Maintaining Professional Boundaries in Challenging Client Situations

Course #9735L-


Study Points

  1. Identify four types of professional boundaries in therapy (psychological, physical, containing, and executed) and their clinical applications.
  2. Describe at least three indicators of being at risk of compromised boundaries and the therapist's ethical responsibility in addressing them.
  3. Analyze a clinical case example to evaluate appropriate boundary-setting strategies using ethical guidelines and self-of-therapist reflection.
  4. Apply at least two consultation or decision-making frameworks for responding to boundary dilemmas in clinical practice.

    1 . What are the four main types of boundaries discussed in the course?
    A) Psychological, physical, containing, and integrated
    B) Psychological, integrated, executed, and managing
    C) Physical, containing, integrated, and managing
    D) Psychological, physical, containing, and executed

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    2 . Which of the following is NOT an ethical guideline related to maintaining boundaries?
    A) Do no harm
    B) Informed consent
    C) Generalizing
    D) Scope of practice

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    3 . Which of the following is NOT a sign that your boundaries may be at risk of being compromised?
    A) Blurring professional and personal lines
    B) Pressure to change session time or cadence
    C) Urgency to find solutions
    D) Deep breaths, regular heart rate

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    4 . Which of the following is a helpful way to respond when faced with uncertainty about boundaries?
    A) Seeking consultation
    B) Speaking to family members
    C) Doing the opposite of what the client asked
    D) Responding as quickly as possible

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    5 . Which of the following best defines a healthy boundary in therapy?
    A) Rigid and unchanging regardless of context
    B) Porous and accommodating to every client's needs
    C) Flexible within a clear ethical and clinical framework
    D) Decided solely by what feels right in the moment

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    6 . What is the therapist's primary ethical responsibility when a client crosses a boundary?
    A) Ignore it unless it happens again
    B) Discuss it only if it makes the therapist uncomfortable
    C) End the therapeutic relationship immediately
    D) Address it clearly and nonshamingly with the client

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    7 . A client texts at midnight during a crisis. The therapist's informed consent states no responses outside business hours. What is the best initial clinical step?
    A) Wait until business hours and discuss in session
    B) Reply immediately with emotional support
    C) Block the client's number
    D) Change your boundaries to allow for late-night texting

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    8 . What is a common indicator that professional boundaries may be too porous?
    A) You rarely feel empathy for clients.
    B) You maintain strict time boundaries.
    C) You feel emotionally drained after sessions.
    D) You don't allow clients to contact you between sessions.

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    9 . When should a therapist seek consultation regarding a boundary issue?
    A) Only when legal issues are involved
    B) Whenever they feel unclear or activated
    C) Only during licensure supervision
    D) When a client requests it

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    10 . According to the NASW Code of Ethics, who is responsible for maintaining therapeutic boundaries?
    A) The client
    B) The client's family
    C) The therapist
    D) The supervisor

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    11 . What is a key benefit of setting clear boundaries at the start of therapy?
    A) Builds client self-trust and safety
    B) Avoids difficult conversations
    C) Establishes therapist authority
    D) Prevents all ruptures

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    12 . What question should guide a therapist's decision to self-disclose in session?
    A) Will this make the client like me more?
    B) How will this benefit the client therapeutically?
    C) Am I comfortable sharing this?
    D) Have other therapists shared similar stories?

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    13 . Which of the following is NOT a recommended response to countertransference?
    A) Seek supervision
    B) Reflect on your internal responses
    C) Act immediately on the feelings
    D) Use the awareness as clinical data

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    14 . What does the "transparent container" metaphor suggest about emotional boundaries in therapy?
    A) Emotions can be felt without getting stuck or overwhelmed.
    B) Therapists should avoid all emotion.
    C) Emotions should be absorbed for the client's sake.
    D) The therapist should never share how they feel.

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    15 . What is the most appropriate response if a long-term client asks for a fee reduction?
    A) Agree immediately to maintain rapport.
    B) Refer to your fee policy and discuss it respectfully.
    C) End therapy due to financial differences.
    D) Delay the conversation until they stop asking.

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