Saturday, April 29, 2023

“I meet so many people – especially women – who give and give so much, only to feel exhausted and even depressed as a result. This is why we live in a culture of burnout.”

Tawwab, 2021, p. 4

Written by:

Katy Tenhulzen, MS, CCLS
Child Life Program Director
Central Washington University

Boundaries are essential for child life specialists and are often discussed in relation to therapeutic relationships, professionalism, patient privacy, scope of practice, and promoting work-life balance. As an integral part of our ethical responsibilities, it is important to reflect on our level of comfort and skill in boundary-setting. Healthy boundaries can promote mental and emotional wellbeing, job satisfaction, and longevity in the field. Set Boundaries, Find Peace: A Guide to Reclaiming Yourself is written by Nedra
Glover Tawwab, a licensed therapist with a specialization in relationship therapy. Although much of this book is focused on boundaries within personal relationships, Tawwab also emphasizes workplace boundaries, and child life professionals may fi nd this resource helpful both personally and professionally.

Despite their importance, Tawwab notes that many people struggle to be clear and assertive in setting boundaries. Often, messages and modeling from childhood still impact people as adults and create barriers in setting and maintaining boundaries with others comfortably and confidently. Professionally, some people avoid setting boundaries because they fear negative responses, relational consequences, or potential negative repercussions in the workplace. Throughout the book, Tawwab encourages the reader to consider why they may feel resistance or lack skills in boundary-setting by engaging in self reflection, including journal prompts at the end of each chapter. Then, she outlines how to set boundaries in various contexts, including examples of assertive statements and how to handle pushback from others.

Child life professionals may find the discussion about burnout and self-care practices particularly relevant, especially given the additional burden of pandemic burnout that has exacerbated an already-demanding job. Tawwab offers examples of what leads to burnout that may resonate with many child
life specialists, such as people-pleasing, feeling underappreciated, and prioritizing the needs of others over one’s own. Then, she discusses the emotional and relational impact of burnout and lack of boundaries that may be helpful to identify as “red fl ags” for ourselves and in our support of colleagues or those we supervise.

Prioritizing self-care is imperative to prevent burnout in helping professions. However, Tawwab suggests that people who get caught up in a desire to help others, or people who struggle to say “no” when they should, are highly likely to neglect their own self-care. She states, “the root of self-care is setting boundaries: it’s saying no to something in order to say yes to your own emotional, physical, and mental well-being” (p. 6). She also explains how boundary violations by others impact self-care practices and offers suggestions for responding to others who do not respect one’s boundaries.

Child life specialists and teams may also benefit from considering Tawwab’s thoughts on how, despite the best of intentions, they may inadvertently violate boundaries of others in their work. For example, over-empathizing with patients and families, taking on the role of “the rescuer,” being unaware of implicit bias, and overextending themselves in their work may negatively impact the provision of effective and equitable care or the ability to work successfully within the multidisciplinary team. It is important to consider how unintentional boundary violations may affect patients, families, or colleagues and potentially thwart goals related to advocacy and family-centered care.

Taken together, Tawwab’s instructions about setting clear and assertive boundaries, perspective on burnout and self-care, and discussion about our ability to both set and respect boundaries may prompt important reflection for child life professionals and within child life teams.