Do professional boundaries limit trust?

Int J Ment Health Nurs. 2018 Feb;27(1):287-295. doi: 10.1111/inm.12319. Epub 2017 Feb 15.

Abstract

The present study uses stories of mental health support workers talking about their relationship with clients to wonder about how trust might be limited by the professional boundaries of nursing. The writing arose out of an appreciative inquiry study looking at the role of mental health support workers. Participants talked about how they worked with their clients. As researchers, we were struck by the depth of trust that was built between worker and client. We have brought a phenomenological lens to wonder about the nature of trust, as shown in the data. The original research sought to identify what was working well for mental health support workers. The present study brings a phenomenological interpretive approach to four stories from the discovery phase of the study, with our thinking informed by Heidegger and van Manen. Interviews were conducted with 26 mental health support workers and six stakeholders in 2012-2103. For this paper, we drew from those transcripts stories of three mental health support workers and one stakeholder. Through a process of talking together, writing, and rewriting, we wondered about the meaning within these stories, with a strong focus on how trust was enacted. We saw that mental health support workers in this study, by not carrying the boundaries of being 'professional', seemed free to grow a stronger relationship of trust which was therapeutic. We ask: Is it time to rethink how professional boundaries limit the level of trust achieved with clients to the detriment of impactful care?

Keywords: mental health; nursing; phenomenology; professional boundaries; support worker; trust.

MeSH terms

  • Humans
  • Interviews as Topic
  • Mental Disorders / nursing
  • Mental Disorders / psychology
  • New Zealand
  • Nurse-Patient Relations*
  • Psychiatric Nursing / methods
  • Trust* / psychology