How to maintain therapist-client relationship boundaries in the age of telehealth
Reviewed by therapist.com team
Written bytherapist.com team
Last updated: 01/23/2024
Whether telehealth has always been part of your practice or a rapidly changing world required you to adjust, there’s no denying that this method of treatment is here to stay. In fact, many clients have come to prefer telehealth for the convenience and accessibility it affords them.
For clinicians, however, going the telehealth route might also require holding virtual sessions with your clients from your home—giving them a glimpse into your life that perhaps you’d rather keep private. This makes it even more necessary to set boundaries between you and your clients.
Try these strategies to protect your personal boundaries while seeing patients remotely.
Craft your space with care
Telehealth provides therapists with the unique opportunity to enter the client’s world. This can be a great opportunity for building rapport, especially with young clients. For instance, they can show you something they like in their space, like a favorite toy or a craft they’ve made.
If you work out of your home, though, be mindful that clients are also getting a unique look into your own world. Pictures of your family hanging on the walls may reveal more about yourself than you’d like your clients to know. Make sure your clients’ glimpse into your home is free of distractions or personal items that you wouldn’t want displayed in your office.
If possible, try working out of an area of your home that you don’t use very often for other purposes. In addition to declaring this space yours to work out of, being able to leave it at the end of the day will create a stronger work/home distinction.
You may even wish to consider adding a “virtual commute” to your routine. In place of driving to and from an office, performing a habit or ritual—such as making tea or taking a walk around the block—can serve to signal the start or end of your workday.
Establish rules for scheduling and no-shows
For many therapists, telehealth has led to fewer last-minute cancellations.1 Even so, it’s still important to set expectations with your clients so you don’t spend 40 minutes on a video call by yourself.
Whether you conduct therapy in person or virtually, part of your intake process should be providing clients with your no-show policy. This should include:
- The window of time a client can cancel an appointment before you consider it a no-show
- The consequences of showing up late or not showing up at all
- How long you’ll wait on a virtual session before disconnecting the call
- The fees associated with missed appointments or last-minute rescheduling
As always, keep your clients’ situations in mind when determining whether to impose financial penalties for missed sessions. Recognize that emergencies (and technical issues!) do happen, and be willing to forgive occasional absences.
Set specific contact hours
When your clients they can connect with you virtually, it may lead them to feel as though they can reach out more frequently. And while telehealth may afford you the opportunity to work more flexible hours, that doesn’t mean your should have to your email or phone constantly.
Having specific contact hours is important in traditional therapy settings as well, but it’s especially critical if you conduct most of your sessions via telehealth. Be specific about setting hours for yourself where you can disconnect from phone calls, text messages, and email.
In fact, it may be worth adding a digital communication policy to your intake forms. Consider crafting a document that covers:
- What methods of contact clients can use to contact you
- How often you check and reply to messages, as well as hours you’ll be offline
- What kind of information should be shared in a text or email, and what should wait for a session
- Contact information for services in case of emergency
Protect your clients’ boundaries
In addition to doing what you can to protect your own boundaries, make sure you’re doing the same for your clients. Your clients deserve a remote therapy experience that looks, sounds, and feels as professional as it does in a face-to-face session.
If you live in a home with other people, make sure they know when and where you conduct therapy sessions. If possible, use a headset during sessions to provide a more intimate feel. Also consider purchasing a white noise machine to block out external noise and keep others in your household from overhearing your sessions.
About the author
The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.
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