Introduction 

The videos that we will see today are common ethical dilemmas that we have all, or likely will be, faced with at some point. There is no resolution on the videos…it is up to each individual to decide how they would handle the situations. The goal is to have policies and procedures in place so that you know how you will handle a given situation, and so you will handle it fairly with every client when something arises. Prevention is always the best policy, but we’re all human, and things happen. The task is to respond in a professional manner, without taking things personally, or being wishy-washy, judgmental, or sounding like their parent. That’s sometimes easier said than done when we react instead of act.

For each video, the important questions are:

1. What would be an appropriate professional response in this situation? A professional response clarifies boundaries in a firm but diplomatic way.
2. Are there any ways this situation could have been avoided, and if so, what are they? In many cases, these situations can be avoided by making your policies clear to clients up front. State pertinent policies (such as your cancellation policy) politely on the phone during first contact, having your policies on your intake form with a checkbox indicating they have read and acknowledge them (or on a separate policy page), and state them on your website. Some situations may need addressing verbally in the moment but having clear policies and informing your clients of them is actually a service to them, and to you. Educating clients is part of our job. Think of all the situations that call for a clear policy: arriving late, missing appointments without notice or on very short notice, showing up sick for an appointment, privacy, confidentiality, payment expected at time of service, payment methods accepted, sexual behavior, to name a few. 

There are usually several ways to respond professionally, but your response should be dependent on whether or not you have previously informed the client of your policies—that’s your responsibility. Professional responses should always be given in an even, polite, non-judgmental tone, while making eye-contact with the client. Many therapists have trouble setting limits and feel uncomfortable informing their clients that they’re crossing a boundary. It can be helpful to do role-playing with a fellow therapist or friend so you can practice giving a professional response. You can use these as guidelines for writing your own policies and procedures, if you haven’t done so already. If you employ others in your business, they should be given a copy of all policies and procedures (and scripts are helpful!). Remember that your clients cannot be expected to follow your policies unless they are informed of them—such as having late arrival and cancellation policies on your website, intake, and business literature.