case, sort of each individual's variation of approach, idiosyncrasies. Absolutely. And this is very much connected to individualized care and knowing who you're connecting with. So let's say, for example, we introduce a little bit of trauma-informed care into this, right? The recognition that potentially the person that you're connecting with may have experienced some level of trauma, right? How do you, when you stand with that space, like, okay, I need to be respectful of boundaries. I need to be thoughtful around what our conversations are going to look like, the consistency, all of those things are incredibly important. So yes, while boundaries and ethics, there is this kind of broad strokes work into it and broad strokes thought process around it. Individual cases definitely are a moment to take a breath back and say, take a breath and say, okay, this particular person, what's happening for this person? What happened in this interaction? Am I potentially crossing a boundary here? And sometimes I know it's going to sound so organic, sometimes just asking the client, are you comfortable with what's happening? Sometimes we are so caught up in our own, I don't want to. Because when you ask the question, you have to be prepared for both responses. No, I don't feel comfortable. We always want our clients to feel comfortable, but we also have to be prepared for if we ask the question, that we may get a response that looks very different than what we thought. So sometimes that keeps us from asking the question, but it's one of the most powerful things you can do. Are you comfortable with what's happening here? Are you comfortable with our conversation? And not only not just asking, but paying attention to the nonverbal communication as well. When someone's leaning back, or leaning forward, or eye contact, et cetera, that is also giving you nonverbal cues that there's something happening that is causing a reaction. And then by asking, that is, are you comfortable, et cetera, the person might just be processing. You might be processing. But it's OK to ask. It's OK to take a combo of the verbal and nonverbal and really respond to that in the moment. And in the moment, recognize, OK, I need to take a step back. I need to take a breath. Dr. Blackwell, if I may ask a question about that. And again, if you want to address this later, that's fine. Just let me know I'm going too far ahead. If we ask that question, which is a very reasonable question, and they say, I'm uncomfortable, but it's something that it would be irresponsible to not do. So for example, I'm uncomfortable taking a drug test right now. OK, I'm really sorry to hear that. But it's completely irresponsible for us to not enforce that. And so is there a way to kind of, are there maybe times where it doesn't make sense to ask that question or like a real way? OK. Absolutely. And you also have your policies and procedures. So this is operated within a context of the policies and procedures of your program, what is expected. We can call them the typical client rules, expectations, et cetera. Having boundaries and ethics, finding folks that may be, hearing that folks may be uncomfortable, et cetera. There's certain aspects like, OK, if toxicologies are an expected part of being in this space, then that's something that you can talk about. But at the end of the day, this is where it is. OK. The conversation, when you have the conversation, it doesn't always mean it's going to work out the way the client wants it to work out or the way you want it to work out. But it's about having the conversation. OK. I hope that answered your question. Yes, thank you. You're welcome. All right. So the other thing we need to take into consideration is cultural context. So context matters when it comes to boundaries. And I think this speaks to something, I think Vic mentioned it, like knowing yourself. But it also sounds like folks are connected to, and it also sounds like Abraham, like knowing the clients. Knowing the clients, but also knowing cultural considerations that may play a role in your work. So what may feel very organic for one client may not feel organic for another. OK. So knowing who your clients, knowing the cultural aspects of any decision-making process or interactions you have is going to be key. So culture must be considered from many different perspectives, right. Now there is no way that you're going to be able to consider every single component of what can lend itself to context. But being very thoughtful about this person who comes from this particular culture, and culture means many things to many folk, may experience this very different than someone else. And when we think about boundaries and ethics, that's that navigation that we need to engage in. OK. So thinking about the cultural considerations is an important part of this. So factors that can influence boundaries when we talk about culture, et cetera, it could be unusual power, unequal power dynamics, right. Regardless as to your role, when you're talking about that alliance between clients and folks who are working with clients, right, whether it is peer recovery coaches, whether it's supervisors, directors, et cetera, there is a natural unequal power dynamic in the room whether you choose to acknowledge it or not. You have a resource that clients may need, right. And so that makes it unequal because one of the things that is very challenging for anyone is to be vulnerable. And your clients are always vulnerable, right. Even the clients who may not appear to live in their vulnerability or show their vulnerability, the very fact that someone is in a space seeking assistance, someone is living in a space, et cetera, there's an unequal power dynamic in the space, OK. So acknowledging that. Community influences can also influence boundaries, right, which is connected to the cultural aspects, et cetera. Mental illness, codependency, addictions, et cetera, can also play a role in boundaries, OK. So this is something to consider as well. And I think it goes back to Abraham's thought process around knowing the clients, the individual who are you interacting with, right. Personal and professional experiences. So we could be talking about lived experiences. We could be talking about when a client has an interaction with you that feels very much connected to your own personal experience. Figuring out what is yours and what is theirs, right, is going to be a part of this boundaries or influences boundaries or maintaining professional boundaries. And also training and professional development in this area. As I indicated in the beginning, this is not a one-off conversation. This is something that we all have to visit, OK. All have to visit at various times throughout our career, our year, et cetera. And things come up that the program or folks in the program may need to discuss, right, because there's no way we could cover all of the potential boundary issues. There's no way we could discuss all of the particular ethical dilemmas. But if something comes up in the program, not feeling like I'm doing this alone or I have to decide this alone, connecting with the appropriate folks to process it, OK. So the ways you could process it in a team meeting or group meeting, you can process it with your supervisor. You can also connect with a peer, like what are your thoughts about this, et cetera, and not feel like you have to do this alone, OK. So I'm going to touch on a code of ethics just a little bit because different disciplines have different code of ethics and some may not have the in-depth code of ethics as others. So I want to be very thoughtful around that. And so a code of ethics is intended to serve as a guide for everyday professional conduct of professionals. And it clarifies the standards and principles that guide the conduct and professional practice of workers. Now, the thing to recognize with the code of ethics is it doesn't tell you it's intended to serve as a guide, right. But it doesn't tell you how to respond to a particular situation. Many code of ethics, if you take a look at them, will say you should do this, right. You should do this. Or maybe you shouldn't do that, right. It's a guide. So it's really important for you to see it in that perspective. If you are in a discipline that has a code of ethics that's enforceable, right, that code of ethics is actually not enforceable by the professional organization you're a part of. It's actually imposed or it's actually upheld by the discipline licensing, right. So if you have a license, if you're a clinical social worker, it's not actually NASW that upholds the code of ethics. It's actually the social work board that does it, OK. So each of you has different thoughts or different connections to the code of ethics. If your particular space or particular discipline has a code of ethics, you should be aware of them because it helps to guide your practice regardless as to where you're landing, wherever you are practicing and engaging folks. But remember that as a guide, OK. The other piece is it's a part of your overall professionalism. Anything that kind of puts us in a space where we have information in which to respond, et cetera, is a key part of professionalism. And it doesn't specify, even if you have a code of ethics, it doesn't specify what values and principles are the most important or outweigh others in instances of conflict. So it's almost like all of this information is put forth as a should guide of what you should do or should not do, right. But it's not definitive. And it also doesn't tell you, well, this is more important than this, right. So kind of leaning into that. The other thing is that if your discipline or your particular title does not have a code of ethics, you ought to rely on the agency policies as your guide, right. Many agencies have embedded policies related to a number of different things. And so you need to, when folks come in and they onboard, et cetera, I always say to folks, don't sign that you read and understand your agency policy and procedure unless you read and understand it. Because that is actually your guideline as to how you conduct yourself in that particular organization or space, right. So generally, organizations do have some sort of built-in code of ethics or some sort of built-in guides around boundaries and ethics in their policies and procedures. So again, if you don't know what the policies and procedures are, please advise yourself of them, OK. So I'm going to open this up for folks just to think about. And if you feel comfortable in leaning into this, you can definitely lean into it for the group. If you don't, that's OK, too, because I always operate from a space of food for thought. Doesn't necessarily mean that you have to share it, but just kind of thinking about it, right. So while ethics may be a specific code of behavior, some boundaries are based upon job expectations, while others are based upon personal values and choices. What are some of your personal boundaries? And is there a difference between ethics and boundaries? And how do you balance your personal beliefs with agency policy and or the code of ethics? So just taking a moment to think about that. And if anyone would like to share or feels comfortable sharing that, you can definitely unmute yourself. Yeah, I just think most of us here are all unlicensed. And I think that puts us in a really, well, often in a tough situation, but in a strange space. Because we're not held or trained in the codes of ethics as supplied by some regulatory board or oversight. We don't have that infrastructure, both educationally and in action, for us. But we are very, very intimate with clients because we're the boots on the ground, right. The people who have those codes of ethics, who have that education, are in their offices. And then we're the ones who are with the client in their homes, with their parents, with their spouses, with their partners, in the most intimate settings, which would immediately be a violation of boundaries for, say, a licensed therapist. But that's where we're expected to be. So I think that this stuff is one, very, very applicable to us in our work, but also in some ways very gray because we're sort of hired or brought in when other people don't want to cross their own ethical professional boundaries, which is just an interesting reality of our role in this field, I think. Absolutely, absolutely. And thinking about it, there's no code of ethics, or you're not guided by a code of ethics, but you do have agency policy. And so how do you balance that with your personal beliefs? And how does that potentially impact your work with clients? I'm seeing folks like, I'm seeing the machinations like their brain neurons are firing off as I'm asking that question, and they're looking at it like, huh, do I want to say something, not say something, et cetera? And that's okay, because this is really that food for thought piece, right? I'll chime in a little bit. Sure. I'm grateful for this training and conversation because, I mean, I think boundaries is one of those universal things that I think should be taught in schools, and it just isn't. It's like so key and central to life, personal life, professional life. And it's something that I wasn't even really acutely aware of until just the last few years, and I'm learning more about it. So I think it's good that more organizations are doing this, and it's becoming more commonplace. And I think it's great for professionals to have this knowledge, but also for clients. And like, how do you begin to incorporate that? That's something institutions and organizations like Transcend will have to figure out as they go. But the interaction and the work, I mean, it's all about recovery in our instance, maintenance and recovery. And I think that's best achieved if certainly the staff understand, have as good an understanding of boundaries as possible. I mean, no one can ever have it right, and two people can be right at the same time. Boundaries are so arbitrary sometimes, especially with cultural relativism. But I mean, my personal experience, I'll tell you how I learned about boundaries after I completely galloped over them and someone broke up with me and told me, I'm sorry, you just violated this boundary with me or whatever. And it's kind of frustrating because two people can have completely different boundaries. I am personally, there's like attachment styles. There's secure, avoidant, and anxious. I was born in a situation where my parents divorced pretty much immediately. I'm very anxious. I let everyone in. I personally don't have a lot of boundaries. I will let people in completely. I will absorb what they say and roll with it. And I'll give myself over to help and be supportive even if it's beyond my capacity sometimes. Just because I don't have very good boundaries and I'm working on building those up. Now someone else could be raised in a very strict or frightening environment where they have nothing but boundaries and they're very reluctant to let anyone in. And that's something we all have to navigate and figure out and learn about. But I think we can get to a better place where we understand boundaries better. We respect ourselves enough to put some up for ourselves, but also have the courage to take down maybe the excessive boundaries that we've had in the past and let other people in. And I think it's so important that organizations and institutions, when possible, I mean, areas like medicine and psychology and client privilege, those things are pretty hard and fast, right? You can't cross those. But we have to be able to give each other space to understand and learn what someone's boundaries are. And latitude, I think, is so important. I certainly like to give it. I hope I get it too. But we're just sort of all figuring it out as we go. I was just thinking, you walk into a room with seven people and you're all having a discussion. The one person you can't see is yourself. But now, all of a sudden, we're in a Zoom that's being recorded and we can see everyone, we can see ourselves, and we're being recorded. And like that all comes into play. But I think it's best just to proceed with a bit of courage, a bit of care, a bit of optimism and positivity, adding value. But it's very interesting because 100 people are gonna have 100 different sets of boundaries and you just have to figure them out together. And it's so important to step over them. If we can avoid it, it can happen. That's where apology comes in. And I find with friends and as I get more into recovery with clients, maybe not asking as much, but letting them bring it out because people will be more comfortable bringing out than being asked to bring out sometimes. So it's like that balance between bringing things out in people and giving them the space to bring it out themselves. Absolutely. And thank you for sharing that because this self-reflection, knowing your boundaries, the client's boundaries, et cetera, is all a part of this. Also, and thank you for also bringing forth that this, and it's something I'm kind of setting this stage for, that this is not just you, it's also the clients being aware of what their boundaries are. And if not having them, is that a part of that recovery conversation? And it should be. It should be something that's built in because when we're in the midst of a variety of different experiences, we're in the midst of that experience, right? And that experience may be the priority and things that we may not ordinarily do, we do. That's one. Two, we have to learn, we have to be taught boundaries, right? They're not something organic. So when we go with the tabula rosa, folks are born as a blank slate and their experiences create their experience of the world, how they see the world, how they see themselves in the world, et cetera. The same would be said for boundaries and ethics. Where do we learn this, right? Where do we learn it? There's an initial thought process is our family, family of origin, et cetera, caregivers, et cetera. Then we go out into the world. But that is very much dependent on what your family of origin or your family, et cetera, who caregivers gave you as tools in regards to boundaries and ethics, right? And then we have different experiences and that reshapes our boundaries and ethics as well, okay? So kind of leaning into this as this is a journey, the same way we talk about recovery, it is the same thing in regards to boundaries, ethics, thoughts, the way we see the world, the way we see ourselves, et cetera. Yeah, discernment is the word that comes to mind for me. Does the client need to know this about myself? I mean, we are in this kind of communal environment and where we have a shared experience. And most, if not all of our employees are in recovery. And sometimes, I mean, one of the first things you learn is don't talk about medications, your medications. It's not your business to discuss your medical history and war stories. I've got great war stories and it's been a learning process that I don't really, there may be a time and a place where I can be relatable to something, but I've gotta be aware. I've gotta have that cap on at all times. I'm not dealing with friends. We're not here to be friends. We're here to be professionals. And that's a big one to navigate, particularly if you're working with or connecting with people with similar lived experience. There's this kind of like, well, you know, have you ever? And there's this thought process, like I need to share this information in order to have a different connection or a higher level of connection with the client. But thinking about taking a breath and saying, what am I sharing? And what is my intention for sharing it? And it doesn't matter who you are, what profession, not profession, et cetera. And it's the same thing with friends. Like if you think about friends and your interactions with folk that you know, you don't share everything with all of your friends. You take a moment and you think about, do I wanna share this? I have my baseball friends. I have my football friends. I have my friends I hang out with. I have my friends that I call when I'm in trouble. And sometimes they're the same person, sometimes they're not, right? But thinking about the same kind of boundaries you have in place with the way you interact in your personal life is the same thought process around your professional life. Am I gonna share everything that I am with this person? And if you're in a professional space, the thought process is no, we don't share everything that we are with a client, nor do we expect everything that a client is for them to share it with us. Yeah, I can just chime in. Oh, sorry. Go ahead No, you go ahead. I was just gonna say that I think that you know, what that said is Is absolutely true. And again, it is sort of by location though in some ways Because I've also like I've been hired before and someone said hey your job is to be their friend And so I think it's like navigating those boundaries ethical lines You know not being a friend while being a friend can be something that we're asked to do and that's definitely somewhere I would like to you know, learn more and be able to grow and it's like What does it look like to be hired to be a friend for a client be a friend for them and still maintain? healthy boundaries and ethical lines So then the other thing kind of commenting on that is when someone says that like let's say there's an expectation Be the clients friend. What does that mean? Can you can you let me know what that means to this organization or means to you? When you say being a client front and letting them explain it So that you're clear on what's the expectations are I if I may on that I think Sort of the idea that like You know if there is there is a power dynamic at play and it's also it also means that like the the relationship is Not necessarily two ways and so oftentimes. Yes. I am the clients friend, but they're not my friend You know what? I mean like like my relation to them Is different than their relation? Relationship with me And that's that's okay. I mean they can you know, they understand that as well You know, I think part of my ethics is being straightforward about that And that is that is the toughest situation for sure is that we work with we work with clients who don't want to be worked with We work we are assigned to work with clients by treatment teams and families who these clients are not Thrilled at all about being in our space or working with us and that that's definitely the hardest thing because Consent is so critical in all this work So, how do you how do you get consent when somebody really doesn't want to give it? You know, how do you find the right like what can I do with you? Cuz I guess we got to do something here You know, and that's that's that's the tricky part of our business. I I Just wanted to comment on the things about our organization I don't know if you know this but we are so we're essentially a splinter off of a larger older organization That's you know, that's like about 16 years old, but we are only three months old And so we have we have inherited a lot from that organization from Trent the greater transcend But we are also kind of reworking this and I was just like texting Simon here Like we've got it. We've got to rewrite these policies and stuff. We our organization needs to have a stronger Guidelines and systems for how to do these things because that's that's you know As you said like that has to be relied on Abe said that most of us are not certified That's actually not true anymore at this point more than half of us are and we are working on getting everybody certified That's actually very important for us to be certified recovery peer advocates To really work on building what that peer status is because that's actually sort of an answer in part to Abe's Point of like what what is that relationship? Well a peer kind of answers a lot of these questions I am a peer to you in this recovery space You know, it's like being a friend but not quite it's like being a you know, like an action partner It's like being you know, sort of like a sponsor but not really and you know Defining what a peer is and that that training I think for everybody here who's taken it can can speak to that training being very helpful in defining what a peer is in in in contrast to other Roles in the recovery world as opposed to a counselor as opposed to a sponsor as opposed to etc But I did just mean like go license like the therapists do one kind of job. We do a different for that. Thank you So so we're working on those ethics and boundaries as as an organization And and so I just I want to say to everybody here that like that's that's a really important goal of ours And I don't know the question about the difference between ethics and boundaries is really interesting I I think that I think that ethics maybe or something. That's a little that's a little more like permanently instilled Or something that like I react to each situation with my ethical principles like they're whereas boundaries are more Dependent on the person, you know, they have to be worked out case by case There's some personal boundaries that I'm you know Do not engage in any sexual contact with any client whatsoever, right? That's a that's a boundary that I will always maintain based on an ethical principle but as Abraham said right some certain interactions with one client would be would be like No way on earth with another client. That's that's how we talk That's the that's the way we get, you know, we get talking, you know, we do a little you know, light ribbing or whatever Anyway, yeah, thank you. Thank you. So Definitely leaning into the premise that certified recovery peer advocates is a they have a code of ethics they have You know, they they shape what you do. And so That's one key. The other thing is is that When I talk about food for thought this may feel very connected to each of you thinking about your you know Reflecting about what you're doing, but also done this and agencies are like, you know what we need to go back and take a look at that Okay, and that's okay, too and so that's why everything is kind of framed in that food for thought because it's food for thought on an individual level and an organizational level Right. What kind of structure are we providing for folks to feel safe in? There in this space not just for and when I say folks feel safe in this space clients and staff Okay, so I'm gonna move us forward But continue to think about this and once again you receive the slide deck and so you can continue to process this on your own And talk with your supervisor around this as well. Okay So, let me move myself forward. Okay. So what purposes do boundaries serve they set parameters They help protect and inform both workers and clients They give workers confidence because you get a sense of there's a structure here that I can operate within Right clear boundaries help to develop trusting Relationships, right when folks are aware of boundaries their boundaries my boundaries, etc It develops a trusting relationship. It can help to develop professionalism because it's something that would consistently look at Clarifying roles, which again that was that conversation around service and what's your role? What's the role of a peer? What's not the role of a peer etc, and it helps separate you from work, you know work from home Right because if you have these very diffuse boundaries, it's like you never ever Take a break from work. You never ever take a break from home Everything is mixed up in this stew and we know when things get mixed up Sometimes it can lead to other challenges as well Okay So it's responsible. The professional is responsible and you are all Professionals regardless as to whether you are licensed not licensed certified peer recovery coaches or not You are all considered professionals because you are in the workspace Okay Professionalism is not dictated by level of licensure or certification It's about how you present in the workspace how you interact in the workspace So we're talking about the professional is responsible for establishing and maintaining boundaries. Sorry at the mill hospital It is a position of power because of the knowledge that you hold and the clients need for that knowledge of service You must not misuse or abuse the position of power by crossing boundaries. Excuse me about that You should maintain or it's your responsibility to maintain a healthy Trusting professional relationships with the folks that you're working with Regardless as to where you're working with them, right? And so let's talk a little bit about Professionalism which is that connective tissue because as a professional it again I go back to that original point It doesn't matter level of licensure Certification, it's such a professional is a professional Okay, and so professionalism includes many aspects of consideration Some of them are the professional behavior and ethics Your organization provides a lot of structure or will provide a lot of structure about what is considered professionalism in your organization And what is not considered professional conduct in the organization? you can maintain yourself in a professional manner while using personal ethics to guide or enhance your practice or Your personal or your policies and procedures to do so Professional development is something the ability to commit to continued learning and professional development, which is what you're doing today, right? Professional development is really engaging in that continual learning None of us learns how to be okay. This is who I am. I don't need any more ethics work I don't need any more the thought process around boundaries, etc. Okay, I've got it That actually is something that is a constant journey Okay Professional judgment judgment is the ability to make sound decisions based upon a combination of a variety of different things It could be training professional experience Consultation with the organization's policies and procedures standards and guidelines So judgment is not okay my gut instinct of what I'm supposed to do. It's a combo of a lot of things. Okay So, why do we care about professionalism, right I Have a friend of mine's who loves to say nothing is a problem until it becomes a problem right Everything is good copacetic. Everything is cool until there becomes a challenge, right? And I love that statement because it speaks to you. We're working with folks. We're connecting with folks We're engaging folks in a variety of different ways home visits, etc. However, you're engaging them and It's not a problem until something comes up and then suddenly you're like, wait a minute. I didn't even know this was happening right, and so you want to lean into the potential of Why care about professionalism you want to avoid any challenges around client grievances Often said and I can tell you one of the things that most client grievances are connected to this person was a professional They didn't handle me professionally didn't speak to me in a way that I thought was respectful Right, and so that's something you want to lean into it prevents burnout and promotes mutual respect because it's something that is a constant Journey that you're connecting with a client connecting with their family, etc in a way that feels organic It increases client satisfaction because when a client comes to you from a space of vulnerability The recognition that you they're going to be spoken to from a space of mutual respect Understanding etc. That is incredibly important. Okay, I will say and I want to circle back to something because I do some work around Challenging clients, I like to use challenging clients versus resistant clients or etc. I will say That for every client who engages you right that means something in them recognizings. I need to do something Right what may start out as an external motivator can eventually become an internal motivator And even if someone is in the face of an external motivator Like I got to do this because of this. They actually don't have to do that They can make a choice not to and you can fill in the blanks Okay, so I've worked with clients. For example, one of my Spaces or one of the spaces I worked in was in the court system, right and folks would come up upstairs and they would be offered a And they would be offered a offered a choice between treatment or incarceration Right, so they stand there for a minute Okay, I'm going to take treatment There were also folks who said nope don't want to do treatment want to do incarceration Okay, that's a choice Folks may have limited choices, but they still have choices So every time a client sits down and talks to you they are making a choice to engage you So there's something there to work with Okay Also, it helps to professionalism also improves or leans into Job satisfaction for staff and there's other concerns as well in regards to professionalism So I would ask for you to continue to kind of think about this and process how professionalism impacts your work How you're present or present in the space that you're in present with the collaborative partners you're working with, etc okay, and How do clients see you? Right. It's also something to consider when you're thinking about professionalism, right because someone mentioned it I'm your peer. I'm not your friend. I'm your friend, but I'm not your friend Okay, what does that all look like? Okay So Uh, let's see. So the professional which is all of you should be responsible for setting and maintain professional boundaries Not exploit the trusting relationship with clients. I will tell you there are a variety of spaces and places That relationships with clients are exploited. Someone mentioned it a little earlier sexual contact, etc There's all of these different things that we could be thinking about and this is just some of the things to think about Okay may not enter into a personal relationship dating sexual relationship That one feels very organic feels like it makes sense. But for some folks it has it does not make sense to do that Okay, so we want to think about that many times when we think about professional boundaries and ethics An organization will respond to something that has happened Okay, so they have the framework that initial framework and then the framework is adjusted based upon something that has happened Whether it's a training whether it's something that's happened in the program, etc okay so you don't want to necessarily engage in violation of professional boundaries with a current client or someone with whom the client has a Significant personal relationship with we also want to be very aware of that as well Do not make any appropriate physical contact with a client Right and also never initiate and engage in any sexual conduct with a client Right some again some of this feels like why would I be mentioning this because it happens It absolutely happens Okay, and we also want to be thoughtful about while i'm talking about that heightened intense situation of sexual contact with a client, etc We could also talk about lending money we could talk about a variety of different things that can be challenging to say the least Right. So being very clear on what you're doing Thinking about the agency's policies around gifts and money. All of those things are things you want to think about. Okay So let's talk about a few ethical dilemmas that are related to professional boundaries issues So I could spend all day talking about personal self-disclosures client-staff relationships, etc Um, we have not even enough time to lean into that because personal self-disclosures Is one of those things that you really need to be thoughtful about what are your personal boundaries around it? Because everyone has different thoughts and ideas around it. I generally when I talk about this in my classes, I will talk about There's black and white and there's gray Right, there are some folks who will never disclose any information, right? There are some folks who will close too much information And there are folks who are in the middle who think about what they're disclosing and why they're disclosing it I would say to you to Land somewhere close to the middle Because even as you're sharing lived experiences Right. Why are you disclosing that? Okay, and how to how it can potentially shift the dynamic the conversation Right. So sometimes in sharing lived experiences The conversation shifts to your experiences versus the client's experiences. There's now been a shift In that conversation and is that really a helpful conversation to that particular client at that particular time? There may be clients who come in contact with everything is connected like they're they're There's kind of almost like this distraction to not talk about what's happening for them Right, so how helpful is that to the client? So you want to think about all of that? Also dual relationships, so gift-giving, receiving, physical contact, other things that could potentially raise two ethical dilemmas So when we think about the dual relationship, a professional enters into a dual relationship when they assume a second role with the client So becoming a worker, a friend, a teacher, business associate, family member, employer, or sex partner Any of those things could potentially fall on the dual relationship When we talk about living and working in the same environment Right that can even land into some challenging stuff as well Because if you are in the residence or you're in the space with a client And you live there that can be very challenging to deal with That can be very challenging to keep some sort of boundaries around the potential of developing that dual relationship Okay, excuse me Yes, sorry. Can I just bump in here because I think that uh here the uh, with us um by far the most uh, you know sort of prevalent issue is definitely around like business association like There we we work with our population to transcend is mostly pretty well-off clients, uh, and they're a bunch of uh, a bunch of young men recovering who often come up with sort of like Schemes and scams and and various like they have all kinds of get rich quick ideas. Um, and uh and and and you know everybody like, you know people and this is also something that people like to talk about in this in the Same setting of a bunch of you know, young men around each other like oh wow. I got this idea Um, and so it can be easy for uh for staff to get caught up in that kind of talk and then go too far Uh, and so yeah that just wanted to say that that we have to watch out for that It is completely inappropriate to enter into any kind of um, business association with our client other than The one that we are in as representatives of transcend Uh, that has to be the sole one it would under it undermines that work that we are doing Which is the most critical work helping them with their recovery mental health, etc to enter into that other relationship um, and and we you know, you have to resist the temptation I and and They're like I I spoke to one of my clients who i've worked with for a long time Uh, and he was asking me about boundaries like what so what kind of boundaries you have? I was like, well, I wouldn't do something like this I wouldn't I wouldn't ask you to give he's starting a company I I wouldn't ask you to give me a piece of your company and he goes Oh, well, I I totally would have if you'd ask me damn. I'm glad you i'm glad you didn't right? Um, you know, they need protection from us, you know as much as it feels like, you know However, it might feel like you might be talking to somebody who you know Yeah, we have influence over them in ways that we have to really really be responsible for Um, and so yeah, that's important for us to watch out Absolutely, and thank you for sharing that because this can be a slippery slope Depending upon the clients that you're working with Conversations and being very thoughtful about this conversation seems to be going in an interesting area Let me take a breath and think about this for a second Okay, the one thing we can control is our interaction Right, we can't control what people think about what we say So if we take a moment and think about what we say check in what folks are thinking this can resolve You know, this can keep us from a lot of challenges later on Right because as my friend says a problem is not a problem until it becomes a problem All right so So the dangers of dual relationships it can impact a client's or a worker's not my clients, uh workers objectivity They can be damaging to the relationship Right, um, it confuses roles and responsibilities It can limit your ability to confront clients, right healthy confrontation When we are in the midst of working with a client and something has happened like let's say for toxicologies If you're in a business as a relationship with the client, right? And you're asking for a toxicology What does that look like and this person's saying no Okay, how does that impact your ability to work? Okay, how does that impact your ability to confront the client Okay There may be a violation of agency policy And there may be unethical and in some cases depending upon what is happening illegal Okay, So we want to be friendly with your client, but you're not your client's friend. And if you're in a space where someone says, I want you to be my friend, what does that look like to you? Because people use that word friend and different folks have different meaning as what friend means to them. Any word that is fairly innocuous and use, I like to look at safety, friendship, et cetera. I always ask the person, but I'll say it in a way like, I know what that means to me, but can you tell me what that means to you? So that we're on the same page. Okay. Any thoughts about that? Thank you for that phrase. That's that is, that is perfectly, perfectly said, get them to define what the heck they're talking about. This is a really silly, really silly example, not from work, but my girlfriend has got me watching this the show called Love Island, a really, really dumb show. Watching some Love Island with Lauren anyway, they, these people, I mean, I mean, and sort of the bit of the show is you're watching kind of stupid people, but, but they keep using these words, like, like that's sus, this is sus. And they're all saying this word back and forth and they're arguing over what it means without anybody actually like defining it and just saying, no, that is, and that isn't. And it's such a, it's so, it's a great example for me over of how critical it is to define these terms, to make clear what the heck we're talking about. We are all blessed with the gift of language and we need to use it. This is, this field is all about communication and all about, you know, sometimes we're like, it can be easy to be like, oh yeah, I get you. Like I, you know, we're on the same wavelength, but, but you don't just trust your instincts about that. You know, like, like, and I do, and you know what, everybody here has pretty good instincts about these things. That's what I, that's what I select for when I'm hiring people. That's what I admire and trust about you guys in many ways, but it's still important to understand that just because of that doesn't actually mean, you know, you can't read minds and people can mean dramatically different things with some of these key terms. So that that's perfect, perfect. Just what, I know what I mean, but what do you mean? Perfect. Yep. And you may be surprised by what folks mean by a particular word. Okay. So it's always super helpful to just ask, right? Just ask. May feel silly, but it's always best to ask, right? Because they might be saying friend and their friend is defining exactly what you're doing as a peer, as somebody to talk to, et cetera. Okay. Then I can work with it. That also ties, sorry, to cultural competency, right? Because some people are, people have different slangs, different vernaculars, et cetera, that they're coming from when they say these things. We had a whole silly argument a year ago about this word that like all the people from the city meant one thing, all the people from the suburbs meant something completely different. There's plenty of things like that. Yes, absolutely. Absolutely. So the other thing I want to touch on is digital guidelines, right? And again, there's so many different moving pieces to all of this. I just kind of pulled out a couple of them. So digital guidelines. When we're thinking about interacting with folks in the virtual world, right? We have Facebook. We have all of these other things, Twitter, all of these other things, right? Being very, very thoughtful about how you're engaging folk via digital, any type of digital platform. So professionals should not permit their private contact to interfere with the ability to fulfill their professional responsibilities. Thinking about membership on social networking sites may affect potential and current clients. And so thinking about your online presence sometimes, I will tell you, I am on Facebook, right? But my Facebook is locked to only family and friends, right? And I'm still, even though I have it locked and it's a small group of folk, I still am very thoughtful about what am I posting, right? Because people can share things, et cetera. And am I comfortable with sharing things on social media that I want a potential client, a potential another person to know, right? So you want to be thoughtful about that. You should also respect clients' right to privacy. One of the things I'm going to say is that when you get a friend request or some sort of request from a client, because clients can search you on social media, what are your thoughts about accepting clients as friends so that they have access to you as social media? I want to throw that question out there. Yeah. I think that's, again, like we're a strange role, you know? Like I've had interventionists who are looking to hire me specifically ask for my social media so that they can pitch my online presence to a client to say, hey, does this person seem like a good fit for you? Here's how they present online, right? And that's something that would never happen for anyone who's clinical, right? A therapist would never be asked, hey, can you give your personal Instagram to a prospective client so that they can vet you out? So we are often put in a strange situation by being the role that we are. And I think this is something that I could certainly stand to benefit from is like, where are the lines there? Especially when our private and personal worlds are often directly implicated, even in that first step of being a viable candidate for a role. Absolutely. We all have heard of cases where individuals have been denied positions or have been, unfortunately, asked to move away from positions because of their social media presence. So we all want to be very thoughtful about this. Now, this is not about saying you should always be policing your social media to use that framework. But being thoughtful about, would I be comfortable of whatever I'm posting, would I be comfortable with a potential, and you can fill in the blank, seeing this? Would I be comfortable with third party or 50 parties seeing this information? Also, there are multiple organizations, especially since the pandemic and the advent of virtual work, et cetera, that many folks are doing, have put in place. They had basic social media policies and procedures, but many of them have beefed them up in a lot of different ways because of the impact of social media. So being very thoughtful about who has access to your social media, what that's going to look like, et cetera, is something that you may want to talk through. Also being thoughtful, professionals, again, should not engage in dual or multiple relationships with clients. And that can get loosey-goosey if someone is a friend on your social media, because guess what? If they're a friend on your social media and there's something that, well, I saw you went to London. How did you enjoy that? It just gets a little gray sometimes. And so you really want to be very thoughtful about that, okay? Conflict of interest, dual relationships, privacy, and confidentiality, and also clinical considerations as well are connected to digital guidelines. So you want to think about that. Now do you need to think about all of that? Not necessarily, but having a conversation around it and having some guidelines or some foundation on it is key, okay? I have maybe a quick comment on that. I'm on Facebook, and I would never try to friend a client. But what do you think about if a client wanted to friend me, I'd find that an ethical dilemma or a personal dilemma, because I may personally think, no, what's the upside to this? This could be tricky to their recovery, the violation of my boundaries and personal space. But at the same time, you don't want to put up a wall and make them feel rejected. So is there like a hard and fast rule in this space about professional staff are just not to connect with or accept invitations to connect with clients on social media? I think that it is something that needs to be discussed within your organization, because I've seen it go both ways. One suggestion has been to have two separate social media presence, where one is your personal social media, your Facebook, and then you create another Facebook profile, because clients can find you, can ask to friend you, et cetera. And what does that look like? The other thing, the other more tricky thing is that if you, let's say you have a friend on your social media as a colleague, and your colleague accepts that friend request, they now have access to your and the colleague's information. So you really want to be clear about what this looks like. My best, my thought process is to talk this through with your peers and figuring out what lands best, because you also may want to embed it in your policy, your social media policy. Any of the transcend crowded opinions on this, maybe Bix, what would you do if someone tried to friend you? I don't have social media. I'm off everything. And so I'm like, blessedly, like, this is so easy for me. I'm only on LinkedIn, which of course, I'm fine with people in a professional sense. I'm just set up for that. My personal social media, I mean, you know, we're all people. My past displayed on my social media is quite embarrassing. I have never done a recuration. I've just part of my recovery was actually getting rid of all that. So yeah, I personally, I've always said, and now like crafting, like transcend policies, this is very interesting stuff, and I'm thinking about it. But I have always said, absolutely not. That's like way, you know, I don't want them seeing that they don't want, they don't want to see it. Yeah, it seems I think Eli tried to friend me or something. And I was like, no, several, several times ago, not accept on that. And I don't accept requests on Facebook, on Instagram, anybody can follow you. But I'm very cognizant of what I, I, I post there, but it's usually accomplishments. So yeah, I went to Columbia years ago, and I heard a discussion about social media. And said, don't post anything you wouldn't want your grandmother looking at. But I remember, I remember I was a substitute teacher for middle school a couple years ago. And they, like, I had like, done all of my private, like deleted a bunch of stuff. And they managed to find like, a really creepy amount of information about me. Like, I had never talked about a girlfriend or wife or anything. And they like, knew her name. They like, knew we had gone to an event together, they like found my private Instagram. And it was just like, wow, like people are, yeah, and like, it immediately, I saw the way that even an acknowledgement of that before any real did like, interaction digitally, the way that that could begin to sort of erode the foundations of that relationship of a professional relationship that is not by design that is asymmetrical. Yeah. And I think there's something also inherent, especially when it comes to that, like, discovery of information is that at a transcendent sort of like, assumed that we're using our personal cell phone number in our work. And that's actually a huge tool for somebody to dig up a wide range of information about us with. And I think that's just worth us mentioning, and also thinking about in a larger context. I will say that when you think about social media, or your presence on the internet, the internet, et cetera, you know, I'm going to land on, and just me being super positive around everything, because that's just who I am. I'd like to believe that most clients are looking for something to connect to you. Like, this person is just like me, right? But there's also the potentiality, again, going back to my friend's phrase, a problem is not a problem until it's a problem. So someone locating information about you, how that information could be used, et cetera, is something to consider, right? And so just kind of leaning into it and figuring out what that looks like is going to be a key part of the ongoing conversation. The recognition that all of this, you know, boundaries can be created, right? So the awareness of personal professional values, the compliance with professional practice guidelines. So if you are a SERPA, what does that look like, et cetera? Informed consent, critical reflective practice, and ethical decision-making are all potentially a part of this process, right? So moving, we've talked a little bit about awareness of professional and personal boundaries, right? And compliance with professional practice guidelines, whether that's a code of ethics, agency policy, et cetera. Just taking a couple of, take a step back and talk about informed consents, critical reflective practice, and ethical decision-making. So informed consent is really about helping folks understand the nature of the help that they're receiving, the scope of the help, and the limitations of it, such as, you know, such limitations of boundary setting, right? There's limitations to this. Informed consent is folks really understanding the breadth of what's going to happen, what could happen, et cetera, the nature of the help. And one of the things about informed consent is never assuming that because someone signed a consent that they understand what that consent is. One of the things that I talk a lot about is going through that consent line by line, going through program policies and procedures line by line, creating space for folks to ask questions, et cetera, is going to be a key part of this. So are we talking about informed consent because someone signed a consent form, or are we talking about the process of informed consent is something to think about. And also, we've talked about this as well, conflict reflective practice, right? So critical thinking involves assessing your own behavior, your choices, and how they impact others, okay? At the end of the day, how does what you are doing, wherever you're landing in a particular situation, how is what you're doing impacting your client, okay? For good or for not for good, okay? So some of the things you want to think about in ethical decision-making, am I placing the client first, okay? Is this about the client or has somehow I leaked in into this interaction or this process? Am I motivated by my own needs, right? And some of these are very, all of them are very challenging questions. Are my professional boundaries being challenged and have I set clear boundaries with my client, right? Folks don't know what your boundaries are until you tell them, right? Or you show them, et cetera. Would I consider it responsive or reasonable for another worker to make a similar decision, right? And that's that breath moment where you take a breath like, okay, what am I doing? Why am I doing this? And as you begin to lean into this and train yourself to do this, that breath, it'll happen like that where you'll be able to go through the, ask these questions in a very rapid fashion. But also you can bring those questions to your supervisor, bring your questions to a peer, et cetera, okay? Also can I explain the rationale for my decision and link it to practice guidelines or code of ethics, right? Can I link it to agency policy and procedure, okay? Those are questions you want to ask yourself. Now these are questions that may not be a yes or no sometimes very clear. Sometimes they are very clear. Ethical decision-making is a series of grades and operating with the best information you have available, connecting with other folk, and then making the best decision, okay? The best decision does not always mean the perfect decision, okay? You can only operate with the information that you have, but remembering any ethical dilemmas, you are not alone in this process, nor should you ever feel like you are. If something is happening with a client, the best thing to do is to connect to a supervisor and say, hey, I just want to talk this over with you. You do not have to do it on your own and you shouldn't be doing it on your own, okay? So we have a quick practice exercise and I am just going to lean into, I'm going to read this for you and just process it. We'll process it together, okay? So James is a staff person in the program, OIN program, and has been in the program for I think six months. Client A has been working with James for two months and consistently sees him every time that he's on site. Client A has at times bought coffee for James and he and James have drank coffee together while working together and it's become a part of their routine. Recently client A has begun to ask James questions about his personal life and was waiting for James one day when he was leaving for the day and walked him to the train when he leaves for the day. And there's a lot of different things that could be going on here. And I made it that way on purpose. Okay, so there's a lot. I like this scenario a lot because like best case scenario, it's like, yeah, they're getting along really well. This is fine. Like there's nothing nefarious here whatsoever. On the other hand, this could be a sign of something extremely worrisome. First of all, I just don't always offer to pay if a client gets you like a coffee, 100%, that just straight off the bat. Luckily with our new espresso machine at the house, you won't have to. But yeah, that's the first one. I mean, it's like I need more context, but certainly this is something that has to be brought up that it definitely reaches a level of concern when they're waiting at the end of somebody's workday, sort of keeping track of that and trying to get perhaps more information about which way they, where they live, et cetera. This has to be brought up to supervisors immediately because I think that what matters here actually is very much is what James is. We don't know what boundaries James has attempted to set. If James has not really set any boundaries, then it's just time to have that conversation. It's just time to have a simple conversation about boundaries. If James has set boundaries and said, look, I'm here to work with you on your recovery. I'm not here, like I'm not, I need you to respect that I don't want you as a part of my personal life. And that's not how I work with you. And the client's still doing this, then we have a much more serious problem. So we have the identification that maybe the coffee is an issue or a challenge, right? The first time, so this is the other piece, when do you lay the foundation for the boundaries? So the first time that James bought the coffee, right? May have been the time to establish like, hey, this is not something that we really can do. This is not our policy, et cetera, but thank you, I appreciate it. But that's not something I can engage with, okay? Sometimes when there is a challenge to boundaries, it happens very slowly. And sometimes it can be a test. Well, you did this, okay, then you'll do this, okay? Just food for thought around this. Other folks? Yeah, I want to point out too that I think that a huge component of this, at least in my experience, is how familiar clients are with the type of care that it is that we provide. I think that clients who have been in and out of treatment, have been to rehabs, have had different coaches, have been in all of those different environments and know how to game that, are much more challenging often when it comes to boundaries because they know what it is we're supposed to do, not supposed to do, and they know how to try to get under that skin, so to speak. So I think also looking at the client's history in care can help us better understand what their potential risk factors are and what their potential ability to transgress boundaries might be. Excellent. Other folk? I thought I saw a hand go up, but let me just check. Okay. I'll also just say that like, when I said this, it's obvious that once he has begun to ask James questions, it's not inappropriate for the client to ask those questions, to start asking those questions. It is inappropriate if the boundaries have been set. And that is the moment at which boundaries need to be discussed if they have not already, is when they start trying to get personal. That's when, again, and again, I would say that in our practice, we definitely err on the side of disclosure about certain aspects of ourselves. Like that is a pretty key element of the peer relationship is that we do tend to disclose parts about, you know, I don't think anybody here doesn't tell their clients, I am in recovery. Like that's like kind of a baseline for us. So they know that about us. They know that we have struggled with substance abuse and mental health in some way or other. And one very simple guideline is kind of like, we will talk about stuff, you know, more personal things from the past, but less so I'm not gonna disclose like what's going on in my relationship with my mother today, you know, most likely, I mean, that's a really vague idea, but whatever it is, I have to define it at that point where they start prying because people can get way under your skin. I've had a client, you know, I'm not on social media, guess who is, my sister. Go and like stalk my sister on social media in a very, very frightening way. And it was all because he had kind of just, he'd just worn down and I didn't set clear enough boundaries in the first place. And, you know, we were talking about it and I just mentioned her first name. It's a pretty unique first name and he knew my last name already. So boom, there you go. And it was off to the races. So yeah, just a lot of caution, boundaries sooner rather than later is what I say here. Absolutely, absolutely. And there's a couple of different points that the boundaries could have been set. We can lean into them, setting them in the beginning, right? And, well, let me take a step back, not just the boundaries, but being clear about what your boundaries are before you attempt to set them with a client. Because then the other thing is, is if you set these boundaries and they're pretty diffuse and they change and they're loosey-goosey and all of us have different experiences. Some of us have loosey-goosey boundaries and that's okay too. But if we bring that into the professional sphere, how does that impact our credibility? And how does that shape the professional relationship we have with clients? Like, you know the boundaries that are loosey-goosey, right? And so thinking about, okay, I need to be mindful of this in this space because this client is not my friend. This client is not a family member, et cetera, okay? So we have the entry points of the coffee, right? What that looks like. They've drank coffee together while working together. It's become a part of their routine. Now, is it the drink and coffee or is it the fact that client A buys the coffee? That's the dilemma right there, right? So that may have been a point of first time that coffee was purchased. Hey, we have coffee in on-site. Or, hey, you know what? Thanks for the coffee, but I can't really accept that, et cetera. And figuring out what that may look like, okay? Then the next thing is waiting for James after work. Very clear flag there. Why would he be waiting for me after work? Or why would they be waiting for me after work, okay? What's that about? Especially off-site, especially out of the program or the space, right? Once something, once you have an interaction with folks off the professional space, whether it is at the train station, et cetera, you wanna be very, very thoughtful about what's going on. Okay? Then asking questions. Another opportunity to kind of figure out, okay, what's happening here? Is this just curiosity? Depends on what the questions are, whether I would answer them or not. There's a whole lot of different things to kind of process here. But the thing is, is that you don't have to process this on your own. And if something happens that you're unsure about, after it happens, right? It's okay to bring it to someone and say, you know what? I was at the train station, I wasn't thinking, and this happened, and I just wanna check in with you about it. So you don't have to be kind of in that space of, you know, I don't wanna tell my supervisor that this happened. It's better for you if you tell them that it happened so that they can respond and help you get through it versus not saying anything. And that's when a problem becomes a problem. I also, I like how you framed it as their opportunities. Like understand, like when you feel what, like your internal boundaries being broached, then seeing that not as a moment to, okay, great, time to talk about boundaries, time to discuss these boundaries with my supervisor. I'm always ready to talk about this. This is really, this is tough. You know, talk about it with them, talk about it with peers, with supervisors, and then talk about it with the clients to make sure that you have a really clear understanding. These are opportunities. These are flags that say, hey, time to talk about this before we get to like a red flag moment, you know? Absolutely. And that speaks back to the self-reflection and the awareness, okay? We don't cease to be people because we are working in a profession, professional standpoint, right? We know what we know. We may be on a healing journey ourselves and that's okay too, okay? So strategies for maintaining professional boundaries can include the role of supervision, utilizing your supervisor as a consultant in this, right? Talking it through. Debriefing with your supervisor or peers, which is something I've kind of embedded in everything that we've been talking about today. It doesn't necessarily, okay, I wanna talk to somebody, maybe your supervisor's not available, et cetera. How can I connect with a peer, right? And the role of supervision, I wanna circle back to that. The role of supervision is not just to talk about tasks. It's about really leaning into the practice of the work that you're doing with clients, okay? No matter what your role is, et cetera, supervision is a key point of reference for that. So if you're not sure of policies, you're not sure of whether or not you need to have a further discussion around boundaries, et cetera, supervision is a space to talk about that, okay? Reflective practice is also leaning into how am I doing? What am I doing, et cetera? Why am I doing this? These are questions. What do I need to change? What do I need to get additional training on? What do I need to, and you can fill in the blanks. That's that constant reflection that we're doing because this is not a one-off. This is something that you will need to lean into throughout your professional careers. We all do, okay? Myself included, okay? Client feedback. Clients giving you the feedback around not feeling comfortable, et cetera. All of those are potential areas of feedback. I always say to folks, never ask a question that you're not prepared for the answer for. Good or for, challenging, okay? Sometimes we hear information. We ask a client, how are you doing? How's everything going? How are we doing? How's the work that we're doing together going? They might say, you know what, you suck. And I actually hate seeing you every week or I hate seeing you every time you come in this space. Then it's like, whoa, okay, breath, not take it personal. Okay, so just being kind of thoughtful around that. Ongoing training and development. Again, something I've kind of embedded in everything we've been talking about today. This is not a one-off. This is something that you want to lean into on an ongoing basis, regardless as to where you land, regardless as to what organization you're connected to, et cetera. Ongoing training and development is an important part of our professional development as professionals in the field. And self-awareness through regular self-reflection and self-care, right? So thinking about when we're talking about self-care, those moments when you're tired, those moments where you may be having some challenges of your own, right? Are those moments where your boundaries are not as firmly in place, are loosey-goosey and those are opportunities that you may make a decision or there may be an interaction that you're not flagging and therefore discussing, okay? When you're tired, when you're hungry, when you're trying to figure out anything in life, whether it's financial, et cetera, all of those things can potentially put you in a space where you're not necessarily thinking as clearly, right? And so it's always best if anything ever happens, definitely talk with your supervisor around it. Sometimes you might say to yourself, you know what, today's not a good day for me. I didn't sleep last night, et cetera. You know, I just wanna, is it okay if I take a couple hours break from seeing clients or whatever the case may be? All of those things are potential options, okay? So thinking about that. Also another option is if you have a client who really is very challenging to your boundaries, bringing that to your supervisor's attention as well, okay? So all of these are potential options. So some basic guidelines to just start is to be mindful of the agency's policies and procedures. Remembering, socializing with clients outside the workplace, just be very thoughtful about that one, okay? How, when, why, okay? Giving personal information to clients. Why, when, how, what is the purpose of this, okay? Giving or receiving gifts, another one to kind of think about. What does that look like? What's your agency policy, et cetera? Lending and borrowing time or borrowing items and money, right, you wanna think about that. And friending on social media. These are just a few of those just to begin to consider, right, again, nothing here is set in stone. This is about creating a space or creating an ongoing thought process where you continue to lean into this or start to lean into it, okay? So at this point, I'd like to leave it open for any questions or feedback, but for ORN, we have an evaluation survey that we ask for you to complete and it's pretty brief and you can scan this to your phone or there is a QR code or not a code, the link that's gonna be placed in the chat so you can fill that evaluation. And that's super help, you know, that continues to help us continue to provide this service, et cetera. And while folks are doing that, I wanted to create a space if anyone had any questions or any additional feedback or even I'll add additional thing on there, any aha moments. So if I might, first, just thank you again so much for taking the time and energy to come and really just help us out so much. So thank you again, Dr. Blackwell. The thing that has been kind of popping up to me and I'm sorry if this is touched on, I'm at Transcend right now and I've had to kind of go back and forth with a few clients. The, with the dual relationships being in recovery, specifically I'm thinking 12-step recovery, it's a situation where given that I actually live near this site and I'm in the same fellowship, the same 12-step fellowship as clients, I will sometimes see them. And so like, there's a chance that I'm going to speak at a meeting tonight with a client. And so there's an inevitable kind of socialization that happens. And so it gets very complicated. There's part of that from the program and professionalism, which I have my own understanding of that. But then from the professional setting, do you have any kind of guidance on how to maintain a professional relationship in this setting while still kind of doing the 12-step thing, so to speak? Well, there's a couple of different thought processes around this. One, that either you or the client changes their meetings. Right? That's kind of one kind of intense reaction to that. Other reactions can include having the conversation with the clients about what the role is in the meetings versus what your role is in the space. Okay? I think where a lot of folks land in regards to folks changing their meeting is because in the meeting, there's absolutely, hopefully, a part of freedom that you discuss certain things in the meeting, your challenges, your journey, et cetera. And feeling like if there are folks in the meeting who are clients, they're hearing that information. And you also don't want to be in a meeting having to filter yourself because there are clients in the room. So really, I think having that conversation with your supervisor or direct supervisor, et cetera, is going to be key because there's a couple of different options there. But those are pretty much the two. Either you change or the client changes. Or you talk about it, but there's a clarity of roles, of who you are in the meeting versus who you are on site. But thinking about the long-term impact of that, that when you're in a meeting, is there a freeness or a freedom that's being taken from you because you don't feel comfortable in sharing information because a client may find out about it? Absolutely. I've noticed I have had to change my meetings. Most of my meetings I go to, a lot of clients are there. And that does hinder me from opening up like I might like to. And so I've had to wear the professional hat. So it is an issue. I, you know, you also mentioned the, this is going back, this was sort of an aha moment or just, yeah, just diving deeper into like the boundaries concepts, boundaries and self-awareness and everything. And you talked about the motivation, why am I disclosing? Rather even than like, what is the impact of this thing, but why am I doing it? Because as much as I'd like to think that like, oh yes, I'm very professional. I'm very, I'm the most, you know, emotionally sober guy. You know, no, I still, I'm still a person. I still have these tendencies. I'm vain. I can absolutely share something that, you know, like it makes me sound cool, you know, and, or there's all kinds of little hidden motivations that I might have. And so like treating myself objectively, you know, is I think a really, really helpful piece of this and recognize, you know, recognizing that I have these flaws and that's okay. I just have to like, I just have to continue to process them. Is yeah, yeah. So check, checking, checking my motives. Cause like overall my motives in the conversation are good, but like in one, one thing, it might be a little bit tilted towards, you know, or like, or a controlling sensibility. Like, oh, I'm going to try to share this to try to make you identify with something that like you're disagreeing with me on. So I'm going to kind of hit you with this. There's all, there's all kinds. So I'm just diving into that for myself. And so that was helpful. Thank you. You're welcome. I share in that experience that we've been talking about, specifically around meetings and the anonymity of the program and those issues. And one of the things I've sort of decided for myself is that like, I'm also, regardless of my profession, entitled to like my human condition. And so rather than trying to be very protective around like me not sharing if a client is present in the meeting by chance or something like that, but rather trying to address like how it's important for me to be treated decently and appropriately by that client and like allowing like my need for my recovery to hold its own space. And that is like, of course, an infinitely nuanced thing. And in each caseload it's different, but I just wanted to sort of raise my hand and saying I identify with that issue and how we navigate it. I could chime in too at the end. I just think it's been really fascinating and productive, I think. And I think one thing that's clear is that we're sort of all figuring this out together. I mean, we have leadership and we have staff together and we all have our questions and anecdotes and we're all just feeling this out and figuring this out together. And I think it's important to be able to talk about it openly. And I guess, Katie, if there's one thing maybe I'd be interested in hearing from you, it's like, I think the most important thing for us to maybe come away with is how to as sensitively and effectively communicate boundaries to a client, because that situation will come up. What's that initial point of contact, that initial conversation like with the client where we're saying, you wanna present that there are some boundary issues we're gonna have to address here, but in a way that's sensitive enough because the last thing we wanna do is make a client feel self-conscious or rejected or in any way jeopardize their recovery. We want them to feel as welcome and open with us as possible. But how do we bring this incredibly sensitive and delicate and nuanced issue of boundaries up to a client for the first time? We're all discussing it and figuring it out. They certainly have a lot to learn about boundaries too. And I would say probably more than even some of us. Is that our Katie, my Katie or your Katie? I think that's you Dr. Blackwell. Yeah. Oh, that's me? No, he said Katie, he started out with Katie. I know, but I think you mean Katie. I'm going from the participation list. Dr. Blackwell, please. I think that that is a whole other conversation because it's talking about how do you have that healing, how do you have that thoughtful conversation, thoughtful, challenging conversation in a way that supports healing and supports the ongoing development of the Alliance and supports the Alliance in the work. That would be an entirely different conversation because I could literally spend hours talking about that as well. And so maybe connecting with Katie to figure out if that's a next step or a natural progression to this opportunity, it might definitely be an option. What would your elevator answer be? My elevator answer would be being very thoughtful and clear about what boundaries you're looking to communicate, why you're looking to communicate them, being thoughtful about the language and the client that you're working with. Amazing, thank you. You're welcome. So I'd like to thank you all for participating today. It has been a very interactive and amazing opportunity, amazing conversation. And thank you, I always appreciate that. Definitely the slide deck will be sent to you as well as I think certificates of completion, et cetera. Katie usually handles the logistical stuff. So you will receive that. And I'd like to wish everyone a happy and healthy holiday season if you observe, okay? And please remember, you are all amazing at what you do and it's so very much appreciated, okay? Thank you again, Dr. Blackwell. An excellent cultural competency if you celebrate it. Thank you. Thank you. Amazing. Thank you. Thank you, that was great. Katie, thank you so much. I will be following up with all of our guys. Everyone please fill out the evaluation link as it said in the chat there, very important. It's very quick. Yeah. Again, thank you so much, Katie. Thank you so much, Dr. Blackwell. Thank you everybody who attended. Of course. Thank you. Take care, everybody. Bye.
Video Summary
The webinar, led by Dr. Dolores Blackwell, a consultant specializing in professional boundaries and ethics, centered on the importance of establishing and maintaining professional boundaries in various professional settings. Dr. Blackwell emphasized that the work on boundaries and ethics is ongoing and should be revisited continually. This conversation is integral for professionals involved in client interactions, especially those working in recovery spaces where dual relationships may emerge.<br /><br />Dr. Blackwell discussed various types of boundaries, including material, physical, mental, and emotional, highlighting the need for professionals to recognize their own boundaries and those of their clients. A common thread throughout the discussion was the necessity of self-awareness and regular self-reflection to maintain these boundaries effectively.<br /><br />Participants shared insights and challenges from their experiences, illustrating real-world applications of boundary setting. They acknowledged the complexity of maintaining professional boundaries, especially when personal recovery and professional duties intersect. Issues such as friends requests from clients on social media and the nuanced role of being a peer in recovery add layers to maintaining professional ethics.<br /><br />Dr. Blackwell also addressed the significance of informed consent and critical reflections on practice. The session concluded with discussions on ways to handle potential boundary crossings, emphasizing the necessity of supervision, debriefing with peers, ongoing training, and being intentional about personal motivations behind disclosures.<br /><br />Overall, the webinar fostered an understanding that establishing professional boundaries is crucial for both the wellbeing of clients and the professionals who serve them, underpinning the necessity of continuous learning and organizational support in boundary management.
Keywords
professional boundaries
ethics
Dr. Dolores Blackwell
client interactions
recovery spaces
dual relationships
material boundaries
physical boundaries
mental boundaries
emotional boundaries
self-awareness
self-reflection
informed consent
boundary crossing
organizational support
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Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 and grant no. 1H79TI085588 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
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