Saturday, May 12, 2012

Professional practice issues

I was in supervision the other day and the supervisee raised an interesting discussion. I thought I would write it down so I could use it later and then I might as well post it here as well. A client of hers had invited her to attend a wedding she was having and the trainee was wondering if she should go or not.
We discussed the various permutations and consequences of what she could do. She looked a bit surprised at one point when I informed her that I had a client a number of years ago whom I gave away as the bride at a wedding. (Is that transference do you think). It was in a registry office and there was about 10 people there and there was a lovely meal at a very fancy restaurant afterwards. It was a nice day indeed and one I wont forget. I have two sons and no daughters so I was lucky in one way as I get to experience giving away the bride at a wedding.

Beach goers2
Human relationships

Then we got onto the topic of gift giving. When the client gives the therapist a gift does the therapist accept it?. I mentioned to my supervisee that the Australian Psychological Society  has a guideline that you do not accept any gift over $20 or $40 dollars. I can’t remember the actual amount. 
Some of these professional organizations really do have a lot to answer for. They have got it wrong again, as they do. Their solution to professional practice issues such as these is to just ban everything and then you will be alright. It has nothing to do with the money, it is about the motive behind the gift giving and the personality of the two parties involved.
If a therapist has difficulty saying no to clients and setting clear boundaries then yes it is probably a good idea just to not accept gifts from clients as a general rule. But if they do not have such problems then one can assess each case on its own as it presents itself.

Money is one way to get the power in a relationship

Some clients can use gift giving to try and alter the power structure of the therapeutic relationship and the more expensive the gift the more this can be done. The therapist needs to assess if this is the case and using supervision to do this is a very good idea. Most gift giving clients are not motivated in this way but instead simply want to express some affection to the therapist. Therapists can financially exploit clients by encouraging expensive gift giving. One needs to be questioning the motives of both parties in these ways when deciding to accept a gift or not. Also if the client (and therapist) can keep their relationships boundaried then accepting the gift is more likely.

Sex is another way to get the power in a relationship

Gift giving can indeed enhance the therapeutic relationship if handled correctly and can be simply a way of expressing positive feelings for another person which can be therapeutic in itself. Of course if your professional organization has a clear rule not to accept gifts over such a value then of course one must follow that. But if it is a guideline or there is no such limitations stated then questions outlined as above can be a way of deciding whether to accept the gift or not.