Ethical Issues Related to Treatment, Therapy, and Continuing Care

Moral and Ethical Issues Related to Treatment, Therapy, and Continuing Care 

Counselors and therapists have to be very careful to defend the rights of their clients who may feel powerless in therapy. As mentioned previously, therapy provides for a significant power imbalance. Sometimes counselors and therapists are tempted by the power available to them, and there are times when this temptation happens subtly enough that the counselor or therapist may not be aware of 

There are several areas where a therapeutic relationship can typically go wrong and cause ethical concerns. The first area of concern has to do with finances. Since counseling and therapy often involve payment, it is important to try to divorce therapy as much as possible from the financial aspects of the business of therapy. However, this is not always possible, especially if you are in private practice and you are your own accountant, too A rule of thumb is this If you cannot treat a client without bias because bills are not being paid, then you have no business treating the client any longer. A therapeutic referral must be made. There is no possible way that you can give your best effort to a client when you are sore about not getting paid. 

On the other hand, a clients problems paying the bills will adversely affect therapy even if you are not personally involved with bill collection. You have an obligation to advocate for your client under such circumstances, but you may be in a spot where administrators in your clinic are pressing both you and the client 

When does it become okay to have a relationship with a former client There is much debate about when it may be ethically okay for a therapist or counselor to have such a relationship, with some professionals expressing the opinion that such a relationship maybe possible, without risk of compromise or coercion, several months or years after therapy has ended. I do not have an easy answer to this question. As a therapist I know there is something unique about a therapeutic relationship that creates or enhances human vulnerability. My feeling is that counselors and therapists must respect the client amid this vulnerability by not taking advantage of that moment. Does this vulnerability between a therapist and a client ever go away I honestly do not know, but a therapist should consider the vulnerability factor in any relationship with a client, even an ex-client, very strongly and deliberately before acting on emotional attractions, even many years after therapy ends. Even if you are convinced sufficient time has passed for that vulnerability to diminish, it may not have diminished from the standpoint of your ex-client. 

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