I have spent the last almost 7 years as an in home counselor. What this means is that I meet my clients within their home environments and conduct therapy there. In other words, I get a peek into daily lives and living situations for my clients. And they get to see me in a little less “stuffy” of a role than what they thought counseling was about. To be honest, I am not sure either of those things is good or bad, it really comes down to the situation/client itself.
Entering into a client’s home environment makes establishing that professional/personal boundary a difficult challenge from the start. If this client was coming into my office, I would only know if there was clutter or chaos if they revealed that information to me. By coming into their home, I get to see a lot of nonverbal information that can help me assess the situation. But it also hinders the situation as well. For example, where do you have the session that affords you privacy and yet protects you as well? How do you avoid becoming “part of the family” when in essence you signal that you don’t want to be considered “the enemy/the outsider” because you are trying to establish that therapeutic relationship?
Most of my clients have boundary issues anyway, and now we complicate matters by bringing in a professional into a very personal setting. And I find myself struggling some times to remember to keep up those professional walls. We talk about beneficial versus harmful relationships for our clients and yet at times, I wonder if an in home therapist walks that line a lot more precariously than those who practice in an office. I am virtually on call 24/7 and while I have learned to let it go to voicemail so that I can determine if I truly need to speak with the client at 7pm, it doesn’t stop them from thinking that they can call me later in the evening. And I personally think a lot of that has to do with the fact that I do come into their homes, they are more comfortable/lax around me than if I saw them in an office. Most of my clients are low-income and live in areas of increased crime rate and poverty and government involvement, so even my dress and demeanor has to be “less professional” to start establishing that trusting relationship. I started out trying to wear business casual and soon realized that I was getting looks as to whether or not I should be trusted in the neighborhoods…was I a parole officer or with CPS or some other person who was just going to cause trouble? So I started to dress down, less threatening. But what does that cost me with regards to the boundaries?
I also work within a rural community, where typically people feel familial rather quickly. Now, I grew up in the deep south, so this is not new to me, but I was not trained on how to deal with this type of environment when going through my schooling. I can’t imagine growing up in a large metro area and then taking a job as an in-home therapist. I imagine the culture shock would leave some individuals questioning their career choice. Honestly, if you aren’t comfortable with self-disclosure, in home therapy is probably not for you. I use self-disclosure as a way to establish that trust because I am asking these people to let me into their home and see the things that normally would not be mentioned in a session. I’m asking for them to jump into the deep end from minute one, so why would I not give them a reason to?
But when it is all said and done, there are moments and certain clients where I have to ask myself did I miss something? Did I blur the lines too much or is this just a client who would have pushed/blurred those lines anyway? I imagine we all do that as counselors, asking ourselves was there more/something different we could have done. It may be a somewhat different world with different “rules” for the in home therapist, but the overall goal is the same as any other setting, help the client and don’t lose yourself in the process.
Michelle E. Wade is a counselor and doctoral student focusing on in-home therapy and technology in counseling.