Why Therapists Struggle to Set Boundaries With Clients

Setting boundaries with your own clients is harder than setting them anywhere else in your life. The reason is the helper identity. The role of holding ground for someone in distress makes the no feel like a withdrawal of the help she came to you for, and articulating the opposite to yourself intellectually doesn’t reach the felt sense. So you say yes when you should have said no, the not-saying accumulates, and by the time you notice it’s late in the work and the boundary is much harder to set than it would have been at the start.

The places where slippage shows up are predictable.

Session length. A session runs to its full time, something interesting happens in the last few minutes, and you let it run over. Once that happens twice, your day becomes a series of sessions bleeding into each other. You’ve stopped having time to write your notes. The fix is ending the session at the time you said it would end, even when something interesting is happening, with a brief acknowledgement that you’ll come back to it next time.

Between-session contact. A client sends what’s essentially a clinical processing request dressed up as a quick question. The pull to engage is real. The boundary that needs to hold is deferring the clinical processing back to session. Processing in fragments by email between sessions hollows out the meeting that’s supposed to be where the work happens.

Late payment. A payment slips by a week, then two, because asking feels mercenary. The fuzziness seeps into the rest of the relationship. The clinical frame is the same frame as the financial one and there isn’t a real way to keep them separate.

What changes the pattern is pre-deciding each boundary in writing, when you’re calm, and holding the written version when the pull is on. The session-length boundary is whatever you decided it would be, written into your practice manual, said the same way every time. The decision was made when you were rested. You’re enacting it, not remaking it.

Rehearse the words you’ll use, out loud, in the room when no one is there. The phrase you’ll find hardest to say is the one worth practising most. Saying “we have two minutes left” until it comes out of you naturally is part of why it will come out of you naturally when you actually need it.

In my-cbt, the in-portal messaging routes between-session contact into the case file rather than your inbox. The clinical email is recorded attached to the file, visible when you open the file to prep for the next session. The boundary you set at intake about how messages get handled is structurally enforced by where the messages go, rather than held in real time by your willpower.

The boundaries hold when you wrote them down before you needed them.