Analysis The ethics committee found in favor of the client. They determined that the therapist had maintained a dual relationship by combining their professional and private lives outside of counseling together. This caused confusion and harm to the client, and the therapist did nothing to resolve the client’s distress and dependency and chose to ignore him, which increased his anxiety.
contacts to her client. The client stated he began to feel so self-confident that he terminated therapy and expected the therapist’s interest in his career to continue. The therapist stopped returning the ex-client’s phone calls, which left the client frantic. An ethics committee contacted the therapist. She explained that she always provided unconditional positive regard to her clients; however, since this particular individual was no longer a client, she felt no further obligation to him. Ethics Case Study: Dual Relationships (continued) The therapist and her ex-client decided they would become friends because the past therapeutic relationship was very harmonious. A month into the friendship, the ex-client perceived that the therapist was controlling and overbearing in their new relationship. He then questioned the therapist’s overall competence and stability, to the point of distancing Analysis An ethics committee determined that incompetence could not be conclusively proven; however, both the complainant and respondent were surprised by the findings of a dual role violation. The investigation uncovered that the therapist planned their developing relationship and a longer-term continuation while the client was still in active therapy. The therapist had actually presented these facts as a defense against the client’s accusations.
himself from the post-therapeutic friendship. The ex-client decided that the therapist had caused him to feel exploited, hurt, and confused. He then consulted another therapist who advised him to press charges against the previous therapist.
This case shows how personas may change from one context to another, and the resulting change may be viewed as negative. The client responded well to the therapist’s authoritative personality in therapy but not in a social context. This case shows the problems that occur when personal and professional boundaries are crossed and the resulting ethical issue that harmed both client and counselor.
BARTERING: COMMON BOUNDARY ISSUE
Current revisions summarized in this code advise against bartering. These revisions provide exceptions, however, as long as the bartering causes no harm. Therapists generally enter bartering arrangements with clients with good intention of offering services to those with limited finances, yet potential problems may exist. If the intent is to help a client with limited funds, delivering services pro bono, without bartering, may be an option. Although bartering with the client for goods or services is not directly prohibited, it is not recommended as a customary practice. The therapist should carefully review the ethics code for their association. Some sections include regulations surrounding bartering or inappropriate relationships with clients that refer to trading or exchanging services in lieu of payment but do not use the term “bartering.” There is much disagreement among practitioners about whether or not bartering is ethical. Client services may not equal the monetary value of the hourly rate for therapy. Clients fall further behind in the amount owed for therapy or counseling and may feel trapped or resentful. The quality of barter services might also become problematic as the therapist or the client may feel shortchanged resulting in resentment and damage to the therapeutic relationship. Case Study: Bartering A counselor provided services to a man with anxiety that adversely affected his work and personal life. He eventually lost his job and his health insurance due to his anxiety. The counselor agreed to hire the client to do maintenance on his house and yard work to help him earn some money while he looked for a job. The counselor paid him minimum wage but continued the counseling sessions at no charge. A month later, the man attempted suicide and was admitted to an inpatient mental health facility. He was assigned to a psychiatrist who learned of the exchange of work for counseling services. The psychiatrist questioned the ethics of the relationship and considered it a boundary violation
The exchange of goods, instead of traditional payments, may result in disputes over negotiating the equivalent number of therapy sessions for the bartered goods. The following list provides general guidelines that are summarized and commonly held from the various ethical codes for mental health practitioners: ● Bartering arrangements create the potential for conflicts of interest and inappropriate boundaries with clients. ● Bartering should occur only in limited circumstances and if it is an accepted practice in the community. ● The mental health practitioner assumes the full burden of demonstrating that this arrangement will cause no harm to the client. ● Bartering arrangements should not put the mental health practitioner at an unfair advantage. ● Bartering agreements should be discussed, and the counselor and client should sign a clear written contract. Establishing a friendship or a social relationship due to bartering may produce a conflict of interest that impairs objectivity for professional judgment. The dual relationship and/or friendship forms a special interest for the counselor or therapist beyond the professional one. For example, a therapist may hesitate to raise a certain issue with the client who is also a friend due to concerns of damaging the friendship. and an inappropriate dual relationship that caused harm to the client. He reported it to the state licensing board, and they opened an investigation. Analysis The therapist was not paying the fair market value for the labor being performed, so the relationship was not a beneficial one for the client, even though he was able to continue counseling for free. The quality and the effectiveness of the counseling services were called into question in light of the firing and subsequent suicide attempt.
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Book Code: PCUS1525
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