We all have learned about the importance of maintaining healthy boundaries between ourselves and our clients. However, the expectation of being constantly available has increased as recent technological advances continue to bring us closer. While there has been evidence that texting as a mode of psychotherapy has been shown to be effective, how do we determine boundaries for client contact outside of session?
Your clients may request ways to contact you outside of session for logistical reasons (i.e. they are running late or scheduling). But it can also open a floodgate for how often the client will contact you. So, how do we determine boundaries for the level of contact we have with our clients outside of session?
Characteristics such as age and diagnoses may be important factors to consider. What population are you working with? For example, research shows younger generations display a stronger preference for texting compared to calling. Unfortunately, there is a common expectation for an immediate response with texting that does not occur with phone calls or emails. Additionally, certain diagnoses, such as personality disorders, often include behaviors demonstrating lack of boundaries.
The next piece to consider: what level of contact are you personally comfortable with? Some clinicians allow clients to text them with the understanding that they will respond when they are available. Others may set parameters, such as only texting for logistical purposes. Finally, some clinicians may set the boundary that clients can only call them. Many find it helpful to determine the times clients can contact you (otherwise texts can roll in at 2 a.m.!). Whatever you decide, it can be easier to loosen a boundary than to tighten it.
Then there is the individual client. Research shows that in some cases, clients might benefit from being able to text their clinician between sessions. This may occur if the client has difficulty creating a clear narrative of an important experience and writing assists them. Some might allow the client to send a text with the understanding that they will read it prior to the session for processing during the session.
However, some clients may be more likely to overuse texting privileges, such as utilizing texts to seek continuous crisis management or as a way to increase a sense of intimacy with their clinician. Assessing client needs and symptoms can help determine whether texting is beneficial.
Setting boundaries with clients about texting can be difficult. As social norms change, we are all expected to evolve with them. However, we are still allowed to determine the boundaries we have with our clients as a whole and on a case-by-case basis. There is not always a right or wrong answer. But it is possible to assess the degree of texting that allows clinicians to keep sanity while still doing what is good for our clients.
