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Now let's look at your value system, and how it defines your behavior, and your relationship with your clients. As you know, to effectively set boundaries you must avoid judging your clients' attitudes and behavior. These judgments are usually made according to your own personal value system. However, this seemingly all too obvious statement, about judging your clients, oftentimes creates a dichotomy and is easier said then done. An example of this may be found in public assistance staff, that are administering financial aid to people who they feel are less than needy or "deserving".
Another example of the personal values-versus-objectivity conflict is often found in the controversy that continues to exist about the ultimate treatment goal for substance-using clients. Some argue that it is not clear whether no use or controlled use should be the treatment goal.
Here, if this area is one for which you have strong feelings, maintaining the ethic of client self-determination, and maintaining a boundary regarding your personal values can be a challenge. I have a colleague who has become sober through 12 step programs. Thus this colleague feels strongly that no use is the ultimate goal for him, personally. However, he periodically struggles to avoid making personal judgments and maintaining a boundary with clients who set a goal for controlled use.
Are You Imposing Your Own Middle-Class Values?
as you know, sometimes in order to survive, clients whose values run contrary
to those of the larger society need to adopt a different way of living. The effective
therapist, however, cannot force or impose changes that will result in embracing
middle-class values. However, society often imposes the need for change upon the
client. The therapist's role is to help the client assess the nature of this change
imposed by society. The therapist's role is also to help the client to decide
how to adapt these imposed changes in a way that is not self-destructive.
As you know, the mental health professional must have sufficient self-awareness to be able to differentiate between value changes that are essential for a client's good social functioning, or merely value changes that are dictated by the therapist's own personal value system. Those values are so internalized that you are often unconscious of the reasons for adopting these values and using them as a basis for judging effective behavior. A good example of this is found in old social agency records that are filled with notations of home visits in the morning where the mother is, "still in her nightgown with the breakfast dishes unwashed, and is drinking coffee, smoking, and watching TV." The middle class value imposed here is that she is sloppy, dirty, and a poor mother.
Four Ground Rules for Avoiding Judgements
- Butheil, TC PhD, "The Concept of Boundaries in Clinical Practice; theoretical and risk-management dimensions." American Journal of Psychiatry 1999, 188-96.
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