6 Temptations

In certain areas of clinical practice, we are at risk for “crossing the line” into unethical or unprofessional actions — sometimes in minor ways, sometimes in ways that put patients – and thus ourselves – at risk. We will illustrate some problematic areas of practice with examples from Virginia licensing board cases and with video clips of therapy sessions with ethical challenges.

Introduction: High Risk Temptations

1. Boundary Issues

Time /Place/Duration/Frequency of Patient Contact
Setting Limits on Problematic Patient Behaviors
Accepting Expensive Gifts from Patients
Profiting from Confidential Information
Crossing Physical Boundaries With Patients
Sexual Relationships
Acting on Sexual Attraction to Patient or Patient’s Significant Other
Engaging in Sexual or Romantic Behavior With Patient, Student, or Supervisee
Entering Post-Termination Sexual Relationship

2. Dual or Multiple Relationship with Patient (Non-Sexual)

Entering Second Professional Relationship with Patient
Beginning Therapy Relationship with Employee; or Employing Patient
Joining in Business Relationship with Patient
Entering Social Professional Relationship with Patient or Recent Patient

3. Financial Temptations

Billing “Errors”
Inconsistent Fee Setting
Fee Splitting

 4.  Informed Consent Temptations

Errors of Omission
Errors of Commission
Dismissive or Defensive Presentation of Information
Inadequate or Misleading Forms

5.  Confidentiality Issues

Sharing Confidential Information with Colleagues, Family, or Friends
Disclosing Beyond “Minimum Necessary”
Failing to Confront Confidentiality Breaches by Staff, Colleagues or Others

6.  Professional & Competency Issues

Failure to Obtain Supervision or Consultation as Needed
Failure to Obtain Continuing Education or Follow Recent Research

Learning Goals:
1.  Describe some temptations that you have experienced in your professional work.
2. Indicate how succumbing to those might affect you or others.
3. Indicate possible safeguards that might prevent such problems.