Your Plan for Therapist / Client "Real World" Interactions

Man saying hello and waving outside a coffee shop with a cup of coffee to go.

Imagine that on that you are at the grocery store on a Saturday morning for a quick stop to get some milk, and you spot one of your clients just a few places in front of you in the checkout line.

What do you do?

Should you wave to them? Walk up and ask if they were able to work things out with their significant other? Remind them of their appointment this Monday (since they missed their last one)? Ignore them and frantically try not to make eye contact?

If this situation is new to you, you may experience some panic.

After all, whether it is the first or the tenth time it has happened to you, running into a client outside of therapy sessions usually catches you off-guard. When you find yourself in an unexpected situation, there is a greater chance of making a mistake or doing something you typically wouldn’t do. This can potentially injure the therapeutic rapport between you and your client, thus impeding progress and, at worst, leading to early termination.

Some clinicians may not worry about these situations, and when the event occurs, they may handle it without any trouble. But for many clinicians, client run-in scenarios can come up time and time again, provoking a lot of anxiety.

The Challenges of Running Into Your Clients

There are many factors to think about when a clinician sees one of their clients in the “real world”:

  • How do you handle acknowledging or not acknowledging the client but also being tactful and reducing the chance of upsetting him/her?
  • How do you ensure confidentiality?
  • Some clients are happy to introduce you to loved ones, family, and friends, while other clients may not have disclosed their participation in therapy to those they are close to. How do you prepare for this?
  • How do you maintain boundaries within a setting that is not as confidential as the therapy room?
  • What if you are with your family or friends and don’t feel comfortable with your client meeting them?

By taking the time to fully examine these questions and concerns, you can begin to develop your own plan for how to handle these types of situations.

Building Your Guidelines

It is important that you develop your own guidelines and then communicate these guidelines to your clients. This eliminates any guesswork in the case that you and your client run into each other outside the therapy room.

There is nothing worse than unexpectedly seeing your client while you are out and about and not having a framework to rely upon. Imagine having to politely decline a client’s impromptu request for therapy sessions while you are at the park with your children. This could result in the client carrying feelings of rejection and hurt into your next therapy session. With a plan, these types of situations have a much better chance of being avoided.

Here are 4 steps to take when developing your own model for how to handle interacting with clients in the “real world”.

1. Identify Boundaries

First, it is important to identify your own boundaries and level of comfort with how you will engage or will not engage with a client outside of the therapy office.

Your comfort level of “real world” engagement with clients will play a big part in building your policy of how to handle these types of interactions.

Here are some things to consider:

  • As a clinician, do you lean towards waving and exchanging pleasantries, avoiding making the first “move,” or having a strict no-interaction policy?
  • What if you are with your family or friends? Would you want to have to introduce your client to the individuals you are with, or would you rather walk away from your client after you have had an exchange?

Some of the answers to these questions may stem from how personally private a therapist wishes to be and how much a therapist is willing to disclose or share with a client. Your answers to some of these questions will determine if you are willing to have some contact, a little contact, or no contact with clients outside of the therapy office.

2. Develop a Policy Based on Your Boundaries

Once you have determined your boundaries, develop a policy based on these boundaries.

For instance, if you decide you are open to engaging with clients outside of the therapy office, ensure that you have identified to what extent and how personal you are willing to be. During this time, think about the clientele and populations you serve, as this may assist you in developing a framework tailored to those specific populations.

For example, if you serve a large population of trauma survivors who are sensitive to attachment issues, you may feel you want to be more willing to at least acknowledge them if you run into them within the community given that a rebuff may be incredibly hurtful to this clientele.

Additional considerations are related to what type of surroundings you work in.

  • Is your therapy office located close to your home?
  • Are you located in a suburban area?
  • Are you the only therapist located within a large radius, and do you serve most of the individuals you see on a daily basis?

These factors will all come into play when developing your policy.

3. Get Feedback on Your Policy

Once you have identified your boundaries and developed your policy, it will be important to get some feedback on it. Writing out your policy and discussing it with others can be an effective means to gather feedback and help with additional processing.

Having a colleague or supervisor review and discuss your current policy can be very helpful for checking to see if you are missing anything and gaining feedback on the policy as a whole. After all, when you are thinking about the potential impact that your policy could have on both yourself as a clinician as well as your clients, it can be a big help to talk things through with others.

And if needed, don’t hesitate to tweak and revise your policy.

4. Share Your Policy With Your Clients

Now that you have developed a policy that you feel confident and comfortable with, you need to share this policy with those you serve.

For some clinicians, this may be included in your orientation material or other paperwork. Other clinicians may choose to briefly discuss this at the onset of therapy. Or, if in the process of therapy you realize that there is a strong potential for the client to be in the same setting as you in the community, this could be a good time to bring up your policy. It is up to you as a clinician to decide how your policy will be discussed and how those you serve will be made aware of it.

Also, bringing up something like your policy for “real world” interactions can be a great way to lay out expectations and boundaries related to the therapeutic relationship as a whole. Additionally, this can be an excellent time to hear the expectations of the individuals you serve regarding interaction outside of the therapy office.

By sharing your policy with your clients, you can minimize any anxiety or discomfort that clients may feel related to the thought of seeing you outside of the office setting.

 

By taking some time upfront to process and develop a framework on how to engage with those you serve during possible run-ins in the community, it allows you to feel prepared and more confident in how to handle these scenarios.

It also allows you and your client to have a dialogue, set expectations, and prepare for that chance encounter in the “real world”.

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Christina Wohleber, PsyD

Christina Wohleber, PsyD

Christina Wohleber, Psy.D. received her doctorate in clinical psychology from Immaculata University in Immaculata, PA. She is currently a clinical supervisor of several behavioral health programs within the same community mental health agency where she completed her pre-doctoral and post-doctoral internships. Dr. Wohleber enjoys working with children, adolescents, and adults who have experienced severe trauma histories and/or attachment issues, as well as conducting evaluations for children and adolescents to determine appropriate levels of care. In addition, she loves to supervise masters and doctoral level interns to assist them in navigating the complex world of community mental health within the Philadelphia area. She is a proud member of both the American Psychological Association and Pennsylvania Psychological Association. When she is not working within the field of psychology she enjoys spending time with family and friends, cooking, and completing arts and crafts as a means to practice self-care.

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