The Importance of Ethics in Clinical Practice Part 2
Client Autonomy and Dependency
The therapist is responsible for working in ways which foster the client’s control over their own life and to respect their ability to make decisions and change within their own values and belief system. Obvious difficulties arise when clients are given specific advice, e.g., the desirability to show feelings. This could lead to inappropriate behaviour and unforeseen consequences such as violent arguments, relationship breakdown, etc., which would leave the therapist open to criticism.
Terms and Conditions
Therapists are required to disclose their terms, conditions and, where appropriate, methods of practice at the outset of therapy. Failure to act thus may be seen as being morally repugnant as well as counter-productive in therapeutic terms.
The client should be made aware of the terms under which therapy is being offered and any changes to such need to be agreed beforehand. Clear contracting shows respect for the client’s autonomy and should include what is being offered, availability, the degree of confidentiality (see ‘Confidentiality’ below), fees, procedure for cancelled appointments and any other significant matters which may be relevant to any particular client or therapist. These should be discussed verbally so that the client has the opportunity not to proceed with therapy before any financial liability is incurred.
Competence
Therapists are required to disclose their qualifications when requested and not to claim or imply qualifications they do not have. Physical evidence of such qualifications should be made available for inspection by any legitimate enquirer.
Therapists must work within the limits of their own competence and be prepared to refer clients on to other more experienced or specialist therapists when necessary.
Work with clients should not be undertaken when the therapist is impaired by personal and/or emotional difficulties, illness, disability, alcohol, drugs or any other reason which would detract from their ability to work for the well-being of the client. In the same way, therapists should not work with clients who are incapable of understanding the work and processes involved because of prescribed or recreational drugs, including alcohol. Competence should be maintained and expanded by Continuing Professional Development (CPD).
