Conflicts of interest can occur for a variety of reasons and is something that we talk about a lot within the service. So what is a conflict of interest? It’s any situation that compromises your therapist's objectivity. Often this is when your therapist has a relationship or personal situation that could affect their professional judgment when offering you therapy.
Some examples that we deal with include:
- a therapist seeing two members of the same family for individual therapy (rather than family or couples counselling)
- if you have a mutual friend, family member or colleague
- if you are a member of the same club or social group.
Although conflicts of interest often involve a third party, this isn’t always the case. Other examples include:
- a therapist accepting goods or services in lieu of payment
- something you’re bringing to therapy may be too close/personal for them. It could pose an ethical conflict if your therapist is struggling to deal with this on a personal level
- a therapist may not feel competent or have the level of training required
- there may be a ‘dual relationship’ where you already have a friendship or business relationship with them.
A further, clear conflict of interest would be if there’s a relationship (sexual or friendship) between a therapist and their client. This can prove tremendously damaging to a client since that person is often incredibly vulnerable in the therapeutic setting.
Good practise means that your therapist makes sure there are no obvious or foreseeable conflicts of interest when taking you on as a new client, bearing in mind that it’s not always possible to know depending on the information given by a new client. However, as soon as your therapist learns of a situation where there’s a conflict of interest, then speaking with their clinical supervisor and referring you to another therapist will be a consideration.
The onus is on the therapist to recognise when there might be a conflict of interest, which could have a detrimental impact on you and then make an appropriate ethical decision that’s in your best interests.
Referring to BACP Ethical Framework should also inform their decision-making. It refers to conflicts of interest as ‘Any professional or personal interests that conflict with putting a client’s interests first will be carefully considered in consultation with a supervisor, an independent experienced colleague or, when appropriate, discussed with the client affected before services are offered.’
Good practise is that therapists are transparent with you about any conflicts of interest. Not telling you may leave you in a place of uncertainty and unable to process the situation. However, although your therapist may be able to advise you if there’s a conflict of interest, they may be unable to disclose the details. This could be to protect a client’s confidentiality, so you may not always know exactly why they are unable to offer you therapy.
It’s worth pointing out that not all outside relationships with a therapist will pose a significant conflict of interest in therapy. For instance, if someone attends a fitness club where their therapist also happens to attend, this may be relatively harmless, although it can potentially affect a client’s privacy, or make them feel slightly uncomfortable if they meet their therapist in a social setting. The therapist is still bound by confidentiality, and can’t disclose that the person is their client, which may make for a few awkward moments if not discussed beforehand. How meetings in the ‘outside world’ are to be handled should be discussed when contracting with the client.
On the other hand, not all clients want to see their therapist in the outside world and prefer anonymity and privacy when attending therapy. They may feel more conflicted about discussing their problems with someone they know or are likely to meet regularly. When dual relationships exist, it’s important to find out if they have the potential to create discomfort in therapy, for either the therapist or client, and to decide if the client would be best served with another therapist. The Ethical Framework states that dual relationships should be avoided if at all possible.
So, there are various reasons a therapist may refuse to start/continue therapy with you due to conflicts of interest. Although this may feel like rejection, it’s typically not personal. Most reasons relate to professional ethics. Being referred on is no reflection on you. It’s about making sure you get the best care possible.
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