Professional Boundaries and Dual Relationships

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Professional Boundaries and Dual Relationships

Professional boundaries and dual relationships remain contentious issues in the health care setting. Major concerns arise from the integration of moral and ethical perspectives in the discussion, making the topic complex, by considering the multiple overlapping of relationships (Baca, 2011). The ethical guidelines concerning professional boundaries and dual relationships require the healthcare worker to set distinct professional boundaries with the current and past clients, their friends and family members. The avoidance of sexual relationships, social networking and friendship, the development of feelings for the client or vice versa, and physical contact among other issues that may cross professional boundaries is critical in the provision of quality services. This paper offers an articulate discussion of the topic by integrating the case study of Kylie, a natural health practitioner, and her client, Jim, who are in a text relationship.professional Boundaries and Dual Relationships

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Maintaining Professional Boundaries and Dual Relationships for NHPs

Ventola (2014) states that the responsibility of defining the boundaries lies with the practitioner. Even with this understanding, Kylie commences a text relationship with her client, Jim. The Codes clearly state that communication between the professional and client should be limited within professional boundaries. At first, Kylie maintains a professional relationship by only texting Jim to remind him of appointments. However, the advancement from sending reminder messages to regular texting crosses the professional boundary, especially when Jim starts texting funny messages and Kylie responds. The regular texting and the acceptance of the Facebook friend request complicate the relationship. As the AASW (2017) states, the Code’s expectations of practitioners is that they should communicate professionally and set boundaries in the process. The consideration of the ethical concerns is important before accepting the friend request. Moreover, Kylie starts a personal and social relationship with Jim’s partner who she had continued to contact via Twitter, Facebook, and Mobile.

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            The AASW (2017) asserts that there is a high likelihood of a patient developing feelings towards the practitioner. However, it is the duty of the practitioner to distinctly define the professional boundaries for effective delivery of the services. Clients share their psychological and emotional concerns with the practitioner over time and may develop the feelings of trust, respect, love, or dislike among others (Nickel, 2004). Jim likes Kylie to the point of sending funny messages and requesting her to become his friend on Facebook. Baca (2011) and Ventola (2014) argue for the possibility of the client developing feelings or a liking for the practitioner as is the case with Jim. The AASW (2017) states that the feelings may at some point be problematic and strain the professional relationship. The friendship of Jim and Kylie does not seem to affect the professional relationship yet. However, further development of feelings with the continued regular communication may result in an intimate or sexual relationship that may affect the client and the professional relationship significantly.professional Boundaries and Dual Relationships

Implications for the Use of Social Media

The increased adoption and use of the social media have revolutionized social and professional interaction, influencing relationships significantly. The use of the social media, mainly social networking sites such as Facebook, Twitter, and WhatsApp among others by health practitioners influences professional relationships. Some practitioners currently use the platforms for counselling and interacting with patients professionally. However, according to Ventola (2014), sometimes professionals cross the boundaries they are supposed to keep for a healthy professional relationship. The Codes of Ethics place the responsibility of maintaining the relationship on the practitioner. Baca (2011) advises that the worker should weigh the ethics of the profession in regard to accepting a friend request or maintaining friendships over the networking sites. The increasing communication over the platforms makes them an effective communication tool but poses a challenge. Kylie commences a personal interaction and relationship with Jim over Facebook and maintains friendship with Jim’s partner over Facebook, Twitter, and mobile. This opens up a possibility of the relationship with the past and current patients ending negatively, especially since Kylie chats with Jim regularly. Moreover, it may raise concerns about confidentiality and privacy since the practitioner has worked with Jim and his partner.

It is the ethical responsibility of Kylie to ensure the privacy and confidentiality of patient information shared in the course of the professional relationship. As a natural health practitioner, Kylie must avoid any circumstances or events that may lead to the breaching of patient privacy and information confidentiality. The interaction across the different social networking sites and the advancing friendships may push Kylie to share information concerning one of the patients with the other thus breaching privacy and confidentiality. Moreover, Kylie has an ethical responsibility to avoid an intimate and sexual relationship with either Jim or his partner (AASW, 2017). Engagement in breaching privacy or engaging in an intimate/sexual relationship with either of the individuals may expose the practitioner to liability under the law (Ventola, 2014).

The use of e-technology continues to influence the provision of health care services, often affecting professional boundaries. Using the e-technology has enhanced communication and interaction between professionals and clients, and sometimes caused the breach of the Codes of Ethics. The Slippery Slope argument states that when a professional crosses one boundary then it becomes simpler to ignore or cross other boundaries (Zur & Lazarus, 2017). Kylie proves the argument since after maintaining a relationship with a former patient (Jim’s partner) she does not consider engaging in regular texting as crossing the boundary, continues to encourage the ‘funny messages’ and even accepts a Facebook friend request. Slippery Slope argues that non-sexual dual relationships may develop sexual or intimate dual relationships (Zur & Lazarus, 2017). There is, therefore, a high likelihood of Kylie developing a sexual relationship with Jim or his partner considering the continued communication.professional Boundaries and Dual Relationships

Conclusion

Professional boundaries make it possible for the practitioner to provide quality services without the influence of any external factors. It is the responsibility of the natural health practitioner to define and maintain a professional relationship with the patient before and throughout the professional interaction. Professional communication, avoiding physical contacts such as hugs, refraining from intimate or close relationships with the patient, past client, or the family and friends of a client is important. Moreover, in a world where communication is dominated by social networking sites’ communication, interactions over the platforms may cross the professional boundaries. Regardless, prioritizing the professional ethics and patient needs in is important to delivering quality, secure, and confidential services and ensuring patient privacy. Anything that compromises the quality and professional interaction between the client and the patient should be shunned. Kylie should reconsider the relationships with Jim and his partner for enhanced professionalism and assistance.

References

AASW. (2017, May). Professional Boundaries and Dual Relationships. Retrieved from Australian Association of Social Workers: https://www.aasw.asn.au/document/item/2354

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