- Center for Ethical Practice - https://centerforethicalpractice.org -

Therapists’ Dutiesvs. Patients’ Responsibilities

Where do our professional duties end and our patients’ responsibilities begin? In this workshop we will focus on some of the ethical dilemma that might raise this question.  For example, if a patient needs hospitalization, what scales do we use for balancing the ethical principle of beneficence against the duty to foster patient autonomy?  What factors are important when deciding whether to terminate therapy, even if the patient objects?

“Balancing” Therapist Duties and Patient Responsibilities

 I.  Beginning the Therapy Relationship

A. Therapist’s Duty To Discuss at Intake (Informed Consent Interview)

Confidentiality and its limits


Duration of therapy

Explaining Potential reasons for termination

B. Others’ responsibilities (agency involvement, family collaterals, etc.)

C. Patient’s Responsibilities

Consent to accept therapist’s policies as described

Participate in goal-setting 

 II. Continuing the Therapy Relationship

A. Therapist’s Duties

Being available in emergencies or alternate plan

Providing services appropriate to problem

As appropriate, re-opening issues discussed in informed consent interview

B. Patient’s Responsibilities

Abide by initial agreements re policies, payment, behavior

Attend scheduled therapy sessions

Participate in therapy process

 III. Ending the Therapy Relationship

A. Therapist’s Duties

Discuss termination throughout treatment, as appropriate

Plan sessions for processing termination issues before ending

End relationship

B. Patients’ Responsibilities

 IV. Special Considerations

A. Third Party Referral Considerations

B. Third Party Reimbursement Considerations

C. Patients’ Threats Toward Therapist

D. Patient-Initiated Premature Termination

E. Therapist-Initiated Termination vs. Abandonment 

1. Compare and contrast therapists’ duties with patients’ responsibilities
2. Name some of the issues which might arise that require weighing of various ethical principles
3. Use case vignettes to practice ways of dealing with such issues