It seems incredible that last year’s January/February column was titled “Avoiding Boundary Burnout,” (page 35) and the discussion began with what a crazy year 2020 was due to COVID-19. While it would be nice to say that 2021 was better, as we all hoped it would be, we know that isn’t so. Many of us have been personally affected by the pandemic, getting sick ourselves, seeing friends and family members sick, and even losing some to the virus. Our lives have changed. Our businesses have changed. Everything has changed, and by necessity, our boundary lines may have changed as well.

Nina McIntosh, the original author of this column and the first three editions of the book The Educated Heart, was an advocate for therapists firmly maintaining their own boundaries, and I have carried on that message, sharing her belief that enforcing our boundaries protects our income and our mental health, and helps keep us in the mindset of enjoying our work. Usually, bending boundaries is a red flag, but there are times when extraordinary circumstances may call for doing just that.

For example, we may (and should) have a cancellation policy requiring a 24-hour notice or charging for the missed session in part or in full, but if someone wakes up ill and possibly contagious on the morning of their appointment, we don’t want them coming into our workspace. Many therapists are letting that policy slide right now, and understandably so. It’s not worth an hour’s pay to put yourself and others at risk.

What about the person who doesn’t cancel, who comes in showing signs of not being well? Some therapists are screening clients and taking temperatures. Some are not. But as soon as we put our hands on someone, if they feel hot and we suspect they have a fever, or if we see that a client is not looking well, or they’re coughing, we have the right of refusal and should not hesitate to exercise it. We can and should err on the side of caution. We don’t have to be rude about it. Saying, “Tom, you feel extremely hot this morning, and I’m afraid you may have a fever. I don’t think we should continue your session. I’d prefer you reschedule. I just don’t feel good about giving you a massage today,” isn’t rude at all. Don’t let the client guilt you into doing something your best judgment is telling you not to do.

We all want to give the best service we can. We all want to honor the client, but we all need to honor ourselves as well. There are times when that means adjusting the boundaries, either in the client’s favor or our own.

takeaway: Enforcing boundaries protects our income and mental health, but sometimes circumstances call for bending boundaries.