Boundary Setting: Your practice survival guide

Do you have a therapist? We do!

Once a month or so, we’re there, ready and willing to look at what’s going on for us with an impartial third party. We do this because it helps keep us on track, helps us challenge our own thoughts and limiting beliefs, and it helps us cut the crap unhelpful behaviour that can prevent us from moving forward or getting to where we want to.

Now, coaching is not psychotherapy, but it creates the same safe space with a third party to help you look at a situation with a birds-eye view.

Why are we talking about this in the context of boundary setting?

Because boundaries, or a lack thereof, are a big part of the aforementioned unhelpful behaviour. They’re unhelpful for us, and they’re unhelpful for many of our coaching clients too.

How do boundaries play out in practice?

Think…

• The patient who always turns up late, and still expects to be seen.
• The receptionist who keeps double booking you, despite you explaining you need a break.
• Finding yourself working later and later, or over your breaks because you can’t say no to that patient in need.

You might be surprised to know that sometimes it’s not patients pushing our boundaries, sometimes it’s our inability to recognise and maintain our own boundaries that cause the problem. Sure, it’s easy to say “well, that patient always turns up late” and put the blame on them, but both you and the patient are equally culpable if you don’t stick to your own boundary there, don’t have a boundary in place or rely on someone else (like your receptionist) to put the boundary in place for you. The last example in the list above shows what happens when we do allow our boundaries to be breached- we end up sacrificing, working later, working harder, becoming resentful- and where does it end? How late do you want to work? How much of your free time do you want to give up?

One of the questions that needs to be asked in this situation (and trust us, we’ve asked ourselves this a thousand times) is- What am I sacrificing when this boundary is crossed?

For many of our coaching clients, the sacrifice is time off. Time with the family. Time for activities they enjoy. Time for hobbies, for exercise, for socialising.

When I first started in practice, I found it impossible to maintain boundaries. The need to grow a diary, the need to get busier, the need to see as many patients as possible to keep an income coming in as the main breadwinner- it wasn’t long before I was working 12 hour days, and then coming home and doing notes until late at night. Not much fun, and certainly not what was best for me, my family, or my patients.

If you find yourself routinely struggling to set a boundary- ask yourself- what am I sacrificing when this boundary is crossed?

If you’re happy with the sacrifice, great. Perhaps that day you don’t need a coffee break and are happy to see that last-minute booking (provided you’re not creating a future rod for your own back…) If you’re not happy with the sacrifice, then it’s time to put a boundary down.

But if I put a boundary down, I’ll lose patients.

Oooh, if we had a pound for every time we’ve heard this…! This seems to be the armour mechanism for most of our coachees- the thought that if we put a boundary in place, we’ll lose patients, we’ll lose income and our practice will fail. So here’s another question for you…

What evidence do you have to support that belief?

Sometimes we create limiting thoughts and beliefs about a situation without actually having evidence to support those thoughts and beliefs. Usually, we only think we’ll lose patients! The reality is, when we create a boundary, we set a standard of how we would like to be treated, and how we intend to treat others. When we politely explain to that perpetually late patient that no, we can’t see them because there’s not enough time left to care for them safely and effectively, we protect the structure we have in place that allows us to provide the same care to all our patients- we don’t run late for the patient after them, and we highlight to Mr/s Perpetually-Late that our time is valuable and they need to attend their appointments on time.

Remember- if someone gets upset with your boundary, it’s evidence that the boundary was needed.

How does coaching help with boundary setting?

Accountability is a huge one. We’ve been working with several clients recently on maintaining their boundaries, and we don’t mind that they often joke- “Well, I had to stick to that boundary as I knew you’d be asking me about it at our next coaching session!”

Sometimes boundaries aren’t set because we aren’t aware that a boundary needs to be set. This is where having a coach or a mentor to shed some insight into the situation can be so helpful. It’s easy to get so caught up in the day-to-day that we don’t even realise that a boundary is needed. Did you start your practice working 9-6, with an hour’s lunch break, and now you’re working 8-7 with a 30 minute lunch? Perhaps your boundaries were encroached upon over time, and it’s only just becoming unsustainable. (It happens a lot with coaching clients who perhaps have welcomed a new baby or suchlike!) When we begin a coaching relationship, this is often one of the first conversations we have- How are things at the moment, and how would you like them to be? What’s going well? What are you tolerating?

We can also support you with putting boundaries in place in a way that feels consistent with you and your practice. For some, that’s a hard and firm boundary that comes in straight away. For others, it’s something we work on over time to gradually accustom our patients and team members to the new way of doing things. Whatever works for you- and we’ll find out what that is in the course of our sessions.

It’s not easy to put boundaries in place, but it can be done sensitively, and effectively, and without being detrimental to you or your practice. We can’t wait to help you through it!

Ready for more? Here’s how you can work with us!

Private Coaching: Work with one of us on a private, one-to-one basis. View our diary and book your initial discovery call here.

Study Coaching Skills in your own time: Visit our online training platform to enrol on our Communication Skills for Clinicians course, which covers practical steps for boundary setting, effective communication with your clients and much more!

Read our eBook: Get started with “How to Coach your Patients”. Get your copy here.

Don’t forget to join our Private Facebook group and access our “Boundary Setting Resource” there!