The helping relationship is a unique interaction between two people, one of whom provides support in a time of need. Those working in palliative care and hospice settings engage with people at some of the most painful and difficult times of their lives. As a result, professional boundaries can become blurred, which affects not only the patient, but creates stress for the professional as well. This course is designed to help those working in palliative care and hospice settings establish and maintain professional boundaries to create healthy, therapeutic relationships with patients and their families. Maintaining boundaries is a key part of stress management and self-care.
Section 1: Introduction A. Learning Objectives Section 2: The Helping Relationship A. Helping Relationship Essentials B. Concepts Underlying Boundaries C. Troublesome Work Motivators D. Healthy Motivators E. The Caring Continuum F. The Attachment Continuum G. The Helping Relationship Space H. A Helpful Relationship Image: Sitting by the Fire I. Knowledge Check Section 3: Professional Boundaries A. Code of Ethics: Basic Elements B. Relationship Guidelines C. The “Fiduciary Relationship” D. Boundary Violation Cycle E. Potential Boundary Violations F. Warning Signals G. Knowledge Check H. Examples of Boundary Violations I. Case Example J. Questions to Ask Yourself K. Models for Understanding Boundary Transgression: Avoid the Drama Triangle L. Practice Settings that Demand Extra Vigilance M. Our Commitment N. Standards of Practice (NHPCO) O. Outcomes of Standard P. Practice Examples Q. To Establish Boundaries R. Maintaining Professional Boundaries in the Use of Social Media and Electronic Forms of Communication S. Knowledge Check T. Personal Responsibilities U. Suggested Actions V. By three methods we may learn wisdom Section 4: Self-Care A. Major Self-Care Concerns B. Understanding Your Personal Signs C. Role-Related Stresses D. Emotional Stresses E. Work Environment Barriers F. Costs and Rewards G. Life on the Edge – Choosing Hospice H. Case Example I. Cognitive Hardness J. Knowledge Check K. Some Predictors of Burnout L. Career Stage and Burnout Section 5: Stress Management A. Avoiding Burnout B. Protective Factors Inventory C. Personal Responsibilities D. Your Personal Power E. The Nature of Support F. Meeting the Challenge G. Stress Tolerance and Resilience H. Facing Suffering and Helplessness I. Promoting Resilience Among Clinicians: Sustainability J. Organizational Responsibility K. Holding Your Ground L. Questions for Reflection: Boundaries M. Your Personal Goals N. Keeping Your Sparks O. Knowledge Check P. References
Marcia is a speaker and consultant to a wide variety of groups and organizations. A licensed counselor, she has also maintained a private psychotherapy practice for more than twenty years. A co-founder of TRU Hospice Community Care, Boulder, Colorado (1976), Marcia has a strong commitment to the Boulder community. Marcia's numerous publications include The Hospice Choice, and Coping with Public Tragedy. Marcia was awarded an honorary doctorate in humane letters in recognition of her work (University of Colorado, 2005), the 1984 Winston Churchill Traveling Fellowship, the 2002 ADEC Educator Award, and NHPCO's 1995 Heart of Hospice. She received the Boulder County District Attorney’s highest award in 1988, the Distinguished Service Award, for her work with victims of crime, and was named a Boulder Pacesetter in 1985. Disclosure: Marcia Lattanzi-Licht, LHD RN LPC has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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