In medico-legal context, the relationship between a psychologist and a patient falls in the ambit of a fiduciary relationship. In a fiduciary relationship, there is an overarching ethical obligation not to derive illegitimate forms of satisfaction that place the patient at risk of harm. A sexual involvement violates the fiduciary nature of the relationship and is therefore unethical. In the end, there is no doubt that a dating relationship between a psychologist and patient is fraught with complications that can prove to be damaging to both parties if boundaries are crossed.
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However once the professional relationships has ceased completely and a considerable time period has elapsed, it may be possible for a doctor and a former patient to date each other provided the new relationship is equal and emotionally healthy. Skip to main content. You are here Home. Log in to post comments Printer-friendly version.
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Subsequently, instead of helping, the social worker may start the path of hurting the client while disclosing or sharing his or her own personal experiences. In child welfare, immediate supervisors must play a vital role in modeling, coaching, and engaging in frequent discussions with workers on topical issues of client engagement, rapport-building, and assurance of proper boundaries in the worker and client relationship.
Social work schools, child welfare training, and other continuing education programs also have a responsibility in providing education and information on the management of client relationships and examination of ongoing ethical issues. In some instances, it may be a labor relations matter, or a training or coaching issue between the worker and supervisor. Why might a caseworker risk contamination of the client engagement process or actual working relationship?
There is no definitive or even easy answer. From others, it may be suggested there are always persons in any given profession who will violate the code of conduct rules and standards, despite any degree of training, supervision, or administrative oversight. As social workers, we have a responsibility to examine the issues of client relationships and ethical boundaries.
This conversation merits discussion among our peers and other related professionals. In the age of increased litigation and constituent complaints, it is not a topic to be ignored. The personal and corporate costs and liabilities associated with claims of unethical behaviors have long lasting impact to those in the profession and for those who are served.
Fortunately, ethics training for social workers must be taken in accordance with state licensure standards. This provides an opportunity to be mindful of our ethical obligations and boundaries in serving others throughout the field. Non-licensed employees are not exempt from the risk of assumed liabilities in child welfare or other social work settings.
'Til Death Do Us Part: Does a Client Ever Stop Being a Client?
Both public and private organizations generally have ascribed core principles, ethical procedures, and guidance with regard to policy safeguards that govern the scope of responsibilities of employees in providing client services. This is intended to keep all safe. This includes verbal and nonverbal communication. Explore and determine whether your client engagement skills are healthy or unhealthy.
Revisit the signals and warning list of possible risk factors provided earlier in this article. If you find yourself or others on the list, take any necessary action to correct the area s of concern. Always remain focused on meeting the needs of the client versus your own personal needs.
Can Psychologists Date Patients or Former Patients? | Futurescopes
Evaluate and pursue other avenues of support, which may include professional counseling, clinical supervision, and training. Finally, critically evaluate whether a career change might be necessary for the protection of self, clients, and agency employer. Ethical dilemmas in the social worker-client relationship. Journal of Progressive Human Services, 15 2 , National Association of Social Workers.
Boundary violations in professional—client relationships. Boundary issues in social work: Social Work, 48 1 , She is a current state government policy administrator, and is a doctoral student at Walden University, School of Public Policy and Administration. Of course, of all the dual or sequential relationships that are potentially possible with patients and former patients, when the issue of sex comes up, most all therapists of all disciplines react forcefully.
Having sex with a current patient or even a recently discharged patient is not only unethical—it is illegal. It is truly a betrayal of the trust the patient places in us. However, over time as in years , can that change in some very special circumstances to allow exceptions to the rule? If a therapist and former patient meet some 10 or 15 years after the last therapeutic session and develop a personal relationship, get married, and have children, can we say that an ethical violation or a crime has been committed?
In most all states, laws prohibiting sex with clients are limited to current or recent clients. Washington State is one exception. However, assuming the former client does not file any complaint, how enforceable would such laws be? For example, what if the former therapist and patient got married, were in a committed relationship, and had children? Would or should an ethics committee have the authority to interfere with a marriage or union among consenting adults?
Should I Tell My Boss If I Start a Relationship With a Client?
What about our belief in the right to free association? What is the rationale for the prohibition against sex with patients? Many believe it is the power differential. Behnke points out that many relationships have significant power differentials, including partnerships and marriages, and that we often do in fact put our own interests above those of clients when we charge fees, for example.
So, neither a power differential nor putting our own needs first is in and of itself unethical. Rather, Behnke says, it is because we have a fiduciary relationship that is compromised and creates additional risks that are not a necessary part of the therapeutic relationship, making psychotherapy impossible. But fiduciary relationships are not static and change with time and circumstances. Some would argue it is based on psychodynamic theory, and perhaps those who practice psychoanalytically have a higher standard.
But interestingly, there is nothing in psychodynamic theory or psychoanalysis that would state such. This would include taking patients on vacation and conducting analysis in hotel room beds. We tend to forget that that was a different time with different standards. Therefore, perhaps, our reactions could possibly be a way of denying and reacting against the behaviors of a previous era we find frankly embarrassing and indefensible. Another possibility is that, whereas all of us require structure of some kind, some of us need more structure and clear inflexible rules more than others.
Some fear that if they bend the rules just a little, they may go down a slippery slope and cross all reasonable bounds. To therapists who believe they are just one rigid rule away from harming their patients, I say maintain all the rules you need. However, not everyone requires such inflexibility.
Attempting to impose such rigidity on everyone is not good practice. It is not good for our clients or the field. If we hold that belief to be literally true, then it would not apply only to sex. We are responsible to protect our clients from harm to self and others. But if we make no distinction between current and long past, can we in this litigious society be sued for the actions of a long past client?
Our clients grow mature and often leave us behind.
If we do our jobs well, we have given them the tools to move on.