Add To Cart

Setting Clear and Ethical Boundaries with Clients

Section 8
Therapist Nonverbal Behavior

Question 8 | Test | Table of Contents

Read content below or listen to audio.
Left click audio track to Listen; Right click to "Save..." mp3

As you know, nonverbal communication takes place between therapist and client the first time you meet...each starts developing ideas about the kind of person with whom each are dealing.

Previously, I described the use of a calm body language as a way of reinforcing a boundary with an out-of-control client. Let's look at nonverbal communication, contradictory messages, and the resulting effect on boundaries. As you know, nonverbal communication takes place universally when two individuals meet, size each other up, and develop ideas about the kind of person with whom they are dealing, whether the other is hostile or friendly, weak or strong, concerned or indifferent.

♦ How to Avoid 2 Types of Contradictory Nonverbal Messages
Because nonverbal communication never ceases, two types of contradictory messages can occur.
-- 1. One related to present circumstances and
-- 2. Another related to your past issues.
You may say verbally, "I am glad that worked out for you," while at the same time you may convey nonverbally, "I'm tired and feeling the effects of my allergy medication, it's late on a Friday afternoon, and I'll be glad to see my last appointment."

Partially Self-Disclosing
I find if I am giving off a mixed message I might partially self-disclose, but still maintain an ethical boundary by saying, "My allergies have been really bothering me today, so excuse me if my eyes look a little glazed over." Acknowledging a reality of which the client may be aware, sets up a situation in which a limitation you have as a person is stated.

Vent to a Fellow Therapist
When I am aware of these feelings that may project contradictory non-verbal messages and recognize their impact on the client, I attempt to deal with my own feelings in constructive ways. To avoid a problem, I may vent my feelings of frustration with a fellow therapist. They can also, in some instances, help me to clarify my feelings regarding the client, help me to try to understand their source, and decide whether it is possible to change the situation that provoked them.

In summary ask yourself, "Do I need to increase the frequency of my body scans regarding my non-verbal messages?" Since body language can convey conflicting feelings to your client, this creates the boundary violation of shifting the focus away from the client and towards yourself.

♦ Exercise: Body Scan
To maintain this ethical boundary, I do a body scan starting with the tilt of my head, to my facial expression, eye contact, to my shoulders being raised, my posture, arms and hands and finally leg and feet movement. By doing my body scan in this order from top to bottom, so to speak, it has become a regular habit that takes little mental distraction and can be done in a few seconds.

How do you vent your feelings of frustration? Think of a client towards which you have conflicting feelings. What feelings do you need to acknowledge? What is their source?

- Stone, M. (1999). Boundary Violations between Therapist and Patient. Psychiatric Annals, 670(7).
Reviewed 2023

Peer-Reviewed Journal Article References:
Dowell, N. M., & Berman, J. S. (2013). Therapist nonverbal behavior and perceptions of empathy, alliance, and treatment credibility. Journal of Psychotherapy Integration, 23(2), 158–165. 

Heide, F. J. (2013). “Easy to sense but hard to define”: Charismatic nonverbal communication and the psychotherapist. Journal of Psychotherapy Integration, 23(3), 305–319.

Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Self-awareness questions for effective psychotherapists: Helping good psychotherapists become even better. Practice Innovations, 2(4), 163–172.

Nissen-Lie, H. A., Orlinsky, D. E., & Rønnestad, M. H. (2021). The emotionally burdened psychotherapist: Personal and situational risk factors. Professional Psychology: Research and Practice.

Schwartz, R. A., Chambless, D. L., Milrod, B., & Barber, J. P. (2021). Patient, therapist, and relational antecedents of hostile resistance in cognitive–behavioral therapy for panic disorder: A qualitative investigation. Psychotherapy, 58(2), 230–241.

Wilson, J. L., Uthman, C., Nichols-Hadeed, C., Kruchten, R., Thompson Stone, J., & Cerulli, C. (2021). Mental health therapists’ perceived barriers to addressing intimate partner violence and suicide. Families, Systems, & Health, 39(2), 188–197.

QUESTION 8
What is one method to develop awareness of your nonverbal communication? To select and enter your answer go to Test.

Test
 Section 9
Table of Contents
Top