1. Setting expectations of roles. Newcomers to Canada are just that, newcomers. When new in any place, a person must quickly figure out what the expectations are of people in certain roles. What if the next time, Josh does not want to or cannot help his client with grocery shopping? How will this impact their relationship? How could it impact other clinicians with whom the client interacts? Does the client feel comfortable to refuse Josh’s offer, given that he may be viewed as being in a role of authority or has power over the client’s status in the country?
2. Cultural expectations. Newcomers to Canada may have different cultural expectations with respect to gender, sexual orientation, social status, etc. How will it impact Josh’s professional relationship if his client views his behaviour as one of dating interest? How would it impact the relationship if Josh drives an expensive car? How would it impact the relationship if Josh’s car is covered in old coffee cups and take-out packages?
3. Burnout. If Josh is at the grocery store with a client in the evening, he cannot enjoy non-work-related activities. Being with a client means being at the office mentally.
4. Traumatization. Imagine if Josh’s client disclosed a traumatic experience in the grocery store, now Josh must deal with that information in a context without a supervisor or colleagues to assist and he must manage any reactions the client may have (and potential breaches of confidentiality given the setting). Further, if the information must be acted upon or reported to authorities, a negative interaction may occur due to confusion of the professional role.
5. Organizational rules. Josh’s organization may not have insurance to cover the transportation of clients, which can open them and Josh to liability if an accident occurs. Further, Josh’s organization may not allow work outside of set hours and set environments, which could have implications for Josh’s employment.
6. Ethical codes. Some professions have specific ethical codes against crossing boundaries or having multiple roles with clients to prevent harm to the client. Ethical breaches can have significant professional consequences for Josh.

So, what could Josh have done better? How do we hold the line of boundaries in this setting?

• Set the expectations for his role clearly both for himself and the client.
• Set the expectations for the organization’s hours and services.
• Assist the client to independently find solutions to the problem. Josh needed to advocate for client capacity rather taking it on himself.
• Educate himself about the cultural and experience backgrounds of the populations with whom he works and reflect about his own cultural background and the impact it may have on how he works with a client.
• Consult with a colleague or supervisor.
• Reflect on why he felt the urge to take on the extra duty of grocery shopping for the client. Why did he feel that need?
• Take care of his own mental health. Burnout is common in professionals working with newcomer populations and as staff become more burnt out, they are more likely to engage in boundary crossing. Taking time away from work, having non-work-related activities, engaging in psychotherapy, exercising, spending time with friends or family, and other methods of self-care are important. All too often we do not focus enough on these important pieces of preventing unmet needs that can lead to boundary crossings.

Here are some resources on boundary setting and staff mental health:

• AMSSA webinar: Creating & Maintaining Ethical Boundaries in Client Relationships
• United Nations: Workplace Mental Health and Well-being Lead and Learn Programme II. Note: This is mostly for leaders but contains information that frontline service providers will find useful.
• Wirth, T., Mette, J., Prill, J., Harth, V., & Nienhaus, A. (2019). Working conditions, mental health and coping of staff in social work with refugees and homeless individuals: A scoping review. Health and Social Care in the Community, 27, e257.
• Kosney, A. & Eakin, J. (2008). The hazards of helping: Work, mission, and risk in non-profit social service organizations. Sociology, 10(2), 149.

*Dr. Tanya Lentz, R. Psych, is practicing in Newfoundland and Labrador since 2014 in the areas of clinical psychology and neuropsychology. She worked with newcomers to Canada during her PhD training at the University of Victoria, her residency with Manitoba Health, and then in Newfoundland and Labrador. She is registered in Ontario, Nova Scotia, and Northwest Territories.  In 2019, Tanya joined the Board of the National Newcomer Navigation Network (N4) with a focus on mental health in the planning of healthcare for refugees and for those working with refugees.