Boundary Crossing scenario Hiring a client

You work as a dietitian for a community agency that serves new immigrants. You have spent some time assisting a client and they have shared some of the terrible things that have happened to them in their life. You know the client is in financially challenging circumstances. The client asks if they could clean your house. In fact, you are looking for a house cleaning service and would be very pleased to pay them generously. Is there a problem?

There are a number of complications arising from this scenario. You are being asked to enter into a dual relationship with the client, to be both dietitian and employer.

Consider how the following difficulties can occur:

• The employer-employee relationship tends to be more directive than the more collaborative dietitian-client relationship. The client might feel compelled to follow your treatment recommendations without question in appreciation of the other relationship with you or for fear of losing their job with you.

• If the client failed to meet your house cleaning expectations, you might have to confront them and perhaps even terminate their services. Such actions could easily damage your ability as a dietitian to engage the client in a continuing dietetic program.

• The client would learn much about your private life, and whether they respect or disdain you for it, this could interfere with the clinical relationship. Either way, the healthy dialogue and give-and-take of the professional relationship could be damaged.

• You could become dependent on the client’s excellent service and be prone to let it interfere with your professional judgment concerning their clinical care. For example, you may keep them on as a client beyond what is indicated in order to maintain the house cleaning relationship. Or, you may give undue weight to their requests for special or even inappropriate assistance.

• ​Other clients who find out about the house cleaning arrangement might feel that you are treating this client as “special”. They might ask for similar consideration and be upset if you say no.