Managing Professional Boundaries _ ____________________________________________________________
Clinicians establish relationships of trust with their clients; they remain aware of their responsibility to clients and society as a whole; they uphold standards of conduct; they promote honesty; and they do not intentionally misrepresent informa- tion. • APA (2017)—Clinicians aspire to work to the ethical standards of the profession, they accept responsibility for their own behavior, and they work to serve the best interests of their client (Principle B). • NASW (2021)—Social workers are continually aware of the profession’s mission, values, ethical principles, and ethical standards and practice in a manner consistent with them (Value: Integrity). • ACA (2014)—Counselors honor commitments, keep promises, and fulfill their responsibility of trust in the professional relationship. They deal truthfully with their clients (Professional Responsibility). • AAMFT (2015)—Marriage and family therapists do not exploit the trust of clients. They maintain high standards of professional competence and integrity (Professional Competence and Integrity). • NBCC (2023)—Counselors seek to listen to others with intention and respond with respect (Counseling Relationships). Clinical Consideration : Issues of justice are not uncommon with access to services. Clinicians serve as advocates for their clients to ensure fair access to treatment. Consider: 1. The client with depression who you have been seeing, whose health insurance will not authorize more psychotherapy sessions. 2. The client with substance abuse who wants rehab but has no financial resources. Ethical professional guidelines instruct providers to work to the best of their ability to help their client access needed services. AUTONOMY/JUSTICE Clinical Consideration : Keeping appointments, starting on time, and remaining attentive in the therapy session are basic examples of fidelity, as is maintaining confiden- tiality to foster trust. Clinicians have a responsibility to be fair and impartial and to treat people equally. They respect the dignity and worth of clients and respect individual, cultural, and role differences. They work to ensure that all clients have access to resources and services.
• APA (2017)—Clinicians have a responsibility to be fair and impartial and to treat people equally. They remain aware of their personal potential biases and boundaries of competence. They respect the rights of individuals to privacy, confidentiality, and self- determination (Principles D, E). • NASW (2021)—Social workers challenge social injustice and pursue social change focused primarily on issues of poverty, unemployment, and discrimination, and they seek to promote sensitivity to oppression. They treat each person in a caring and respectful manner, and they stay aware of individual differences and cultural and ethnic diversity (Value: Social Justice). • ACA (2014)—Counselors work to help the client foster control over the direction of their life. They treat individuals equitably and foster fairness and equality (Client Welfare). • AAMFT (2015)—Marriage and family therapists provide services to persons without discrimination. They foster diversity, equity, and excellence in clinical practice (Responsibilities to Clients). • NBCC (2023)—Counselors strive to be sensitive to differences in attitudes and culture. They provide services to all of those in need, utilize available resources, and advocate for the expansion of resources in underserved communities. They avoid discrimination, oppression, or any form of social injustice (Core Values). Barnett (2019) emphasizes that familiarity with one’s profes- sional ethics codes is necessary but not sufficient for ensuring ethical practice. Ethics codes are by design general guidelines and cannot address every possible ethical dilemma or chal- lenge. Some aspects provide clear and specific behavioral guidance, while many of the standards are broad and vague. It then becomes difficult at times to navigate real-life dilemmas within the boundaries of the codes. Barnett suggests that ethics codes represent the minimum standards for ethical behavior, the ethical floor, and that providers should instead focus on aspirational standards: Focus on doing your best at all times for the benefit of the client and others. He reviews the core principles that transcend all disciplines and also adds self-care as an essential obligation. He argues that without appropriately attending to therapist functioning and well-being, over time the therapist’s ability to effectively implement the core principles becomes jeopardized.
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