This is part of an episodic series, The Therapist’s Networking Guide.
To see the previous post in this series, click here.
Donna loves Yorkies. She has decided that a good way to make new friends is to organize a Yorkie Meetup Group. That will get her out in the community as well as allow her to meet other Yorkie-lovers.
Donna is also a Licensed Clinical Social Worker who wants to build her private practice. Is the Yorkie MeetUp Group a good way for her to get clients?”
Definitely YES! Meetup Groups, as well as support groups and other special interest venues can be great ways to network. At these groups you will find other folks with similar interests who are interested in meeting other people.
It’s here that you can really get to know individuals (and, more importantly, they can get to know you). As other Halloween-lovers get to know you and run across clients of their own in need of your services, they will likely refer directly to you!
Definitely NO! On the other hand, as a mental health professional, you cannot ethically or legally hang out with the Yorkie Group, exchange dog stories, go have breakfast together, and then see someone from the Yorkie Group (now or later) as a client. Neither can you see their family member or close friend as a client.
How to do it right? Be clear . . . very clear about what your purpose is when you venture out into the community and maintain the appropriate boundaries that go with that particular role. Whether it is at church, . . . at a support group meeting, . . . at a fundraiser, . . .or at a formal business networking event, it is very likely that you cannot ethically or legally sit on a board of directors alongside your client. You cannot go to Bible study with your client. And, you cannot attend a brunch that is hosted by one of your favorite referral sources if your client is also attending.
Note that ALL of these situations have come up for me.
So what do you do when as a result of finding out that you are a counselor, your church now wants you to provide counseling services to members of the congregation? Or the fact that you have taught classes at ministry events, and as a result some of the participants want to come see you?
Hi, Carla! Welcome!
Yes, that’s exactly the dilemma, isn’t it?! And, I have run into both of those situations . . . .
How I handle them now is different than how I handled them when I first went into private practice. Now I seek consultation from several therapists who are NOT in similar situations to get a different perspective. I also consult with a local mental health attorney, the Chair of Ethics for my state professional association (Colorado Counseling Association), college instructors of ethics courses for counseling, and, on occassion, the (free) counsel provided by my liability insurance company, CPH. When I resided in TX, I could also contact my state licensing board for LPC’s to get their input. (In the State of Colorado, the licensing board is unwilling to provide this type of feedback and support for LPCs)
The bottom line is that I don’t make those decisions based only on my 20 years of experience and my good intentions. When in doubt, I consult with multiple people. And, when I’m not in doubt, I consult with even more people!
I would like to know how members of our community handle fees for consulting with the clients’ medical docs, at the request of the client, of course.
1) Do you bill separately for the time you spend with a client’s doc?
2) Do you include this value-added service in your psychotherapy fee structure?
3) Do you consider this a cost of doing business and not bill for this additional quality of service?
4) Do you only bill after 10 minutes?
I have found that I can spend some significant time playing “telephone tag”, discussing the case, noting client records, etc.
Thanks for your ideas.
Kristene, you ask some really good questions here. I’ll post about these in the near future so I hope you’ll check back in!
Hi Tamara, just reading this now and as always you offer some great guidelines. Just wondering is this only refers to the time you are actually involved the the client? How long after counselling sessions ended would you feel comfortable in meeting your former client in church, groups, etc?
Dianne
Hi, Dianne! Thanks for dropping back in to chat! Truthfully, I would prefer to never run into my client after I’ve begun working with them. Of course, that’s not how life really works. And, paying attention to the way you have written your question . . . when would I feel comfortable . . . . Is a bit tricky to answer for several reasons . . . . The state law often dictates what is legal in terms of being in any type of relationship with a “former” client. Your professional codes of ethics (yes, I have more than one that I abide by) may dictate a different standard with which which I must also comply with. (And, yes, I am aware that the law and the codes of ethics do, on occasion conflict with each other.) And, then, I have to factor in my own comfort.
I want to be really honest with you guys here and say that earlier in my profession, I played a bit looser with my policy concerning boundaries with clients. if it was legal and technically ethical to enter into some type of business or collegial relationship with a client post-termination, I did make the choice on occasion. However, today – 20 years later – I can tell you that I tell each of my clients “once a client, always a client” and today I do not veer away from those words in practice. Sometimes hindsight is 20 / 20. And, I am smarter now than I was in 1991.
Here’s the learning for me . . . . I have never heard from someone who was a client (of mine or someone else’s) who after therapy entered into a personal or collegial or even business relationship with their “former” therapist who felt that it was an equal relationship. In fact, I’ve repeatedly been told that the “former” client has always felt “one down” or at a bit of a disadvantage in the relationship because they had previously been a client in a professional relationship with their now “friend,” “lover,” “colleague,” or “business partner.”
Here in Colorado, the Department of Regulatory Agencies, DORA, who oversees all professional licensing, is particularly opposed to dual relationships. There are time limits set in place by the state after which a therapist is legally allowed to relate differently to his / her “former” client. However, as for me, I’m sticking with “once a client, always a client.” It is clear and it has worked well for me.
I’m sure I’ll get some flack about this rigid stance. And, I’m not suggesting that you need to do as I do . . . . What I am suggesting is that you consider the possibility that you (and I) don’t always know what is in a client’s or even our own best interest in the moment. And, if you can concur with that, consider that it might be prudent to make a choice that errs on the conservative side.
OK, gang – what do you think about this issue?