As a therapist, you have your share of ethical dilemmas to weed through. And with the holidays on your heels, you’re probably staring one dilemma in the face right now: should you accept client gifts?Unfortunately, there isn’t a quick and easy answer to this question. The answer exists in the ethical gray area and must be considered on a case-by-case basis.The good news is that we can shine some light on the issue. In this post, we’ll discuss what’s appropriate and ethical. Let’s get started.
The Damage of Not Accepting Gifts
As Jenny Newsome mentioned in her thought-provoking post, The Necklace: When Does a Rule Become a Straightjacket, not accepting a gift from a client can be dehumanizing to them. As a matter of fact, it can do more damage than you think. It can actually undo some of the progress you’ve made with them or create new problems where none currently exist.In the sacred space of the therapist-client relationship, not receiving gifts can be viewed as a rejection of that person. It could cause rifts in the trust between therapist and client. The client can start to harbor negative feelings toward the therapist who rejects his or her gift, and those negative feelings can sabotage their therapy.
Should You Institute a “No Gifts” Policy?
It’s always a good idea to map out your policies before you come face to face with a potential issue. Nowhere does this apply more than with the sticky circ*mstance of whether or not to accept a gift from your client?Having a clear gift policy can help you navigate the murky waters. You absolutely need to set boundaries for what is acceptable and what is not. For example, will you accept homemade pastries? Will you accept tickets to a Broadway show? Will you accept an all-expenses-paid trip to Switzerland? Why or why not? What are the reasons behind your acceptance or rejection?It’s important to get clear about it with yourself so that you don’t stumble or stutter with your clients. You don’t want them to feel like you’re making exceptions or singling them out in a way that’s inappropriate.But remember that even if you have a “no gifts” policy, it won’t discourage every client. Some clients may not notice your “no gifts” policy. Some will willfully ignore it believing that they’ve established trust, and built a special bond with you that can supersede that policy.Also, consider documenting any gifts you receive from your clients in your records. Be sure to detail what the gift was, when it was presented, and what response you may have had.
What is Considered a Gift?
There are two types of gifts that your client can give you: physical and abstract. An example of a physical gift would be a coffee mug. An example of an abstract gift would be a handwritten note. Gifts can be handmade or store-bought. They can be symbolic in nature or extremely literal.
Creating Criteria for Accepting Gifts
What should you consider before accepting a gift from your clients?While there’s nothing written in stone, here are a few soft considerations outlined by the American Counseling Association:The Therapeutic RelationshipWhen considering whether or not to accept a gift, consider the nature of your relationship. Will declining the gift harm the progress you’ve made with the client?How Much the Gift CostsWhat’s the value (real or perceived) of the gift? Inexpensive gifts are more likely to be a token of your client’s appreciation and not a deeper problem.The Client’s MotivationMotivations are a lot harder to determine than costs, but as a therapist, you should figure out what is motivating the client to offer you a gift. This is especially true when a gift is given absent of any holiday or cultural event.The Timing of the GiftTiming is also an important factor here. Gifts at the end of your therapeutic relationship make more sense than gifts presented on the very first appointment. Be sure to explore the possible meanings and motivations behind the timing of the gift.Your Own MotivationLast, but not least, consider what’s motivating you to accept or decline a gift.
How to Respond to the Gift-Giver
Let’s discuss how to approach your acceptance or rejection of a gift in a way that doesn’t damage your relationship with the client.If you choose to reject the gift…Some clients give gifts that are obviously inappropriate. If the gift is born out of transference, or it comes from misplaced feelings of guilt and acceptance, you may determine that it’s best to politely decline the gift. Take this as an opportunity to discuss why you cannot accept the gift.If you choose to accept the gift…Some gifts are culturally or seasonally appropriate. A holiday gift, for example, may be an innocent gesture of goodwill. Gifts from children, no matter the time or theme, often carry the same level of face-value innocence. If you determine that the gift will not change your therapist-client relationship, it’s okay to graciously accept the gift with a simple “thank you”.Ultimately, your response will depend on the gift and your relationship with the client. You have unique insight into the client’s mental state (and the license to ask if you’re unclear). Use your tools to determine whether this gift is just a gift or if it’s a plea for help in disguise. You can then take this as an opportunity to explore deeper meanings.
When Should You Always Reject a Gift
There are certain circ*mstances when the complete rejection of a gift is appropriate. As always, use your judgment as a guide, but here are a few gift types to clearly avoid:
- Any gift that is sexual in nature, include sexual innuendo, should be flatly rejected.
- Racially offensive gifts should also be rejected.
- Any gift depicting or suggesting violence.
- Investment tips and “insider” trading advice.
Final Thoughts
Remember that, when coming from a pure place, gift giving is a wonderful way for your clients to express their sincere gratitude. As long as you don’t suspect transference or other mental/ emotional issues, and the gift doesn’t violate any other ethical boundaries, be open to the experience.
