Working within the field of addiction treatment provides unique challenges to professionals with respect to keeping boundaries while providing compassionate care. When individuals working in treatment centers are also in recovery—and both staff and clients are involved in community groups and fellowship—lines can blur with the best of intentions. The opportunities for all staff forming more of a friendly relationship and less of a professional one are also increased in residential settings. One common issue is “over sharing.” Sharing one’s story is an important piece of recovery. When, however, does staff sharing details of their story become more about the staff member than about the client? How much personal information should clients know about their treatment providers? Another issue can be the “physical comfort” aspect of fellowship. Many women in treatment have experienced sexual abuse and physical trauma and may also have deep rooted sex/love/relationship issues or addiction. How do staff manage this for themselves, in community meetings and in the milieu?
Setting and keeping good boundaries requires practice, effort and professional collaboration—regardless of the role of the provider in the treatment setting. In addition to boundary issues specific to the substance use disorder treatment field, all staff should be aware of general boundary guidelines and principles of ethics set forth by behavioral health licensing entities—even if they themselves are not licensed or credentialed. One way to increase awareness of boundary issues is to have a forum to discuss case examples—perhaps in a staff meeting or before or after a designated training day. Specific training on this subject would also be very valuable as most staff want to do the right thing but need guidance in understanding boundary issues.
The Rose House is a 16-bed, gender-specific, dual-diagnosis treatment center in Boulder County, Colorado. For nearly 10 years, our three-month-plus program has been helping women heal through evidence-based addiction, mental health, and trauma treatment.
The Rose House: Women get better here.
Ann Matino, LCSW
Executive Director, The Rose House