ppt - boundaries 3.14 - kepro 3.14 packet.pdf · • recall aspects of supportive communication ......

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March 2014 eas

Boundaries

Presented by: APS HealthcareSouthwestern PA Health Care Quality Unit(APS HCQU)

© 2012 APS Healthcare, Inc. © 2012 APS Healthcare, Inc. © 2012 APS Healthcare, Inc. 2

Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented.

Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies.

Disclaimer

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• Define the term boundaries

• Distinguish between external and internal boundaries

• Recognize healthy techniques for supporting people with I/DD without invading their boundaries

• Recall aspects of supportive communication

Objectives


• Boundaries are a set of parameters that make each person unique, independent, and free to be creative and problem‐solve.

• Boundaries designate the appropriate amount of emotional and physical closeness one needs to maintain so that over‐dependence or over‐independence does not develop.

• Boundaries change

Defining Boundaries

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• Self‐protection

• Control and choice

• “No” when needed

• Respect for limits

Why Are Boundaries Needed?


• Personal property line

• Where one person ends and another person begins

Boundaries – External

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PERSONAL SPACE

Activity


• Proximity or closeness

• Touch

• Privacy

• Bathrooms

• Bedrooms

• Personal property

External Boundaries – Examples

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• Beliefs, spirituality, emotions, feelings, perceptions, and self‐esteem

• Internal boundaries define where one person’s feelings end and another person’s feelings begin

Boundaries – Internal


• Subtle comments

• Sensitive topics

• Micro‐violence

• Bullying

• Power‐over approaches

Internal Boundaries – Examples

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Four core types of psychological boundaries:

1. Soft

2. Rigid

3. Spongy

4. Flexible

Types of Psychological Boundaries


All walls have doors (that open) and all doors can be closed (a little)

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• Unaware of their rights

• Believe that setting boundaries jeopardizes relationships

• Prevent closeness and intimacy

• Difficulty expressing wants, needs, and feelings

• May not have learned healthy boundaries

Characteristics of People with Unhealthy Boundaries


• Awareness

• Self‐acceptance

• Self‐worth

• Permission

Developing Healthy Boundaries in People with I/DD

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Suggestions for developing healthy boundaries include:

• Talk about the plan for establishing a boundary

• Start small

• Communicate

• Develop specific, clear, direct request

• Follow‐up

Developing Healthy Boundaries in People with I/DD


• People may no longer…

• I have a right to ask for…

• To protect my personal space, it is ok for me to…

• To protect my privacy, it is ok for me to…

Practice

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• Privacy

• Personal space

• Touch

• Sensitive Topics

Issues Related to External Boundaries


• Bullying

• Self‐determination

• Self‐assertiveness

Issues Related to Internal Boundaries

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• Development of healthy boundaries is a process; there are no quick fixes

• Explore a person’s history for possible trauma/abuse or clinical issues

• Requires a therapeutic environment

• Supportive communication

• Right to say “no”

Considerations for Supporting People with I/DD


• Expression or sign sent

• Does not have to be verbal

• Acknowledge it

• Understand it

• Response to it

More about Supportive Communication

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Communication

Activity


It is important for

• Caregivers to respect the boundaries of individuals

• Individuals to communicate their boundaries

• Individuals to respect the boundaries of caregivers and housemates

Respecting Boundaries of Others

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• Every person has rights to personal space, thoughts, and feelings, as well as the right to establish boundaries to protect those rights

• Supporting people with I/DD to develop healthy boundaries is a process of learning, acknowledging, validating, understanding, and responding

• Respond to people with I/DD with respect and compassion and provide meaningful supports

Concluding Thoughts


• Abuse: Individual to Individual

• Behavior is Communication

• Communication: Positive Techniques

• Positive Approaches: An Overview

• Self‐Determination

Suggested Accompanying Trainings

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• Healthy Boundaries Where the Gone Things Go Living with PTSD and Other Assorted Visitors. Retrieved on December 3, 2013, from http://lizabethf.wordpress.com/

• Lancer, D. (2013). What Are personal Boundaries? How Do I Get Some? Psych Central. Retrieved from http://psychcentral.com/lib/what‐are‐personal‐boundaries‐how‐do‐i‐get‐some/0016100

• Tartakovsky, M. (2011). 10 Way to Build and Preserve Better Boundaries. Psych Central. Retrieved from http://psychcentral.com/lib/10‐way‐to‐build‐and‐preserve‐better‐boundaries/0007498

References


To register for future trainings,

or

for more information on this or any other physical or behavioral health topic, please visit our website at

www.hcqu.apshealthcare.com

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Please take a few moments to complete the evaluation form found in the back of your packets.

Thank You!

Evaluation

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There will be a test review after all tests have been completed and turned in to the Instructor.

Test Review

ppt - boundaries 3.14 - kepro 3.14 packet.pdf · • recall aspects of supportive communication ......

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