(Also see HILLCREST policy on “Staff Contact and Relationships With Students”.)

INTRODUCTION

By its very nature, residential care and treatment with children and adolescents sometimes involves intense interpersonal dynamics and some intensely intimate aspects of the lives of students. The nature of our work can result in complicated emotions and strong personal feelings and/or relationships among staff and students. The familiarity that develops between staff and residential students also contributes to a relationship that may be so comfortable at times that feelings and responses may be more personal than professional. However, nurturance, acceptance, encouragement, and support can and must be provided by staff while still maintaining professional boundaries.

A student will interpret the staff’s actions based on the student’s own developmental level, on their cognitive ability to understand the parameters of the relationship, and on their level of emotional need and psycho-emotional condition. Abused, neglected and emotionally disturbed students frequently have issues or problems in interpersonal relationships. They often have inadequate sense of boundaries, and they sometimes interpret the staff’s actions in relation to their unmet needs and their experience in unhealthy relationships. Additionally, as caring adults, we are naturally inclined to reach out protectively to students who are showing distress or emotional pain. Without self-reflection, understanding and objective guidance (e.g., good supervision), the needs of a particular student and the needs of a particular staff can interact in such a way that the relationship moves in an unhealthy or inappropriate direction.

The work we do requires an ability to be meaningfully related to a student yet separate enough to distinguish one’s own feelings and needs. We owe it to our students to be introspective about ourselves and our own needs so that we do not blur or confuse relationships and send mixed messages.

These feelings and relationships, if understood, acknowledged and managed well, can have positive, beneficial, therapeutic impacts on students without causing harm to any student or staff. However, if misunderstood, unacknowledged or poorly managed, they have the potential to cause serious harm to students and/or staff. The challenge is to:
• understand, acknowledge and manage feelings and behaviors appropriately and professionally.
• develop staff – student relationships that are professional, therapeutic and in the best interests of Hillcrest students.

BOUNDARIES – DEFINITION AND FUNCTION
The term “boundaries” is a metaphor for the protective limits between the staff and the student. It refers to the psychological, emotional, interpersonal and even physical space that allows for a safe connection and relationship based on the student’s needs, not those of the staff. Boundaries, including such constructs as codes of ethics, professional standards and licensure, perform a number of important functions. For example, they:
• help to structure the staff – student relationship to be professional and therapeutic, not personal or social relationship.
• define appropriate behavior, and provide security and order.
• help to define roles and responsibilities, and set the parameters within which care, treatment and other services are delivered.
• allow students to get safely close to others, yet remain separate.

A professional/therapeutic relationship is a planned and goal directed series of interaction between agency staff and a student for the purpose of providing care and treatment to the student. In a professional/therapeutic relationship:
• the needs of the student, rather than of the staff, are the highest priority.
• the roles are clearly defined, structured and they do not change or reverse; the focus of the relationship is on the student.
• the interactions, interventions and outcomes are periodically evaluated.

In a friendship or social relationship, on the other hand:
• mutual needs are met, rather than the needs of the student, and it is appropriate at times to put one’s needs first.
• roles may shift periodically and even dramatically.
• there is little emphasis on evaluation of the interaction or the outcome.

The primary concern and focus in therapeutic relationships, and when establishing and managing boundaries with current and former students, must be the best interests of the student, as well as associated Hillcrest policies and procedures.

The development of a trusting “connection” between staff and the student is essential because it allows the student to take the necessary risks involved in making change. It is the responsibility of the staff to simultaneously maintain the boundaries of this professional relationship while establishing and maintaining a therapeutic “connection” with the student. It is essential, though not necessarily easy, to balance a caring and supportive relationship with students with appropriate professional distance and boundaries. This task is particularly complicated, difficult and critical with children and adolescents whose needs, urges, impulses and boundaries are often confused and distorted.

Some staff rationalize and justify their friendship or boundary violations with a student as being “the kind of help the student really needs” and as “really caring”. However, students come to Hillcrest for care and treatment; the long-term goals and plans for the students are the primary consideration. Inappropriate relationships are a shift away from the needs of the student needs to the needs of the staff. Students have the right to professional and therapeutic care, and Hillcrest has a responsibility to insure that staff have caring, but professional relationships with students.

Regardless of their role or position, almost all Hillcrest staff come to know and have contact with students as part of their professional function and because of their Hillcrest employment. As Hillcrest staff, good practice and professional standards of conduct require us to treat and deal with all students in an unbiased, equal and professional manner, regardless of our personal feelings about them or our reactions to them. The role modeling of professional boundaries by all staff, regardless of role or function, promotes mutual respect and a culture of respect. It helps to insure proper care and treatment for students, and it protects the staff as well as the students.

There are potentially serious consequences to the blurring of boundaries and to unprofessional relationships. When this happens, neither the student nor the staff are able to respond objectively due to the “friendship”. When objectivity is lost, staff respond out of emotion, rather than out of therapeutic objectivity and professional judgment about a student’s best interests. There is a conflict of interest that interferes with student treatment, and with the group and Team process and relationships.

Additionally, staff put themselves at risk for liability because of inappropriate or unapproved contact. If a student or student’s family were to pursue litigation or other legal action against a staff member, the staff may not have legal support from Hillcrest because they were not acting according to Hillcrest policy or appropriately in the capacity of an employee.

IMBALANCE OF POWER
In any professional relationship there is an inherent power imbalance, and the staff – student relationship is one of unequal power. Staff have knowledge, access to privileged information, authority and influence. Staff provide daily care and assistance to students, and students often grow to trust staff and value their help and care, which adds to the imbalance in the power structure within the relationship. Staff provide information about student behavior and progress, and they have input into important decisions made about students’ lives. Whether they realize it or not staff have tremendous influence over students. Therefore, staff have a responsibility to act in the best interests of the student. We, and not the students, are ultimately responsible for managing boundary issues, and we are accountable should violations occur.

Given the power imbalance that exists in the staff – student relationship, students may find it difficult to negotiate boundaries or to recognize or defend themselves against boundary violations. For that matter, students are usually unaware of the need for professional boundaries, and they may frequently initiate behavior or make requests that could constitute boundary violations. When a relationship is strictly professional, it has checks and balances that help to insure that staff – student interactions are appropriate and in the student’s best interests. As soon as the relationship becomes emotional and personal, however, the professional relationship is lost. The checks and balances designed to protect the student and the staff break down, and the staff responds more personally rather than professionally to the student.

It is possible to maintain a compassionate, warm and caring professional relationship with students that helps them feel cared for and motivated to work in treatment without violating professional boundaries.

BOUNDARY VIOLATION
“Boundary violation” means “outside the limits of the therapeutic and professional relationship”. Most boundary violations are unwitting, subtle, and largely unconscious. The history and plight of some students may persuade some staff to respond in a therapeutically inappropriate way. The seductive pull of helping can sometimes make the distinction between appropriate and inappropriate unclear. Boundary violations may occur with either current or former students, and they may occur even after staff have left employment with Hillcrest Educational Centers.

The following are examples of the types of professional boundaries violations that may occur between staff and students.:
Role boundaries:
o Doing things for the student that are not a part of job responsibilities (e.g., buying clothes for a student with your own money).
o Treating a student as a “friend” or confidant.
o Interacting with coworkers in a “social” manner with students present (e.g., discussing a date or a night out” in front of students).
o Having “rescue fantasies” about or “over-identifying” with a student or students.
Time, Place and Space boundaries:
o Spending more time or unusual time (e.g., during staff’s time off) with a student.
o Spending free time or private time with a student to the exclusion of other students.
o Having unapproved contacts with students in settings other than approved settings (e.g., during a community outing, bringing students to one’s own home).
o Violating the ‘rule of three”.
Money, Business and Service boundaries:
o Having any type of business, financial or service transaction with a student (e.g., borrowing or lending money; giving or taking personal money, buying or selling items).
Gifts and favors boundaries:
o Accepting or giving personal gifts, including personal photos (as opposed to giving or receiving gifts between staff and the Team).
o Allowing/encouraging the student to do favors for the staff (e.g., wash a staff’s car), or the staff for the student (e.g., make an unauthorized purchase for the student).
Fair and Equal Treatment boundaries:
o Treating students on the basis of your “like” or “dislike”.
o Favoring one student over others.
o Treating a student unfairly or differently from others; giving special attention/treatment to a student that differs from that given to other students, or refusing to provide normal or prescribed care and treatment to a student for personal reasons (e.g., dislike).

Clothing boundaries:
o Dressing in a way that is unsuitable for work or in a seductive manner or in any way that blurs, confuses or distorts the relationship with the student.
Language boundaries:
o Using too familiar or inappropriate names or nicknames in addressing each other, use of inappropriate or suggestive humor or language (e.g. profanity).
Self-disclosure boundaries:
o Sharing with a student personal or intimate information, work concerns or private information about other staff or students;
o sharing any sort of secrets with a student.
Physical Contact boundaries:
o Having a type of physical contact, or more physical contact than is appropriate or necessary, or than is allowed by campus policies, or than is reasonably required for a situation.
Abuse boundaries:
o Physical, verbal, emotional abuse; inappropriate or unnecessary use of restraints.
o Having any sort of sexual contact with a student.

The list above is not all-inclusive. It is intended for use as a guideline and to provide examples of unprofessional behavior and boundary violation.
Staff are expected to observe appropriate and professional conduct, including boundary maintenance, at all times. Failure to maintain professional conduct and to observe appropriate and professional boundaries will result in disciplinary action up to and including termination from employment.

Similarly, during any form of contact with a student’s family, guardian, or advocate, or with any representative an outside agency, staff are expected to act in a professional manner. For example, at no time during a professional contact may staff violate professional boundaries, form personal relationship or share personal information.
 
QUESTIONS TO CONSIDER IN EXAMINING POTENTIAL BOUNDARY ISSUES
In some cases, boundary issues may pose dilemmas for a staff, and there may not seem to be any clear or obvious answers. In determining how to proceed, in addition to discussion with one’s immediate supervisor, consideration of the following questions may be helpful.
o Is this in the student’s best interest?
o Whose needs are being served? Does this action benefit me rather than the student?
o Am I dealing with this student (or student’s family) differently than I would another student (or family) under similar circumstances? Am I treating this student differently (better or not as well) than I treat other students?
o Does my behavior with this client differ from my usual professional behavior (e.g., dressing differently, being more concerned about appearance)?
o How would this be viewed by the student’s family, guardian or custodial agency?
o Would I say or do this particular thing if a coworker were present? How would I feel telling a coworker or supervisor about this?
o Will this have an impact on the student’s care, treatment or emotional condition?
o Should I discuss my feelings, concerns or questions with my supervisor?
o Does this student mean something ‘special’ to me?
o Am I taking advantage of the student or allowing the student to take advantage of me?
o Would I be comfortable documenting this decision or this behavior in the Team Log or student’s file?
o Would this (or does this) decision or behavior violate state regulations, the Hillcrest Code of Ethics, Hillcrest Policies and Procedures, or any other common or reasonable standard for appropriate behavior?
The answers to these questions may provide some indication that professional boundaries may be at risk.
In order to prevent compromising the best interests of a Hillcrest student or staff job security, it is best to discuss potential boundary violations with one’s immediate supervisor before performing any questionable behavior. Remember, when in doubt, ask for help. Sometimes a staff will have a vague sense that something is not quite right with a particular student relationship but may be unable to put into words exactly what the problem or difficulty is. By talking with a supervisor the staff may gain a new perspective on the issue and perhaps develop some options and alternatives to deal with the issue or concern.

WARNING SIGNS
There may be times in residential care work when staff in any job or role could feel drawn toward a student, or experience feelings of attraction to a student. Similarly, staff could feel unjustified negative feelings toward or “bad chemistry” with a student. It is important that staff recognize these feelings as early as possible and take action to prevent the relationship from developing into something other than a professional one. The obligation is always on the staff, rather than on the student, not to cross the line.

Before actual physical or sexual contact or abuse occurs there may be a number of warning signs, or changes in the staff’s behavior. Additionally, this type of misconduct often follows a pattern wherein minor boundary violations (e.g., subtle favoritism or negative bias) gradually shift into major boundary violations (e.g., sexual contact or physical abuse). Staff should be alert to such signs that suggest he/she or a coworker may be starting to treat a particular student differently.
The following indicators should be considered as possible warning signs:
• frequently thinking (positively or negatively) of the student while away from work.
• Having rescue fantasies about or over identification with a student.
• spending time with the student away from other students or staff.
• planning or arranging the care of other students around the student.
• self-disclosure of personal information, or confidential or personal information about other students or staff to a student.
• undue concern about meeting the expectations or demands of the student, or disregarding the student’s legitimate needs or requests.
• inability to accept alternate opinions from colleagues about the student’s condition, progress or treatment goals.
• believing that only you truly understand or care about the student.
• feelings of personal responsibility for student’s progress, or a lack of caring about the student’s condition or progress.
• awareness of, or desire for more (or for less) physical contact and touch than with other students.
• flirtatious or overt sexual content in interactions with the student, regardless of who initiates that behavior.

WHAT STAFF CAN DO
When a staff recognizes any of these indicators or warning signs in their own behavior, or finds himself or herself having a problem with how he or she is treating or feeling about a student or how students are feeling about them, they should:
• get assistance as soon as possible.
• reflect and review their feelings and motivations.
• consider talking about the indicators, feelings or behaviors with their supervisor.
• adjust their behavior accordingly.

When staff recognize any of these warning signs in the behavior of a coworker, staff should:
• make the coworker and/or supervisor aware of the behavior,
• encourage and support reflection and review of behavior.

SUMMARY OF KEY POINTS
• The best interests of the student, and associated Hillcrest policies and procedures, are the highest priorities, and the deciding factors in relationships between current/former staff and current/former students, and in possible boundary violations.
• It is our responsibility, not the student’s, to maintain appropriate boundaries in our professional relationships with students.
• Initiation and or consent by the student for behavior that constitutes a boundary violation between staff and student is not an excuse or justification.
• It is important that staff maintain a professional and personal support structure that provides for feedback and advice on the management of boundary issues as it impacts on their work with students and coworkers.
• A staff’s termination of employment with Hillcrest, and/or the transfer or discharge of a student from Hillcrest Educational Centers’ care and treatment does not absolve staff’s responsibility to observe and respect professional boundaries and ethics.