Gain: Ethical boundaries relating to client gifts

[note: I found this document in my Ethics course files. I think I wrote this some time ago…but I don’t remember. It is possible that I received a WORD document with this in it from someone else. If so, I apologize for posting without acknowledging the source. Ah, the joys of aging.]

Professional counseling is founded on the assumption of the patient/practitioner relationship. The practitioner/expert provides a needed and appropriate service and the patient pays a reasonable fee—or their insurance company does for them. However, the extremely personal nature of counseling work often creates strong feelings between client and therapist and consequently the client may wish to bring a token gift signifying their thankfulness for a job well done.

Gifts beyond the token category provide therapists with “gain” and likely disrupt the fee/service relationship mentioned in the previous paragraph. While gain may not cause actual harm and may be unavoidable, the wise counselor remains aware of possible sources of gain and their consequences.

Consider the following examples and check whether you think they may be problematic:

  • A Board member of the counseling center offers one of the counselors tickets to a ball game
  • A Client offers his private counselor tickets to a ball game.
  • A student offers her teacher tickets to a ball game

Should the counselor in any of these scenarios accept the tickets? Does the cost of the gift or the wealth of the person giving a gift matter? Would it change your answer if the gift were a week’s stay at a beach house? Does it matter if the student is currently in a class with the teacher or not?

Gifts are a form of gain. Others may come in other forms of benefit for the counselor. If the counselee owns a publishing company, should the counselor accept an offer to have him or her publish his next book? If the counselor has a non-profit ministry, should he or she accept client gifts to that ministry? If a client offers to sit for a testimonial ad for the counselor’s new technique, should the counselor accept?

Gifts, though, represent expressions of thankfulness and thus a policy of rejecting all gifts may bring harm to the counseling relationship.

Wise Counselors explore with their clients any possibilities of gain and their potential consequences. Counselors consider how gains may harm the client or create an indebtedness that in the future clouds clinical judgment. For example, counselors do not accept gifts or fee sharing from treatment facilities in return for referrals. On the other hand, a cup of coffee brought to the session likely is just a cup of coffee, a friendly gesture. Christmas cookies are a small but personal thank you for a job well done. But, don’t assume that small gifts can not produce a quid pro quo (this for that) interaction. So, back to our first line in this paragraph. Take the time to explore the meaning of an offered gift and be willing to talk about it with clients.


Filed under christian counseling, christian psychology, counseling, counseling skills, ethics

3 responses to “Gain: Ethical boundaries relating to client gifts

  1. When I started seeing a counselor, I had no idea the gift thing was such a big to-do.

    I brought christmas cookies once (I had been baking all day and made, like, fifty packets of treats to pass out to neighbors, teachers and friends.)

    Suddenly, the conversation was all about these cookies and the therapeutic relationship and what it MEANS that I brought cookies…

    To which I had to say:

    sometimes a cookie is just a cookie. 🙂

    • Oh, but notice the gain your counselor got by making you guys talk about it. Your point is correct, unless they were fortune cookies with personalized messages 😉

  2. D. Stevenson

    When I was in 3rd grade I had a classmate who everyday tried to give me some little gift. I tried to assure her that it didn’t matter if she gave me something. I was still her friend. I considered her my friend. Still, she wanted to give me something. I don’t know how I knew that her gift wasn’t just a gift, but a way to get me to like her. I remember she had oily, blonde, scraggly hair. I remember her smile. I wonder what happened to that little girl. I hope it was good.

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