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Net maintains responsibility for this program and its content. Net maintains responsibility for the program. Social workers should contact their regulatory board to determine course approval.

Course format distance learning - online activity. Programs that do not qualify for NBCC credit are clearly identified. Net is solely responsible for all aspects of the programs. This is a beginning to intermediate level course. Upon completion of this course, mental health professionals will be able to:. Almost all case scenarios presented in this course are adapted from actual incidents. We use improbable names throughout to enhance interest and ensure that identities of all parties are not discernible.

It is not our intention to trivialize the seriousness of the issues. As part of our disguising process, we also randomly assign various professional designations, earned degrees or licensure status. The materials in this course are based on current published ethical standards and the most accurate information available to the authors at the time of writing. Many ethical challenges arise based on highly variable and unpredictable contextual factors.

This course material will equip clinicians to have a basic understanding of core ethical principles and standards related to the topics discussed and to ethical decision making generally, but cannot cover every possible circumstance. Mental health professionals may puzzle over how intelligent, educated men and women could foolishly engage in unprofessional and unethical behaviors that pose significant threats to their clients as well as to themselves.

One might assume that therapists found guilty of forming high risk relationships with clients consist chiefly of poorly trained, obtuse, or psychopathic individuals.

Amazingly, actual cases of serious infractions from our personal experience serving on ethics committees include more than one past president of state psychological associations, current and former members of state licensing boards, a professor at a major university who authored an article on professional ethics, and even chair of a state psychological association ethics committee! Although one can identify various types of high risk therapists and situations, we also conclude that no one seems immune from temptation.

Psychotherapeutic alliances have peculiar and significant features that require firm professional resolve and self-monitoring. Consider the following scenarios adapted from our case files:. The first incident represents the most frequently reported type of temptation. Therapists become unhappy with their personal lives and their professional self-awareness wains. In the actual case, a brief affair soon ensued and proved unsatisfactory to both parties.

That a therapist would be upset by a negative review, as illustrated in the second scenario, seems quite understandable. However, the client pressed ethics charges, claiming that he was publicly diagnosed, which caused him mental anguish because several of his friends knew he was consulting this therapist. An ethics committee did find him guilty of poor professional judgment. See other ways to handle bad online reviews later in this lesson.

The two already experienced how well they worked together. However, the actual case resulted in calamity. When the therapist said he wanted out and a return of his investment the client refused, noting that they had signed a valid contract.

The fourth scenario seems more innocent, but the outcome in the actual case resulted in a sustained ethics charge of client exploitation. Nevertheless, the therapeutic alliance began to decline.

When the therapist attempted to collect her fees using a collection agency, the client pressed an ethics complaint charging that the therapist was only after her money and her merchandise. The fifth scenario has a couple of unusual features in that the counselor did not know much about the client because the group focused solely on test-taking anxiety as opposed to the more sensitive issues that arise in individual psychotherapy.

Yet, agreeing to meet in a very cozy setting with someone who had come for help, even in a carefully circumscribed way, always holds the potential of putting the therapist in jeopardy.

The final scenario may seem a bit out of place. After all, the therapist tried to do the client a favor. Allowing clients the opportunity to run up large bills, however, runs the risk that they may never acquire the resources to pay them off. The therapist who served as a safe haven for this fragile client has now superimposed the role of lender. In the actual case, the client ran up a huge tab, never found work, felt intense guilt over the inability to pay back the large sum to the person on whom he had depended, and attempted suicide.

This lesson will focus on high risk behaviors that can sneak up on therapists who do not pay sufficient attention to their professional responsibilities and personal needs. Reasons include giving in to their own vulnerabilities, rationalizing their actions as acceptable, crossing over a line after several seemingly innocent baby steps, or simply being caught off guard and failing to make an appropriate decision.

Most of these behaviors involve sexual, financial, or authority issues — the very same interpersonal issues that get us into trouble outside of our professional offices. As we saw in one of the opening scenarios, business partnerships are vulnerable to interpersonal conflict and financial risk.

In the context of that certainty, it seems surprising that mental health professionals have willfully undertaken risky business associations with their clients. Other similar ventures that have gone awry illustrate the damage done to both therapists and their clients:.

No rational person goes into business unless a prospect to profit in some way seems likely, which puts immediate and complicating expectations and pressures on client with whom a secondary relationship role is imposed. Each one should have reasonably foreseen that these deals could impair their objectivity and judgment.

Grabbit ultimately did lose her entire investment and received a formal admonition from the licensing board. Dip believed that because Sculpt instigated the partnership and because she terminated the therapy with him, she had no responsibility for what ultimately transpired; The responsibility rested exclusively with her because she should have foreseen potential hitches in such a plan. Terminating a client for the purpose of going into business constitutes unacceptable professional practice, even if Dip did assist Sculpt in finding a new therapist.

If Dip files a complaint against Sculpt, she will find the tables turning on her. The workplace breeds multiple role relationships. Many prove positive and enhance the quality of our lives. Employees and their supervisors are often friendly, care about each other's welfare, and attend some of the same social events.

The workplace can also be rife with land mines — gossip, conflicts, incivility, competition for promotions and resources, and difficult co-workers — all of which contribute to the potential for volatility.

Therefore, mental health professionals must remain vigilant to this ever-changing environment and avoid complicating it by willfully appending their services to those they work with. Employees almost always have reasonable external alternatives for needed psychotherapy or counseling. Jan Typer worked as a records clerk for a community mental health agency. Typer experienced some personal problems, she asked Dr. Honcho if he would counsel her.

Typer later issued an ethics complaint against Honcho, charging him with blocking her promotion based on assessments of her as a client instead of on her performance as an employee.

It may prove impossible to unravel the true basis for any job-related decision in such situations. Whether valid or not, Ms. Typer can always interpret any unpleasant reactions to what happens on the job as linked to the therapy, or vice-versa. When a client is also an employee, the consequences of a multiple role relationship gone awry can be especially devastating because of the potentially adverse career and economic ramifications for the client and sometimes the employer if a complaint is sustained.

In addition, some laws that apply in workplace relationships can complicate psychotherapeutic relationships. For example, clients can become unhappy with their therapists based on comments made by the therapist with legitimate therapeutic intent or a negative transference i.

If this happened in treatment with Dr. Therapy clients who possess special skills may inevitably lead to a temptation to consider what these clients might have to offer you. Moreover, many clients feel financially strapped in this difficult economy. Offering to employ them may seem like a good deed. However, as with business relationships, such alliances are fraught with risk that can obliterate the professional relationship and disperse additional emotional and financial debris in its wake.

The relationship seemed to be working well until Clerk asked for a raise. Scatterbill refused, saying that Clerk already earned a good hourly wage. Clerk countered by reciting Scatterbill's monthly income and comparing it to his own. Scatterbill allegedly laughed, responding that a comparison between the two was ludicrous. An insulted Clerk quit his job as well as his therapy, and wrote to an ethics committee claiming that Dr. Scatterbill should have known better than to employ an ongoing client, especially for such a sensitive position that gave the client access to confidential information.

Click Shutter needed additional work to make overdue payments on a new car. When Click offered to photograph the upcoming wedding of his counselor at a reduced price, Melvin Groom, L. Shutter quit therapy, told everyone in town that Groom had married a witch, and successfully sued Groom in small claims court.

Even in situations where the task seems specific and time-limited, clear judgment must supersede giving in to what appears to be a reasonable arrangement.

Mental health professionals often receive words of sincere appreciation from clients. Sometimes an expression of gratitude extends beyond a verbal or written thank-you. Accepting a small material token, such as homemade cookies or an appropriate inexpensive item, typically poses no ethical problem.

At times, however, accepting certain types of gifts e. As we all know, gift giving may reflect motives that have nothing to do with appreciation. Gifts have the power to control, manipulate, or symbolize far more than the recipient can fully understand.

Some clients may even attempt to equalize power within the relationship by bestowing a gift Akerstrom, ; Knox, Hess, Williams, et al. When a gift goes beyond a simple gesture of gratitude, problems of ethics and competent professional judgment arise Barnett, The following cases demonstrate ethical boundary crossing with adverse consequences, especially in the case of expensive gifts. Freshly felt flattered and excited.

He convinced himself that his services were worth the bonus because Porsche recounted how he had churned through many previous therapists with disappointing results. As a more seasoned therapist would have predicted, Rich soon began to find fault with Dr. Freshly and sued him for manipulating him into giving an expensive gift. Regardless of any other dynamics or considerations, a very valuable gift should be refused.

The son had wanted the watch all along, but never pressured his mother, figuring he would inherit it after she passed.

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