Do you create and maintain appropriate boundaries within the client-service provider relationship?

• A Core Competency in the Prevention of Sexually Transmitted and Blood-Borne Infections (STBBIs)

Consider...
Kia is a peer counsellor in a sexual health program at the local community centre. For several months, she has been providing support to Valentina, a young woman with hepatitis B who struggles with depression and anxiety. Kia has done her best to support Valentina and even met with her several times at a local coffee shop. Recently, Valentina has been calling Kia almost every day, often in a state of panic, and requesting that they meet at a moment's notice. Kia finds she is becoming increasingly impatient with Valentina and is feeling overwhelmed by her problems as well as her constant requests.

Do you work in the area of sexual health or STBBI prevention and support? Are you able to create and maintain appropriate boundaries with your clients?

Use the questions below to help you self-assess your knowledge, skills, attitudes and practices related to boundaries within the client-service provider relationship. Remember that depending on your role, you may require different levels of proficiency for the various core competencies and it is possible that some of the competencies are not relevant to your work.

1. In your particular role or service, what are some ways of establishing appropriate boundaries between you and your clients?
2. What can you do if you think a co-worker has an inappropriate relationship with a client?
3. Does your organization have clear guidelines related to client confidentiality?  Do you understand your duty to protect your clients' personal information, as well as possible limitations to client confidentiality?
4. Are you aware of your own limitations and of your responsibility to refer clients who require more specialized services?  
5. Can you recognize the signs of compassion fatigue, vicarious trauma and burn-out in yourself and your co-workers, and do you know how to take appropriate actions to address these signs?

Suggested resources:

• Pre and Post HIV Test Counselling Guide: Aboriginal Community and Health Care Professionals, Canadian Aboriginal AIDS Network, 2011
• Mental Health, HIV/AIDS and HCV Co-Infection, Chapter Six: Role of the Front-line Worker, Pacific AIDS network, 2010
• Code of Ethics, by G.W. Sheppard and W.E. Schulz, Canadian Counselling and Psychotherapy Association, 2007
• Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers, Health Canada, 2001

This is one of a series of cases on the core competencies for STBBI prevention. View all 26 cases on the core competencies for STBBI prevention.

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