How do you help peers maintain appropriate boundaries with clients?

There is no simple answer for this. Peers are on the front line of helping HIV-positive people with a variety of problems, and they have explicitly different relationships with their clients than do non-peer staff. In peer training, all the programs spend a considerable amount of time discussing boundaries – helping trainees understand various gradations and create a working definition of boundaries for themselves. Peers are also encouraged to work with their supervisors to create boundaries for themselves.

Peers develop strategies to define and safeguard interpersonal boundaries in the context of building a mutually respectful relationship with their clients. While these strategies vary from peer to peer and are tailored for individual clients, they should indicate the boundaries of peer support in three crucial domains:

• Peers must define the limits of their expertise, so that clients do not confuse education about a prescribed HIV regimen with medical advice, or a sympathetic ear with psychotherapy.
• Peers must be clear about the amount of time and energy they can give, especially if they are available to clients outside of normal working hours.
• Peers should advise and periodically remind clients of any program requirements that limit the duration of support.

More information:

• Supervising Peers: Administrative Supervision (PDF), part of the Building Blocks to Peer Program Success toolkit for developing HIV peer programs
• Read more: Understanding boundaries in peer-client relationships (PDF), part of the Building Blocks to Peer Program Success toolkit for developing HIV peer programs, includes a checklist which can provide a supervisor with a framework to discuss potential boundary issues between a peer and a client.
• HRSA Webcast: Supervising peers who support clients in HIV care and treatment (Part 2) discusses case studies which include issues of boundaries

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