Healthcare Chaplains
Ministry Association
(formerly Hospital Chaplains' Ministry of America)
377 E. Chapman Ave
Suite 260
Placentia, CA 92870-5094
Phone: (714) 572-3626
Fax: (714) 572-0585
info@HCMAChaplains.org

Well-established and maintained boundaries serve to guide and protect us in all areas of life and ministry. One illustration of viewing boundaries as an important line of protection is to look at our own skin. Our skin helps to keep out countless, ever present threats to our physical well-being. For example, this natural barrier keeps our bodies safe and protected from germs. When there is a break in the skin, such as when we get a cut, we become open to infection. Just as our bodies need a barrier of skin for protection, as Chaplains we also need ministry barriers that protect our ministries.

Psychologist Archibald Hart believes that every person involved in counseling, which includes Chaplains, walks on the edge of a virtual moral precipice. One wrong step and you are over the edge.[1] That is why it is important for every Chaplain to evaluate whether he or she has set appropriate personal and professional parameters for his or her ministry activities. As a Chaplain, you are often responsible for caring, exploring alternatives, listening and praying for hurting individuals. However, you are not responsible for their entire emotional well-being. As a caregiver, you must create some type of emotional, physical and moral line (boundary, fence, limit) that you are committed to never cross with a patient, family member, staff person, or another Chaplain.

You may mean well in your caring, but the Bible clearly speaks of the dilemma we face when attempting to justify and rationalize our good intentions: "The heart is the most deceitful thing there is, and desperately wicked. No one can really know how bad it is!" (Jeremiah 17:9, TLB)

As a Chaplain, you need to think through and establish boundaries that will help you to respond appropriately to people you come in contact with. In no area is this more important than in your interactions with members of the opposite gender. And remember that these ministry boundaries are meant to be there for your own self-control, not for controlling others. This article is designed to be a general overview of some (it is not meant to be exhaustive) of the prudent boundaries you need to consider when involved in pastoral relationships. May God bless you as you establish boundaries that preserve and enhance your ministry as a Chaplain.

1. Importance of Boundaries.
   Why do we need ministry boundaries?
   1. To guard against harm to the public whom you serve. You may have good intentions to help, but you must also be competent to help. "The counselor stands responsible to guard the safety of the client and is culpable for not doing so, no matter how the client behaves."[2]
      1. Guard against exploiting clients. You must not intentionally take advantage of your "power" and "authority" with their "weakness" and "vulnerability." According to Anne Katherine:
         
         The therapist-client relationship mirrors other relationships where one person is in the position of mentor, steward, authority, employer, or parent to another. Those with power have certain responsibilities toward the people they serve, assist, teach, supervise, or lead. The person who has power carries an ethical mandate not to exploit their position, not to abuse a subordinate in order to extract personal gain.[3]
         
         
      2. Guard against "rescuing" clients. You must stay away from "going overboard" in your caregiving. You must not go beyond what is professionally appropriate while trying to help them. You must steer clear of over-investing yourself.
         
         According to Ken Royer, pastoral counselor at Link Care Center in Fresno, California, "The ultimate goal of Christian counseling is to increase the client's dependence upon God, not man. Counselors can be tempted to assume responsibility for the outcome of the presenting dilemma. An over-responsible counselor can unknowingly cripple a client's growth by fostering an unhealthy dependence that resembles a parent-child relationship. Meeting every need and answering every request is also a sure way to burnout."
         
         
      3. Guard against your own neediness. You need to avoid role reversal regarding support. "Counter-transference" is the counselor's feelings toward the patient as a result of his or her own emotional needs and projections, and must be carefully guarded against.
         
         
      4. Guard against distorted expectations of the client. You must not attempt to fix everything with simple solutions.
         
         
   2. To protect against having a bias or distorted judgment. For example, avoid counseling close, personal relationships.
      
      
   3. To safeguard against ruining your ministry (unless you would like being a truck driver). Thomas Fischer, consulting director of Ministry Health, LLC, wisely declares that: "The combination of poor boundaries and a passionate calling from God is like giving an adolescent the car keys for the first time. At best, it's precarious. At worst, it's an accident waiting to happen. The crash can be devastating."[4] Having boundaries will protect you and your ministry from the damage that a moral failure would cause. So much can be lost even through an accidental or well-intentioned violation. Remember Joseph and Potiphar's wife? Ask God regularly to preserve you from such a trial.
      
      
2. Confidentiality.
   What guidelines have you established for ensuring that privileged communication remains private?
   
   
   1. Definition: Keeping things confidential means that you do not pass on any communication revealed to you by a patient/client in confidence to anyone else. Situations you know about are kept quiet, secure and private. Confidential client information includes all verbal, written, telephonic, or electronic communications arising within the helping relationship.
      
      
   2. Doing anything beyond a simple spiritual assessment and support requires the fully informed and uncoerced consent of the patient. Initiating prayer with patients, for example, should take place only when the Chaplain knows beyond any doubt that the patient would welcome such a suggestion. Likewise, before discussing a patient's case with the patient's clergy or others, the Chaplain must obtain consent from the patient.
      
      
   3. If asked by legal counsel for information about a particular patient, then respond with, "I assert privilege (a legal term) on that matter." That means no information about a client is to be shared(even in a court of law.
      
      
   4. Exceptions include:
      1. The client (and all parties involved) signs a release.
      2. The client demonstrates deadly harm to self and/or others (such as elder or child abuse). Such confessions require mandatory disclosure to the proper authorities, even in a clergy-client counseling context.
      3. Minors. Anything a kid says under the age of twelve, you may tell the parents. Remember to get written permission from the parents in order to counsel a minor.
         
         
3. Spiritual Boundaries.
   The spiritual aspect of our lives is never simply a part of life. Rather, it is at the heart and center of life. What spiritual disciplines have you established to advance your spiritual growth and to help guard against you crossing over your boundaries?
   1. You need to hear from God daily. Your relationship with the Lord Jesus Christ takes priority over your ministry activities. (See the example of Moses and Joshua in Exodus 33:11.) In other words, do not counsel others unless you have first had personal counsel from God.
   2. Our effectiveness as professional caregivers is directly and proportionately connected to our relationship with the Lord Jesus. We need to put personal devotion time at the top of our "to do" list.
   3. Servanthood versus servitude.[5]
      1. Servitude is associated with slavery. It involves four negative problems:
         1. Overidentification: taking on the problems of others at the expense of losing your own identity. You do not need to jump into the mudhole in order to get someone out of it.
         2. Superficial sweetness and gushiness: covering up your true feelings of frustration. You do not have to be delighted to have dinner with your spouse interrupted by an urgent (not an emergency) call.
         3. Being manipulated: allowing others to abuse your caregiving relationship. You are being manipulated when another person controls your behavior or plays on your emotions for selfish ends. Do not be a doormat, with an inability to say no to unreasonable requests.
         4. Begrudging care: complaining about your caregiving relationships. Your resentment of the situation will block effective relating and caring.
      2. Servanthood incorporates the idea of voluntary commitment. It involves four healthy aspects:
         1. Empathy: feeling with another person while retaining good objectivity and maintaining your own identity.
         2. Genuineness: being yourself: Always be in congruence with who you are.
         3. Meeting needs, not wants: speaking the truth in love. If you seek to help others, you must meet their needs (e.g., needing a balanced diet), not their wants (e.g., only wanting sweets).
         4. Intentionality: choosing to be in a caregiving relationship, or getting out of it when that is the best option for all concerned.
            
            
4. Physical Boundaries.
   What physical limits have you put into effect between you and those you minister to as a Chaplain?
   1. No sexual contact/touching. There is absolutely no room or place for such behavior. It is always a serious boundary violation.
   2. No sexual misconduct. This would include, but not be limited to, the solicitation of sexual or romantic relations, sexual harassment by comments, touch, or promises/threats of special action, seductive sexual speech or non-verbal behavior, nudity, innuendos, or "off-color" jokes.
   3. When is touching okay (e.g., hugging)? Answer the following questions:
      1. How well do you know this person? Is there any emotional intimacy between the two of you?
      2. Is this person ready for a hug?
      3. How will this person and others interpret it? What message does a caring embrace send to another individual who is looking to you for direction and purpose, but is also vulnerable to anyone with a caring touch?
      4. Is it side-to-side or frontal?
      5. What if the person asks for a hug? It still may not be appropriate!
      6. Is your own marriage healthy?
         
         
5. Emotional/Social Boundaries.
   What emotional/social restrictions have you set up between you and those you counsel? An "affair" is not usually a steamy, sexual experience. However, it is about accommodation, affirmation, adoration and affection.
   1. No counseling close, personal relationships. You will be prone to have a biased judgment and the potential for client exploitation. Many dual relationships are wrong and indefensible (e.g., romantic or business relations, close friends or family members). The Chaplain has the burden of proving a justified dual relationship by showing (1) informed consent, including discussion of how the counseling relationship might be harmed as other relations proceed, and (2) lack of harm or exploitation to the client.
   2. No rescuing, fixing or care taking (versus helping).
   3. No relying on client for personal support.
   4. No flirting. This should never occur in a professional relationship.
   5. Be careful with self-disclosure. Ask yourself, "Will what I say help them or me?" If it detracts from a focus on the patient/counselee, then it is inappropriate. Share only if you are convinced your comments will help solve the counselee's present problem and not distract the attention or diffuse the focus.
   6. No counseling someone of the opposite gender in a closed room or more than once. Leave the door open or go to a room that has a window. Counseling (including mentoring and discipleship) is an intimate activity. And counseling the opposite sex can be like playing with fire. Limit the number of times you will counsel someone of the opposite gender (once is best), and then refer him or her to another counselor.
   7. No eating a meal alone with someone of the opposite gender. Sharing a meal together can be an intimate affair. Regardless of the innocence of your cross-gender friendship, people can get the wrong idea if you are seen spending too much time together or are exclusive of others.
   8. No riding alone in a car with someone of the opposite gender (other than a family member). That means no carpooling with a social worker or Chaplain to a meeting. No lifts home for a nurse, doctor, babysitter, etc.
   9. No complimenting someone of the opposite gender about his or her coiffure, clothing or physical appearance. Such references can be misinterpreted as romantic or sexual advances. As Chaplains, it is understandable that we want to be an encouragement to others. However, focus on things God is doing in a person's life rather than the externals that can be easily misunderstood.
      
      
6. Financial Boundaries.
   What monetary boundaries have you established for yourself in relation to those you minister to and with in the health care setting?
   1. Discourage non-monetary compensation from patients/clients (e.g., doing favors, giving gifts, etc.). Your hospital probably has a policy against such behavior between patients/family and staff.
   2. Pass up any kind of financial entanglement (e.g., borrowing, lending, etc.).
   3. Be very cautious on gift giving. It must be very inexpensive and not of a personal nature (like, jewelry or clothing). What's their/your motivation/intent?
      
      
7. Additional Boundaries.
   1. Learn the concept of time-limited counseling sessions, phone calls and visits. Be wise in allocating the time God has given you to care for people in need. (Ephesians 5:15-16; Luke 4:42)
   2. Understand the difference between urgency and an emergency.
      1. Urgency is a situation where the person wants you to help him or her immediately. What they are requesting may be important (at least to them), but it is probably not necessary for you to immediately respond. If it can wait (and it usually can), postpone it.
      2. An emergency is a situation where they need you to help them immediately.
   3. Learn to recognize and utilize teamwork. Understand your own counseling and knowledge limits. This is a boundary of humility. Make appropriate referrals to other clergy, social workers and psychologists. You are not an expert in everything. Have a healthy respect for the expertise of other professionals.
   4. Exercise self-care and self-understanding. In the midst of so many demands and the temptation to meet personal needs, what is appropriate self-care?[6]
      1. Physical self-care. This would include stress management, exercising regularly, eating properly, getting enough rest and having an annual physical by your family physician
      2. Mental self-care. Proverbs 23:7 says, as a person thinks, so is that person. Mental self-care might include seeing a counselor to check out how you perceive your situation.
      3. Emotional self-care. The Psalms are a primary resource for us as persons gifted with the capacity for feeling. A trained counselor can also help us sort out our sometimes conflicting feelings and guide us in the ways to express or act on those feelings that are consistent with our values and responsibilities.
      4. Spiritual self-care. Talk to God regularly about your boundaries, as well as your ministry involvement. Listen to Him often as you meditate on His Word.
         
         
   5. Ten Laws of Boundaries.[7]
      Some of these "laws" have already been covered elsewhere.
      1. The law of sowing and reaping: Our actions have consequences.
      2. The law of responsibility: Boundaries help us to determine who is responsible for what. We are responsible to each other, but not for each other. We are responsible for our own feelings, attitudes, values and handling of life's difficulties.
      3. The law of power: We have power over some things (e.g., influencing others, confessing our hurtful ways and repenting); we do not have power over other things (e.g., we cannot change others).
      4. The law of respect: If we wish for others to respect our boundaries, we need to respect theirs.
      5. The law of motivation: We must be free to say no before we can wholeheartedly say yes. Realize that when you say yes to one activity, you are also saying no to another. For example, when you say yes to teach an evening seminar, you are also saying no to spending time with your family that evening.
      6. The law of evaluation: We need to evaluate the pain our boundaries (or not having boundaries) cause others. Sometimes that pain may lead to growth and sometimes it may lead to injury.
      7. The law of proactivity: We take action to solve problems based on our values, wants and needs.
      8. The law of envy: We will never get what we want if we focus outside our boundaries onto what others have. Envy is devaluing what we have, thinking it is not enough.
      9. The law of Activity: We need to take the initiative (rather than being passive and waiting for someone else to make the first move) in setting limits.
      10. The law of Exposure: We need to communicate our boundaries to each other.
8. Warning Signs.
   Those who have trespassed their moral boundaries must have ignored some danger signs. Here are a few "red flags" and "flashing lights" that may indicate that you are about to or have already crossed a "no trespassing" line.
   1. Having no accountability partner. You need someone else, preferably a peer, to objectively evaluate your ministry involvement and relationships.
   2. Suffering persistent or increasing marital frustrations. Unhappiness in marriage will increase your vulnerability to temptation.
   3. Undergoing excessive stress. Fatigue increases your vulnerability to temptation.
   4. Experiencing chronic, low-level depression increases your vulnerability to temptation.
   5. Going alone to breakfast, lunch, dinner, or social activities with a member of the opposite gender.
   6. Dating or romantic involvement with a patient/client. (That one should have sirens going off as well as the flashing lights!)
   7. Changing normal office practices or routines (e.g., seeing someone away from the office, talking on the phone excessively or after hours with someone of the opposite gender, or sending e-mails to someone of the opposite gender too often or after hours).
   8. Confiding in someone of the opposite gender. This should be done only with your spouse or accountability partner, never a patient/counselee.
   9. Relying on someone of the opposite gender for personal affirmation. We all need personal "strokes." But to seek or expect such affirmation from a member of the opposite gender (other than your spouse) is a boundary violation that should not occur.
   10. Asking very personal questions of someone of the opposite gender. Permitting someone of the opposite gender to ask you very personal questions.
   11. Giving intimate, personal gifts to someone of the opposite gender. Allowing someone of the opposite gender to give you an intimate, personal gift.
   12. Thinking of a patient as a friend rather than a client. A counselor is in danger of overstepping professional boundaries if he or she treats the client in a way that encourages personal friendship or becomes personally involved with the patient or the patient's problems. Such over-involvement will threaten to compromise objectivity, the development of transference (the patient's projection onto the counselor of qualities of a significant other, usually a parent), and the counselor's ability to use the therapeutic relationship to help the client.
       
       
9. Avoiding a Problem.
   The above guidelines will help you avoid most problems. In applying these guidelines to your life, you will want to consider the following:
   
   
   1. Pray about your vulnerability. This invokes God's protection and increases your awareness of your vulnerability.
   2. Develop a healthy fear of God. Read and reflect on the following passages: Joshua 24:14; 2 Kings 17:36, 39; Job 28:28; Psalm 34:7, 9; 85:9; Proverbs 8:13; 14:2, 16, 26-27; 19:23; Isaiah 2:10, 19-21; 2 Corinthians 7:1; Hebrews 12:28-29; Revelation 14:7.
   3. Intensify a super heightened awareness of the significant damage you will do to your ministry, marriage, family, friends, etc. if you crash through the barriers (even unintentionally) and fall over the edge. Read and reflect on the following passages: Proverbs 5:3-6; 7:1-27; 9:13-18.
   4. Make your fences public. A boundary is useless if you can take it down any time your heart desires. Those around you (spouse, confidant, etc.) must understand your boundaries and be willing to tell you if they see one broken.
   5. Be accountable for the moral fences you have established. We cannot trust ourselves to remain objective when it comes to sexuality. Be transparently accountable with a peer. No one understands the pressures on a minister as well as another minister. This person should be able to ask you straightforward questions like, "Have you set anything unclean before your eyes (Internet, TV, movies, magazines) this week?" (See Psalm 101:3.) And you need to give an honest answer. David is a good example of someone who attempted to rationalize his emotional vulnerability by having an affair with Bathsheba (2 Samuel 11:1-24). David needed an accountability partner (Nathan), and so do we.
      
      NOTE: Some of the objectives of an accountability group are:
      To help clergy understand and accept their need for peer affirmation and for mutual accountability in personal life and in conducting public ministry, to offer clergy a place where they may temporarily set aside the role of "pastoral caregiver" and focus on their own care, health, and wholeness, to provide a safe place where clergy (or other leaders) can speak honestly about their personal or pastoral concerns and receive feedback in an informal and non-judgmental atmosphere, to reduce some of the intellectual, spiritual, and role-connected isolation experienced by many leaders.[8]
   6. Avoid sexual or romantic fantasies about your patients/clients. It is one clear sign you have lost control of your counter-transference. This would include looking forward with unusual enthusiasm to a counseling session with the person.
   7. Recognize Satan's traps. Temptation can be subtle, but the payoff is not! Be on guard! As the Apostle Paul cautioned: "So be careful. If you are thinking, 'Oh, I would never behave like that'-let this be a warning to you. For you too may fall into sin" (1 Corinthians 10:12, TLB).
      
      Breaking major boundaries often happens over a gradual period of time. It is not a sudden blow out, but a slow leak. You may take small steps that subtly cross some minor boundaries without incident. These little infractions may eventually lead to crossing over some major boundaries. You might think, "I crossed the others without a problem, so there's no risk in crossing this one either." Do not believe that lie!
      
      
10. Correcting a Problem.
    What if you discover that you have transgressed (even unintentionally) any of your boundaries? What should you do?
    1. Stop seeing the client! Refer the client to someone else.
    2. Take a break from counseling. Rebuild your fences.
    3. Consult with a professional counselor. Repair your fences.
    4. Get supervision from your Area Director. Reinforce your fences.

Endnotes:

1. Archibald D. Hart, "Walking on the Edge: The Counselor's Sexuality" Christian Counseling Today Vol. 7, No. 3, 1999, p. 20.
2. Mark R. Laaser, "Therapists Who Offend" Christian Counseling Today 1998 Vol. 6, No. 1, p.59.
3. Anne Katherine, Where to Draw the Line (New York: Simon & Schuster, 2000).
4. Thomas A. Fischer, "7 Things Every Counselor Should Know to Nurture Congregational Health" Christian Counseling Today 2002 Vol.10, No. 3, p. 23-24.
5. This subject is covered quite well by Kenneth Haugk in Chapter 9 of Christian Caregiving: A Way of Life (Minneapolis, MN: Augsburg Publishing House, 1984), p. 71-80. I suggest you read it.
6. You may want to refer to the article on "Balancing the Burdens of Caregiving."
7. Henry Cloud and John Townsend, Boundaries in Marriage (Grand Rapids, MI: Zondervan Publishing House, 1999), p.59.
8. Gary L. Harbaugh, Rebecca Lee Brenneis and Rodney R. Hutton, Covenants & Care: Boundaries in Life, Faith, and Ministry (Minneapolis, MN: Fortress Press, 1998), p. 17.

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