Multi-Client Therapy: Ethical & Legal Considerations

(Couple, Family, Group, Child+Parent, Individual With Collateral Participant)

When providing multi-client therapy — couple, family, or group therapy; child therapy with parent consultation; or collateal participant in an individual adult therapy — certain ethical, legal, and/or clinical dilemmas often arise.  Are you avoiding the predictable dilemmas and preparing clients for the “unpredictables”? Do you remember that “clinically interesting” is not synonymous with “ethically appropriate”?  This workshop is designed to help clinicians anticipate, prevent, and/or minimize the risks to clients — and thus to themselves — when providing therapy in multiple-client configurations.

OUTLINE

I. Ethical Standards About Wearing Multiple Clinical Hats

II. Legal Standards Affecting Multiple-Client Therapy

III. Practical Issues About Informed Consent

A. First Session Issue: Informing All Clients

1. Your Rules About Confidentiality

2. General Policies

B. First Session Issue: Obtaining Consent from All Clients

1. Formal Contract With Client(s)

2. Formal Contract With Collaterals

C. Ongoing Issue: Who is the Client Now?

1. Clinical Implications of the Answer

2. Ethical Implications of the Answer

3. Legal Implications of the Answer

IV. Third Party Payer Contracts & Reimbursement Issues

V. Anticipating Ethical/Legal/Clinical Pitfalls

A. Inevitable Dual/Multiple Relationship Issues

B. Potential for Changes in Roles/Boundaries

C. Potential for (or Perception of) Conflict of Interest

D. Potential for (or Perception of) Coercion/Harm