___________________________________ Code of Ethics for Counselors and Marriage and Family Therapists
BARTERING: A COMMON BOUNDARY ISSUE Current revisions summarized in this code advise against bar- tering. 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 custom- ary 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. Cli- ents 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. 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 sum- marized 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 barter- ing 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.
SEXUAL DUAL RELATIONSHIPS One of the oldest ethical mandates in the healthcare profession is the prohibition of sexual intimacies with clients. Clients may suffer reactions similar to victims of rape, spousal abuse, incest, abandonment, and post-traumatic stress disorder. Additionally, feelings of guilt, rage, isolation, confusion, and an impaired ability to trust may occur. Harm from sexual relationships with the practitioner is univer- sally accepted and easy to prove. There are no credible opinions in the profession that defend sexual relationships with clients. The codes of ethics for all mental health organizations include established moratoriums, timeframes, and strict regulations concerning sexual contact with clients. The mental health practitioner must review the sections of their association’s and employing organization’s code of ethics and regulations that govern sexual contact with clients in their entirety. The following list contains information held in common among major codes of ethics regarding regulations for sexual contact between mental health practitioners and clients: • Mental health practitioners do not engage in sexual intimacies with current therapy clients/patients. • Mental health practitioners do not engage in sexual contact with former clients, according to the limits set in their organization’s code of conduct. • Sexual intimacy with former clients is likely to be harmful. • Even after the appropriate time period allowed in the professional’s code of conduct, the burden shifts to the therapist to demonstrate there has been no exploitation or injury to the client or the client’s immediate family. • Whether such contact is consensual or forced, under no circumstances will the counselor engage in sexual activities or sexual contact with current clients. • Mental health practitioners should not engage in sexual activity with anyone associated directly with the client, such as friends, family members, or colleagues. The indecency of sexual conduct with clients is widely acknowl- edged. Clients who sue for damages have an excellent chance of winning their lawsuits if allegations are true. Civil lawsuits by clients in these cases may include the following allegations against practitioners: • Malpractice • Negligent infliction of emotional distress • Battery • Intentional infliction of emotional distress • Fraudulent misrepresentation
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