Controversy: Support Work Boundaries

As worthy as this cliché is of a fridge magnet in a cheap gift store, friendships are one of the most precious gifts in life. That may be what makes the question of whether support workers should be allowed to form friendships with the people they support so contentious: we all know what could be at stake if we get the answer wrong. Does friendship between support workers and people with disability violate professional boundaries, endanger the working relationship, and unwittingly contribute to social isolation? Or is it a positive, natural by-product of compatible people spending a lot of time together? 

At DSC, we have been revisiting the work of the late disability advocate Dave Hingsburger. The video below, questioning friendships between people with disability and their support workers, generated an intense amount of discussion. 

We wanted to bring you in on the conversation. We’ve asked people with lived experience of disability from DSC and the sector as a whole to respond to the question, “Can support workers be friends with the people they support?"

We’ve also enabled comments on this article, so please share your thoughts and join the conversation. And, while we know this is the internet, please try to be nice. 

Can support workers be friends with the people they support?

I agree with Dave's sentiments that a support worker should be treated as an employee first. However, this distinction is not as clear cut as he makes it out to be. A worker-client relationship by necessity requires the client, in particular, to be vulnerable. A client trusts the worker to be present in their most intimate moments, so of course a special and unique connection will develop. With that said, any relationship I have with a support worker has clear boundaries. Any worker I employ is my worker first, a (possible) friend second. I work hard to ensure that anybody who works with me is aware of the boundaries I set. Honest, direct feedback is necessary. I am acutely aware of other aspects of my workers’ lives, but I do not interact with them outside the work environment until I can guarantee that their work with me will not be affected. This is an infrequent occurrence.

- Todd Winther, Consultant at DSC 

I’ve spoken with several people about their relationships with support workers and what a good relationship looks like and have learned that the answer varies greatly. It ranges from people who insist that their support relationships are purely professional to those that insist deep friendship is a must and everything in between. I’ve come to know that I don’t have the right to tell people if they can or cannot be friends with their support workers. So, I’d like to rephrase the question. In cases where people chose to have friendships with their support workers, “What does it take for support workers to be friends with the people they support?” There’s a lot to creating healthy friendships between people and their support workers, but I would prioritise three things: 

1. High emotional intelligence and capacity building in this area where necessary. This might include traits like empathy, self-awareness, adaptability, selflessness, ability to manage conflict, openness to others’ perspectives, and a willingness to communicate.

2. Clear boundaries around when spent time together is work time versus when it’s friendship time. A person has the right to control decision making during work time, whereas decision making during friendship time is shared.

3. The ‘friendship’ should never get in the way of the person forming other friendships; in fact, the role of the support worker should be to support the person to make new friends and stay in touch with existing friends

- Sally Coddington, Consultant at DSC

The film from Dave Hingsburger is interesting: it’s one dimensional and paints people with disabilities as having no choice and no control. We are much more complex than that. I have a disability and need support with some activities. The word “carer” is anathema to people with disabilities. I don't employ “carers”; I employ professional support workers. I may have friendships with them, but during working hours, I am their employer. Society has an assumption that people with disabilities are unable to tell the difference between professional services and personal relationships. What we need to do is to make sure that we have a well-trained, professional workforce who can recognise an unequal power relationship and act appropriately. Where do most people make friends? Where do you meet your partner? Chances are that it was at work. Do we deny my community the opportunity to have friends we met at work? People who want to be friends with us outside working hours? The tricky part is how to make sure we have staff who understand their obligations and policies in place to address power imbalance, while ensuring that the requirements of CRPD article 3 (a) “Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons” are met.

- Tricia Malowney, President of Women with Disability Australia

The more I think about this question, the less confident I am in my answer. Dave has identified a very real problem that arises at the intersection between social isolation and paid support. But people with disability are not a monolith; what is an issue for one person might not even be a factor for someone else. And then we must consider that people with disability themselves might change their personal boundaries depending on the worker. Personally, my relationships with support workers are all different – some which are closer to friendship and others which are more professional. 

I think what Dave is talking about in his video is friendships that are, in his words, a lie. Fake friendships will never serve anybody, regardless of the context. To me, people with disability and support workers both need to ask themselves the question, “Would I want to pursue a friendship with this person if I met them in social situation?” If the answer is no, the relationship must remain professional. 

- Sara Gingold, Editor-in-Chief at DSC 

It's always true that my support workers are friendly but not friends, but there has been one really notable exception (and another smaller one) where they have become excellent long-term friends and it's been worth the “leap of faith” to let that happen for me. That's only one really big exception in over 20 years of daily support workers, though, just for scale.

- Ricky Buchanan, via Facebook

I still think of support workers as “friends for a reason”. There are many forms of friendship. We all have friends for a reason, a season, or a lifetime. My hairdresser is my friend for a reason. The lady that cleans my nan’s house is a friend for a reason, and my sister who has 24/7 care needs and a team of 10 support workers also views her support workers as friends. Some of them have become friends for a lifetime, finishing up their support worker roles and remaining lifelong friends . But I totally respect that some individuals would prefer to keep very tight boundaries and not blur lines between service providers and friends.

- Jamie Lavender, via Facebook

If you are a service provider developing internal policies about boundaries in support work, you have a difficult job ahead of you. As the above quotes demonstrate, the issue is riddled with complexity and lacks easy answers. Hit up the comments to let us know how you have approached this as a service provider, person with disability, or support worker.