The Aspiring Psychologist Podcast - Boundary Setting for Yourself and Your Clients as an Aspiring Psychologist

Episode Date: January 31, 2022

Show Notes for The Aspiring Psychologist Podcast Episode: 8Boundary setting for yourself and your clients as an aspiring psychologist. Thank you for listening to the Aspiring Psychologist Podcast. Boundaries help humans to feel safe. Here’s why it’s important to set them and some examples of how to do it. Welcome & Intro: 00:30 Why we set boundaries: 01:00Predictability and safeness: 03:00 Confidentiality & Safeguarding - How I set boundaries: 05:00Boundaries for zoom culture: 12:30Navigating Tech: 17:30Dealing with No-Shows: 18:30Summary & Close: 20:00Links: To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0To check out The Grief collective Book: https://amzn.to/3pmbz5tTo check out The Our Tricky Brain Kit: https://www.goodthinkingpsychology.co.uk/tricky-brainConnect on Socials:Facebook: https://www.facebook.com/GoodThinkingPsychologicalServicesInstagram: https://www.instagram.com/drmariannetrent/LinkedIn: www.linkedin.com/in/dr-marianne-trent-psychology Twitter: https://twitter.com/GoodThinkingPs1YouTube: https://www.youtube.com/c/GoodThinkingPsychologicalServices

Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field, the principles can work for you.

There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode.

If you're looking to become a psychologist, then let this be your guide. episode. With Dr. Mary Andrews Hi, welcome along to the Aspiring Psychologist podcast. Let's think today about boundary setting. Now, what do we know about boundary setting? What we know is that boundaries help humans to feel safe. That's kind of universally acknowledged as true. And you might notice that when you think about children. So children don't always like being told no, but boundaries, you know, such as bedtime, such as regular mealtimes, such as knowing the limits of what's tolerated, help children feel safe. And, you know, also, when you think about society,

we generally have a society that's peaceful and that runs well, most of the time because of boundaries. So laws are boundaries. You know, the reason you're able to generally walk down the street and feel like you can do so with minimal risk is because we know there are consequences to people having actions that aren't very nice. So these boundaries are really important. And what we want to be able to do as effective clinicians is help the clients that we're working with to feel safe. And so boundaries are really important as well and of course you know the people we're working with might not have experienced feeling you know the appropriate fair kind consistent boundaries have been used and so this is a really nice opportunity maybe for the first time in people's lives to hold boundaries that actually lead people to feel safe and to feel that you are predictable

and consistent because what we want to be able to do is to have people internalize you and the work they're doing to be able to think you know in my case well what would Marianne say about that if you're predictable and consistent and they like the messages that you have been talking about together then you will become internalized. And that is when your work really begins to get really significant ground running. Because it means that your time is not just limited to, you know, the therapy hour, or however much time you've got together. But it, you know, it spans beyond that. And that's when the magic happens. So let's think a little bit about what boundaries might look like,

and how to discuss them with clients too. So one of the first things that I will say to a client is to talk about confidentiality and safeguarding. Now that is not a very catchy or engaging topic to discuss with somebody and it can of course also feel a little bit scary, potentially invasive and it might get red flags up for them if they've been let down or hurt by people or services in the past. you know or experiences of friends and family having had experiences that were stressful or problematic that might get the hackles up and similarly you know same with police and you know other services that you might need to to refer to and so we're going to be doing this sensitively and with the goal of helping the client, you know, being on their team. So let's think about how I explore and introduce this to clients that I work with. So here's a little bit of my script and you might find it helpful to use this or something similar. Okay, so I would say,

okay, today we're going to be meeting, you know, for about an hour, about an hour and a half, however long your session is, and we're going to be thinking about what might help meet your needs right now. And you might notice as we talk that I'm going to be scribbling down some notes. I'll often sort of scribble a family tree and some ideas and things that you might say that I think you know I want to remember. If you want to know at any point what it is I've written or why I've written it then do let me know. It is just an aid for me and it will be kept because it counts as a clinical entry. But what I will be doing is I'll be using what I've scribbled down to put together, you know, an assessment letter or report for you so that we

have an idea of, you know, not only what the problems you've got are at the moment, but what we think and what we've discussed together might be a really good way of helping you to meet your needs and meet the goals that you've got. If when we're talking, something comes up that means that I'm a little bit worried that you might not be okay or someone that you talk to me about might not be okay and then it might mean that I need to pass that information on so that we can keep everybody safe it might mean that I'd need to speak to the police or social services or some other emergency service in order to make sure that we are keeping everybody safe. I know that can feel a little bit scary sometimes but what

happens is if I feel like I need to do that then I will always try and discuss that with you first so this should never come as a surprise. the only exception to that would be if upon reflection or upon discussion with my team we think about some sort of risk that we hadn't discussed and i'm not able to reach you to discuss that first then i might need to make that referral without having spoken to you explicitly about that. Is anything about that confusing or worrying and are you happy to go ahead with this appointment based on everything that I have said? So you can see that it's a friendly tone, it sort of guides people through the process um and you know largely people say yes that's fine um but you know for the reasons that i've outlined um previously you know through to negative experiences um previously some people do ask for a little bit of more information. And that's okay. You know, we want people to be able

to be making an informed choice, you know, to have informed consent. And so that's why I really, you know, give details about, you know, what will happen, what it might involve. Because what I don't think is useful is if, you know, we just say we might need to pass that on. And then, of course, if something does happen, which invariably in your career, it will, if something does happen, that means you then need to make a safeguarding referral or to speak to the police or fire service or you know ambulance that they might then say well I didn't know you meant you were going to speak to children's services you know if I'd known that was a risk then I never would have spoken to you before and so if that happens it can lead to a rupture in your relationship, which can feel a little bit tricky to repair and might

ultimately lead to the client disengaging from services, disengaging from you and being, you know, trickier to re-engage in future. So this really is a golden opportunity that you've got with clients. And so we want to get it right first time, every time, so that we can really help you and your service and your clients to meet the goals that you've identified. I hope this is useful food for thought so far. Just going to pause for a quick break and I'll be right back with some more skills in boundary setting. Get how you feel. This book is a chance to be supported in grief and to learn how to support one another. Over 50 stories written by those that are grieved. They've been there too, so they know how you suffer. It's the grief. Collective stories of life loss and learning to heal

The Grief Collective Written by people who get how you feel I'm really grateful for the Grief Collective book. I've spent the last three years hiding how I feel because we as a society are so messed up about grief it's ridiculous. Here at last is a book from real people, telling it like it is and not shying away from anything. I would recommend that everyone read this. If you're grieving, it might help you to know you're not alone. And if you're not grieving, then it will help you understand those who are.

Thank you, Marianne. The Grief Collective Stories of life lost and learning to heal The Grief Collective Written by people who get how you feel This book is a chance to be supported in grief Collective written by people who get how you feel. This book is a chance to be supported in grief and to learn how to support one another. Over 50 stories written by those that are grieved.

They've been there too, so they know how you suffer. It's the grief collective stories of life loss and learning to heal the grief collective written by people who get how you feel Welcome back. Let's think about boundary setting now within the general clinical work that you do with people. So let's think about, you know, you've already covered the confidentiality and safeguarding aspect, but it would be really useful to lay down the foundations and the boundaries for what to expect and what is tolerated really in terms of your clinical work and in terms of your you know your day-to-day work your day-to-day sessions with people so in this zoom culture we have due to the pandemic, there can obviously be more of a tendency to be a little bit more relaxed in what people are wearing to sessions and where they have the sessions. So generally speaking, I ask people to be dressed when they speak to me. Obviously,

if you're working in a chronic pain service, or if you're working with someone who does spend all day in bed, then there might need to be some flexibility for that. But if you are working with somebody, you know, who is up and about and is able to freely get from their bedroom and get to their wardrobe and you know back to the sofa or their dining chair wherever they see you then I think it's reasonable to expect that they not be you know just in their dressing gown so I have certainly started sessions with people where them you know they've been in dressing gowns perhaps with nothing else underneath and you know for me that's not okay and so um you know I will say oh let's pause the session here um you know I'll restart it in in

five or ten minutes I'm just going to give you a chance to go and get dressed um okay so before we start um I would have laid down the boundaries to actually showing up ready for therapy or ready for whatever the intervention that you're doing. It's really important and it's great to be able to, you know, crack on and make a start at the time that we've said we're going to start the session. Think about if someone was turning up in person you know that they'd not be wearing their pajamas never once have I done a session in person with someone where they've turned up in their pajamas it doesn't mean that you haven't you know I know it's really common people pop to the shops in their pajamas but never heard about anybody turning up in their pyjamas and it would certainly lead to an interesting discussion with me if they did. Turning up on time and also making sure that there's not too many distractions going on so again with our Zoom culture it can be really

common that people just kind of think it's all right to have people in the room with them whilst you are doing your work. But it means that perhaps people might feel more reluctant to talk about things or that they, you know, they might be called to do things at short notice so if they've got children in the room my children are always asking for drinks and snacks or you know watch this mummy watch this do this oh or if there's two children in the room invariably he's kicked me in the head um you know I can't run a therapy session in those circumstances and I certainly wouldn't be able to think about accessing therapy with that set of circumstances, it just wouldn't be possible. What we want to be able to do is for your client to be able to really focus on themselves and focus on what it is you're going to be talking about. And so when you're laying those boundaries it can be really

useful to think about having a private space or if they have got young children or people that they need to care for that they've got somebody in the house as well to be able to meet those needs or perhaps they could go out for an hour to be able to access your session. I absolutely have seen people in their car, you know, using their Wi-Fi, not as they drive, but you know, perhaps on the drive or on the street near their house, so that they are able to just focus on themselves, and so that they don't have to worry about being overheard. Again, in these remote times, connection difficulties can be, you know, a really big consideration. And someone's Wi-Fi might be great one day and just really glitchy the next.

And so it might be useful to think about what happens if things, you know, don't run smoothly. So do you have the client's number to be able to call them to have a telephone call if things aren't working when things have been a bit glitchy I've sometimes found it helpful to turn the audio off on you know attend anywhere or zoom or whatever platform you're using to see clients and then to telephone and get the audio through through the mobile so if you both turn your microphone off and then just use the audio it often speeds up the process because some aspect of face-to-face is usually preferable telephone therapy of course gets great results and is better than nothing but some aspect of

someone being able to see you you know the face that hopefully they're learning to really trust in is really useful so just have a little bit of an agreement about what happens if if connection isn't working and of course it's really useful to think about what happens if people don't show up when you're expecting them and vice versa. You know, we are forgetful creatures by nature of being human. So what do they do if, you know, you haven't turned up to an appointment that they were expecting you to turn up to? So, you know, my personal approach for doing this with clients is that if I'm still hanging about in Zoom, five minutes after the scheduled start time of a session, I will text a client and just say a simple message like, hi, hope you're okay.

I'm ready and waiting on zoom whenever you're free if they haven't then responded within another five minutes so 10 minutes after our planned start time then I will try and give them a ring and if they don't respond to that I don't tend to leave voicemails because I find it often needs explicit consent to be able to leave a voicemail for somebody. I will just say via another text message, it seems like there might be a problem with us getting together today. What I will do is I will end our Zoom session for today. But if you are available before the scheduled finish time, whatever that might be for your session, then just send me a text or give me a ring and we can

restart the session and I'll be here for you. So I do it that way because, you know, I think it's compassionate to myself. I don't want to stare at myself for 50 minutes. You know, there's always useful stuff that I can be doing. If you're a dynamic therapist, you might like to sit and think about the client for 50 minutes, but I'm not working predominantly with dynamic ideas. And so, you know, it also takes time to record did not attend or was not brought clinical notes as well and my clients will know because I've already discussed with them and terms and conditions will say as much that this is the procedure for when sessions haven't started. So in services I've worked in before there has been a policy that

if you're not there within 15 minutes that the session needs to be rescheduled but I think especially when many of us are working from home or working remotely if someone is expecting that service and needing that service and especially if they've paid for that service that I'm going to make myself available even if it's just to say you know we've only got five minutes left I'm really sorry we weren't able to get together but let's think about when we might next get together and all of this is in terms and conditions and I know in NHS services terms and conditions aren't really something we get people to sign up to but it can be useful to discuss all of this in person with someone. I hope this has given you really useful ideas for putting theory into practice and for why it is so important. If this

would be useful for me to think about in more detail in future, do just let me know. It would be wonderful if you could rate this episode, like it, subscribe to the podcast and tell anyone about it who you think might find it useful too. I will very much look forward to chatting with you again in our next episode. Until then, take care of you. Bye. With this podcast that you're set to be on your way to being qualified, it's the Aspiring Psychologist Podcast with Dr. Marianne Trent. My name's Jana and I'm a trainee psychological well-being practitioner. I read the Clinical Psychologist Collective book. I found it really interesting about all the different stories and how people got to become a clinical psychologist. It just amazed me how many different routes there are to get there and there's no

perfect way to become one and this kind of filled me of confidence that no I'm not doing it wrong and put less pressure on myself so if you're feeling a bit uneasy about becoming a clinical psychologist I definitely recommend this just to put yourself at ease and everything will be okay. But trust me, you will not put the book down once you start.