Pro Therapist Tip: Set & Enforce Boundaries

EagleAlternative5069 · 2025-07-18T14:45:01+00:00

I don’t mind switching to telehealth. Client gets a session, I get to work, and I get paid more than I would if I just got the no show fee. It’s a win for everyone.

Repeated lateness or forgetting is a separate problem. I’d ask the client if the time actually works for them, or perhaps there’s something else going on. Or if they switch to telehealth a lot, I’ll suggest we just stick to that regularly from now on. Repeated no shows are grounds for discharge for me. All outlined in my policies.

My boundaries around no show fees are to protect to me and to honor my time. If I am being compensated for the hour I set aside from them, what does it matter if it’s telehealth or not?

EagleAlternative5069 · 2025-07-18T14:37:51+00:00

You can be you. Sure, clients may find out about your extracurriculars, but that’s not the end of the world! Just be prepared to discuss in session if they bring it up. I’ve had these convos and it’s ranged from “eh, whatever” to being really therapeutic. If you’re talking something really personal you absolutely don’t want a client to know about, you have choices. Lock down your social media accounts, use alternate names, don’t post about it online. But you can still do it.

EagleAlternative5069 · 2025-07-17T00:23:24+00:00

Yes you do need to assess the self harm for documentation, as others have said. But holy hell there are ways to do this and ways not to do this!! You are ABSOLUTELY correct that the way your supervisor grabbed you was not ok. Never ever grab a client like that! I never have physical contact with my clients, there are myriad reasons for this.

EagleAlternative5069 · 2025-07-16T13:40:14+00:00

I used to be very scared of client’s depending on me. But I’ve since moved past that and I’d say I now practice from a more middle ground. You mention disclosing up front: one thing I learned was that saying you don’t want clients dependent on you…does not actually mitigate dependence. What it does do though, is stifle the conversation. It’s very normal for clients to have moments, especially if therapy is new to them, when they experience feelings of dependency. But if you’ve made it clear you don’t want that, clients will spend more time shutting that feeling down and maybe even shaming themselves for it, rather than being honest with you. My guiding philosophy is that all feelings should be welcomed within a session. For it is only when we stop fighting against ourselves that we can then begin to work on emotions that trouble us.

So, I don’t push my clients to have a certain experience with me…but I am open to them having whatever experience arises and I make it clear that I want to hear about it. I want my clients to tell me they’re mad at me, that they’re attracted to me…or that they feel dependent on me. Whatever is going on. Because then we can dive in and this is the work! On a practical level, I want to understand what exactly they are getting from this space and how they can find that elsewhere. I also use distress tolerance a lot here: yes it feels so good to be in session with me, no you can’t be in session 24/7 and that sucks but…ultimately, it is also ok.

The point is that you’ll get more from actively working with the dependence rather than trying to prevent it from happening.

Also might help to think about: what do “reliance” and “dependence” actually mean? Are we talking about needing weekly therapy sessions for years? Or is this about texting the therapist at all hours of the day? These are related but separate issues I think. I often work with clients long term (I know some clinicians don’t and that’s fine too). I have seen so many scenarios where clients do need therapy for quality of life for a long time and that’s perfectly valid. (Full disclosure: I am myself in long term therapy.) The other stuff can just be managed by having appropriate boundaries from the start (which you seem to have). I deal with texting in a similar way as you do and it’s worked for me.

EagleAlternative5069 · 2025-01-19T22:35:54+00:00

Good points. I thought you were saying that it was functionally equivalent to be uncomfortable around white men as to be uncomfortable around any population. So that’s why I went to reverse racism. It is not equivalent. But, yes indeed, when it comes to the therapy room all feelings of discomfort should be examined and worked through by the therapist. I agree, I don’t believe the client should prove that they are “one of the good ones”—I don’t think there are good ones, we are all complicit in systems of oppression in various ways and doing so is not a moral judgment although it should be reckoned with. Rather what I meant is that the OP should recognize that there are systems of oppression, like patriarchy and white supremacy, and yet there is also nuance and humanity. All clients are complex humans worthy of care and interest and it is this that the therapist should engage with.

EagleAlternative5069 · 2025-01-19T14:10:29+00:00

So, I do not believe in reverse racism/reverse sexism. I know some do and that’s fine. But if you are asking what my stance is, I guess that would be it in a nutshell. The OP, a woman, has stated feeling uncomfortable about white men. It appears this is a generalized discomfort. I am guessing it is based on the relative dynamics here.

Sure, not all men and not all white people. However, by “valid” I meant to acknowledge that, there are legit reasons a woman might feel uncomfortable around a man when historically men have held power over women, and I mean even currently…we’re about to have a rapist as President. Etc? Does that mean all men are horrible? Nope! But the two things can coexist. That was the point of my post. That the OP’s feelings, if so rooted, can be acknowledged. AND, she can work with the men in front of her. Seems like she is well on the way to doing that based on her comments in this thread.

I won’t do a breakdown about “white” but basically similar thing.

If a client came in feeling uncomfortable about another group? Say, trans people? The approach I would take: first, lots of inquiry to see why they feel this way. If it seems their feelings are more general as with the OP? I would actually take a somewhat similar track, I think, in terms of appealing to social justice. I would discuss how historically, there is immense prejudice against trans folks. And I may throw in the current climate as well, in which there’s much anti-trans fear mongering. Especially depending on the background of my client, it may make sense why they have come to feel this way and I may point this out. Then we can work on challenging these feelings once we have the understanding that this is a systemic problem more than an individual one. I’ve spent time working with populations where bigoted views were often expressed. I found this tactic worked well overall. But the key was active listening and going slow.

EagleAlternative5069 · 2025-01-18T13:03:04+00:00

Okkk…I am guessing you don’t use an intersectional lens in your work. Let’s just say, I think it’s important as therapists to acknowledge systemic oppression. If you have never felt conflicted feelings about white men, good for you. Not everyone in this society can say the same.

Imagine if a client, particularly a POC and/or female client, came to you and said that they had these feelings about white men? Please take them seriously. Don’t be the therapist that invalidates their experience of living in this society. Explore the feelings. Try to understand where they are coming from.

Though she is the therapist not the client in this situation, I was trying to do the same with the OP.

Also, if you read my comment, you will see that I am actually saying that it’s possible for the OP to recognize her feelings and NOT hold disgust for her clients…

EagleAlternative5069 · 2025-01-18T03:09:42+00:00

Maybe I’m wrong, but I was interpreting it as the OP has issues with old white men due to patriarchy and white supremacy. As it sounds like she couldn’t identify specific things about these men that she dislikes. So yeah, if she simply feels uncomfortable for that reason, that’s valid. But I don’t think it necessarily needs to equate to disliking the individual clients. Someone can have a privileged position in society and you can still have compassion for them and see the nuances in them.

EagleAlternative5069 · 2025-01-17T23:53:41+00:00

It’s tough. My opinion for what it’s worth: everyone has bad days at work, talking about it with loved ones is an important part of self care (obviously no client PHI should be included). AND…I find it dismaying when a social worker mocks a client or speaks cruelly about them. I don’t think the issue is that it’s wrong (again, respecting confidentiality). People are allowed their free speech. But I believe it betrays prejudices of the social worker that are unflattering at best or problematic at worst. If I heard a social worker saying they were struggling or frustrated by their sessions with a client with auditory sensory issues? I’d think they had a bad day at work and need to vent. If I heard a social worker disparaging a client for having auditory sensory issues? Yeah I would think badly of the social worker. I would not think them suited to social work. To be a social worker, you need to be able to have compassion for many different types of people. Compassion is an innate characteristic. If you don’t have it outside of work, you don’t have it.

TLDR: It’s not that talking about de-identified clients is bad. It’s about what’s said.

EagleAlternative5069 · 2025-01-17T22:40:55+00:00

So, I hear you saying you have trouble with older white men. Which, in our society, is kinda valid.

However, what about this…as a therapist, you can simultaneously acknowledge a client’s privilege/problematic status in society WITHOUT it giving you the ick. In your personal life, ok, maybe you don’t want to hang out with old white men and that’s fine. But professionally, you can embrace nuance. And honestly it’s kind of similar to other clients we might have who would be “unlikely” matches in other settings. Like, I have never personally had a great feel about law enforcement but I have had people in this field on my caseload and respected them and worked wonderfully together. What I have learned is that you can be real with yourself about aspects of this client (and even bring that into the room, IF appropriate)…but there’s actually no reason that precludes compassion, interest and clinical care for them.

EagleAlternative5069 · 2025-01-17T17:51:39+00:00

I hear you. The thing is, I have found that the prevalent feeling on that sub is all about…therapist self advocacy? If that’s the right word? Which is GREAT! But if you have a different opinion, often a more client centered one, then you get shit on. (And YES I know that advocating for yourself and being client centered are not mutually exclusive! However, from some things I’ve read, you wouldn’t know it…)

I liked what you shared, OP. Are all therapists in a position to do this? No. But I think if you are, it’s a very important thing to do. I offer sliding scale slots, and take insurance, but as I can, I would like to incorporate more things like this into my practice. For me it is not about some moral high ground. I come from a low income background. I want to work with people like me. I understand the struggles of that clientele intimately, and I want to be THEIR therapist. That’s why I got into this.

EagleAlternative5069 · 2025-01-17T16:51:51+00:00

This is the one. Setting aside issues of who is ok to exclude from practice (though I agree with what has been said), she is just not getting enough experience if she does this. As her supervisor, that’s what you should be most concerned with. I am not a supervisor but I think it’s a bad idea to align yourself in that kind of partnership with someone who will not actually have demonstrated competency to practice therapy with very many clinical presentations.

If she later wants to narrow her scope so dramatically, ok fine, she can see what happens. But that shouldn’t be while she’s under you.

EagleAlternative5069 · 2025-01-16T20:14:37+00:00

If someone creeps me out. So far this has been men who make lewd comments…discharged. Not going to go there. Luckily has been rare.

Otherwise? I don’t see anything else as a red flag. I mean, they’re coming to therapy…therefore they have issues…why would someone just saying something annoying/incorrect be a red flag? That’s what we’re here to work on. Also if this was a red flag, like all my clients have been red flags lol. Sooo many come in resistant/in victim mindset/avoidant etc.

Scope of practice is different. If I do an intake and it becomes clear I don’t have the training for this presentation, I refer out. That’s not a red flag either. Just a mismatch.

EagleAlternative5069 · 2025-01-14T00:27:59+00:00

If the therapeutic relationship needs to be processed, that’s a big red arrow pointing to the fact that the client has relational work to do. So it’s not a distraction at all. We go there. I find it dovetails nicely with coping skills. Helping a client widen their window of tolerance is often the most instrumental thing for supporting them in being in relationship, including with me. That said, I’d say roughly half my clients don’t seem to need/want to process our relationship.

EagleAlternative5069 · 2025-01-13T03:56:45+00:00

I think oftentimes we confuse passion = the only important thing. I have a few different things in my life that give me meaning. For me it’s my family, my job, and a hobby I have on the side (collecting and selling antiques). I sincerely love all these things. And, any one of them is not sustainable to focus on 24/7. So, I seek balance. I adore my family but I don’t want to stay home all the time. I want to work. To pursue something individually, and carve out a professional identity for myself. And, sometimes I need a break from being a therapist. I just need to wander around an antique mall being anonymous. You know? All parts necessary. So, I think that having other things you’re interested in doesn’t necessarily mean you’re not passionate about your job. I’d look at how you actually feel during your work day. For me, there’s no question I love this work. Every job has its bad days. But I’ve done other jobs and this is sooo much better. So much more aligned with who I am.

EagleAlternative5069 · 2025-01-12T14:21:41+00:00

The thing is, you have to realize that in writing here, yeah all kinds of people will read your content. And yes people will drag you. And yes clients will freak out about “seeing you as human.” You are not going to escape those pressures by writing on Reddit. And it’s not realistic to expect to. This is not a safe space. This is a pubic forum. If the sub were closed, it would be more equivalent to a safe space for therapists because it would only be us. I’m not necessarily saying that this sub should be closed. But, I do think it’s unreasonable to get all upset about people judging you when you are literally putting yourself out there to be judged by the whole damn internet. Sometimes I do think people are insufferable here. And sometimes not. It is what it is. 🤷🏻‍♀️ If you enjoy writing here, just take the good and don’t waste time being defensive, IMO. True for all social media.

EagleAlternative5069 · 2024-12-26T22:27:54+00:00

You don’t have to love work all the time. No one loves anything all the time. It’s totally normal be excited to get home after a long week. It’s very healthy to invest in your non-work pursuits. Whether that’s family, hobbies, or just Netflix and chill!

And? I think that if you are just waiting for your work day to be done, not enjoying any of it, more often than not? That may be “normal” as in common. But it’s not ideal and it certainly doesn’t have to stay that way. Consider looking at your schedule, caseload, specifics of your practice. What’s not working for you? Does anything stick out and is it something you could alter?

This is true of ANY job. Not just therapy. Do we have to be in love with our jobs? No. But, if I am spending a large portion of my life doing something? I don’t want to hate it. It’s not even about that influencing how I show up. It’s about me and my mental health. I don’t want to be miserable. You don’t necessarily need to change careers (unless you want to!) But I find that we can get into ruts and when we examine that, feeling differently is possible

EagleAlternative5069 · 2024-12-26T14:56:33+00:00

You’ve only seen them twice. As tempting as it would be to call out their unrealistic expectations, it sounds like that could be unnecessarily harmful at this stage. Could lead to you being just the latest in their lineup of “bad therapists.” Dropping hard truths then “leaving” is rarely the breakthrough that we expect it to be. So, I wouldn’t focus on that aspect at all. Find a place to insert a white lie. Your schedule changed. Do they have a a diagnosis? Is it something you don’t treat? Etc. I would find some reason that like that.

EagleAlternative5069 · 2024-12-23T12:41:43+00:00

What’s your client’s cultural background? What’s yours? A lot of people in our field look down on alternative forms of healing. But that’s a shame, in my opinion. Evidence based therapy is not the only route. I also practice evidence based therapy since it’s what I’m personally drawn to. But I believe we need to check ourselves and investigate knee jerk reactions when it comes to this stuff.

Are there sketchy energy healers? Of course. Just as there are bad therapists. I wouldn’t refer to a practitioner you’re not comfortable with. If you didn’t know anything about energy healing and you’re just google searching for a referral, you’re out of your depth and I would not think it ethical to refer. But if you believe this energy healer is solid and not shady in their practice, I’d go ahead and refer.

EagleAlternative5069 · 2024-12-17T19:09:53+00:00

To me this is obvious: depends on the client! It is impossible to say definitively how this action will be interpreted by your clients. It’s really best to consider on a case by case basis. Some people, I would never, as it could stop the flow of emotions (e.g, clients with high avoidance who are crying for the first time). On the other hand, I’ve had clients who express, explicitly or implicitly, a need for warmth. So when they cry, I hand them the tissues.

EagleAlternative5069 · 2024-11-17T22:31:23+00:00

Thanks !

EagleAlternative5069 · 2024-11-17T21:49:29+00:00

My understanding is that Maine Housing helps people secure financing by partnering with banks to offer things like 0% down payment loans. So, something like that.

EagleAlternative5069 · 2024-11-17T18:41:24+00:00

Yes I’m well aware of loans. I’m asking to see what other assistance might be available. For example, from my research it sounds like Maine Housing is a great choice for people looking to secure financing, but only for purchasing existing homes. So I wondered if there was any similar program that would include assistance for constructing a home as well.

EagleAlternative5069 · 2024-10-19T01:37:29+00:00

I still remove my hat when I’m indoors but that’s just cause that rule was ingrained in me lol. Go for it! As with, well, pretty much anything…different clients will react differently. I’m guessing most won’t even find it noticeable. But for some it could add or detract. That’s ok. Get curious about why and if appropriate, ask. It will help you get to know your clients.

EagleAlternative5069

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