Establishing boundaries

It is important to define terms of engagement for working with people in relation to their health and wellbeing.  These terms clarify boundaries and  manage expectations of your service. It is a good idea to capture these terms in handouts and disclaimers about your service. In words for wellbeing sessions, it is recommended that you agree terms of engagement with the individual or group  at the start of your first session.

In this video, Juliet Ridgway-Tait, Healthy Reading Bibliotherapist with Midlothian Library Services, shares her approach to defining terms of engagement and boundaries for a words for wellbeing session.

Health literacy

Terms of engagement should set out clearly that:

	Your role is to help people find the information they need.
	You are not a health or care professional and your role does not include interpreting that information or advising on health and wellbeing issues.
	You recommend that people consult with a healthcare professional if they are looking for advice.

Words for wellbeing

Terms of engagement should set out clearly that:

	Your role is to help people explore how reading can support their personal growth, wellbeing and confidence in living well on their own terms with any health issues they may have.
	You are not a therapist or counsellor and your role does not include professional psychotherapy.
	You recommend that people consult with a healthcare professional if they feel they would like to explore professional psychotherapy.

The following are examples of situations where you may need to be self-aware and manage boundaries while you are interacting with a person seeking your help.

		Examples of rescuing can be telling a person that 'everything will be alright', or taking on responsibility for the person's problems and decisions - for example, speaking with a healthcare professional o their behalf.  your responsibility is to help the person with information and resources that can build their confidence to make their one decisions.  The choice of action remains theirs.
		You may know a person seeking your help in another capacity - for example, as a friend, a colleague or neighbour.  You need to think carefully about how to keep the professional interaction separate from your personal relationship with that person.  If in doubt, ask a colleague to take on this interaction.​
		Sometimes you may find that you take a strong liking or dislike to a person without an obvious reason.  They may subconsciously remind you of someone in your own life, or there may be a personality clash.  You will need to manage your feelings in order to uphold the principle of treating everyone fairly and equitably.
		You may disagree strongly with the views a person expresses - for example, their moral or political opinions.  In this situation, you need to remember not to apply judgements and to treat everyone's views with respect.​
		You may want to tell the person about a similar situation  you  have experienced. This is usually not recommended.  It takes the focus off the person  and the uniqueness of their experience.   It also risks making assumptions about what the person is feeling or what they should do – and this can be perceived as devaluing their experience.​

 Workbook Exercise

Workbook exercise (1)

Magda is approached by Phil, a library user looking for help with wellbeing information. As Magda notes the enquirer’s details she is shocked to realise that Phil is a neighbour she knew some four years ago, who moved away after separating from his wife. Phil looks tired, old and overweight when previously he was very fit.

Phil explains that he wants to know about support and advice services that can help him to ‘get his life back on track.’ He reveals that he was made redundant two years ago, is plagued by money worries, and is smoking and possibly drinking more than he should. He was hospitalised with a heart attack two months previously. The consultant and GP both told him that he needs to change his lifestyle.

Magda discusses his needs, helps him to identify key websites, charities and support groups, and tells him how to make an appointment with the local Money Matters service. She prints off the information and uses Teachback to confirm that he understands what each service is for and how to contact them. However she has doubts about whether he will follow up, and suspects that he simply wanted to talk to someone about his problems.

As Magda is walking along the high street to get her bus that evening she sees Phil emerging from the off-licence with a full carrier bag. That evening, she can’t stop worrying about the encounter with Phil. She wonders if she should set up some appointments for Phil with a couple of the services they identified, to give him a helping hand to make a change.

In your workbook, note down:

• What do you think of Magda’s idea? Are there other actions you would suggest?
• In your answer, remember, for example, the principles of trust and autonomy, and boundaries around  confidentiality, rescuing and dual relationships.