11.11 Bartering, Gift Giving, and Receiving Gifts
Bartering
Occasionally, counselors may encounter situations where clients desire to exchange goods or services for counseling instead of direct payment. The reality of institutional systems and limited access for people to necessities and treatment can contribute to counselors considering these arrangements. However, they must prioritize legal and ethical stances. Bartering arrangements bring legal and ethical risks for counselors, and regardless of the arrangement or who proposed it, the risk always falls on the clinician (Woody, 1998). Each state has unique laws, so professionals must consult state statutes for further guidance. Legal consequences can include malpractice lawsuits, civil action for “undue influence, distress,” or other causes of action due to the differential power inherent to the counseling relationship (Woody, 1998). Timing is essential, as clients could determine in the letter that they were vulnerable, “helpless,” unable to make decisions when the agreement was created, and claim that the counselor acted outside of their fiduciary duty (Woody, 1998). Ethically, the ACA code regarding bartering for services is presented below (ACA, 2014). As always, counselors adhere to the more stringent guidelines in comparing responsibilities laid out by legal and ethical codes.
Counselors know that bartering introduces a dual relationship with business and financial considerations, as the counselor acts in more than one role or capacity (Woody, 1998). These arrangements must not harm the client or counseling relationship and must not jeopardize client autonomy (Woody, 1998). Counselors are responsible for noticing shifts in their ability to remain objective, practical, and attuned to client welfare (Woody, 1998). They consider factors such as the counselor’s theoretical orientation, the patient’s concerns, severity, the nature of the agreement, the duration of the relationship, the client’s history of boundary concerns, etc., before entering into a bartering arrangement (Woody, 1998). Table 11.2 offers additional factors to consider in formal ethical decision-making processes (Zur, 2014).
While entering into bartering arrangements with clients is not advised in the counseling community, there are important considerations if one does decide to proceed (Woody, 1998). They must prove that the arrangement is “a) in the best interest of the client, is reasonable, equitable and undertaken without due influence, b) does not negatively impact the professional services provided to the client” (Woody, 1998, pg. 175). They thoroughly document the situation and create a written contract including intention, specific arrangements, and conflict resolution strategies to be signed by both parties (Woody, 1998). It is recommended to consult with a lawyer when these arrangements are made due to the risks to each party. If harm or conflict arises due to a bartering arrangement, the counselor takes reasonable action to resolve it, which may involve hiring a mediator to sort out legal issues (Woody, 1998). There may also be emotional and relational conflicts where counselors trade services for construction work in their homes and are unsatisfied with the outcome (Woody, 1998).
The ACA (2014) Code of Ethics discusses bartering:
“Counselors may barter only if the bartering does not result in exploitation or harm if the client requests it, and if such arrangements are an accepted practice among professionals in the community. Counselors consider the cultural implications of bartering discuss relevant concerns with clients and document such agreements in a written contract” (Standard A.10.e.).
Receiving Gifts
Receiving gifts is generally understood as clients offering a “significant or symbolic object” to a counselor (Brown, 2008). Best practice as outlined in the ACA (2014) ethical code is included below:
“Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, and the counselor’s motivation for wanting to accept or decline the gift” (Standard A.10.f.).
It is an interesting interpersonal situation with therapeutic considerations to receive a gift from a client (Brown, 2008). One can view gifts from clients on the spectrum of boundary crossings to boundary violations within the counseling relationship (Brown, 2008). Gifts that align with boundary crossings are appropriate, well-intentioned, show gratitude, and have a reasonable monetary or emotional value (Brown, 2008). Gifts that are boundary violations are inappropriate, come with manipulative intent, or cause harm to the client and the relationship. Counselors may explore with clients or make inferences about the gift-giving’s intention to understand its meaning and respond therapeutically (Brown, 2008).
Clients are welcome to offer gifts, and the counselor must respond as a healthy, mature, ethically-minded professional. Deciding to accept or refuse a gift requires careful consideration. As Brown et al. (2008, pg. 506) stated, “It is far easier to refuse a gift, but one must know how and when to accept one.” Brown et al. (2008) further suggest considering factors such as the financial value of the gift (low cost, recommendation is usually about $10 or less), timing of the gift, what the gift is, frequency of gift-giving, intention of the giver, cultural factors, if the client has a history of boundary issues, treatment goals, treatment phase, sentimental value of the gift, sense of gratitude and the impact of the decision on the counseling relationship in determining to accept a gift or not. If they decide to reject a gift, counselors work to repair any damage to the relationship.
Often, cultural considerations are at play in determining whether to accept the gift, which asks counselors to balance multiple ethical codes related to receiving gifts and multicultural competence. Sometimes, ethical codes may contradict each other. Because gift-giving can take on different symbolic meanings across cultures, refusing them impacts the person, their sense of culture, and the relationship (Barnett, 2007). For example, in Tamil culture, an ethnic group from India, sharing gifts is an essential cultural practice. Refusing a gift from a Tamil native would lead to feelings of rejection and humiliation (Brown, 2008). They remain open to each client’s lens, lived experience, practices, values, and beliefs. They also manage their humility and discomfort and respond to the situation with the client’s identity and welfare at the forefront (Barnett, 2007). Overall, counselors are responsible for developing cultural sensitivity, attunement, and competence, so to negate cultural factors in gift-giving constitutes an ethical violation. It is ok for clients to cross boundaries for the client’s sound and their relationship.
Gift Giving
Some counselors consider giving gifts to their clients. In these cases, counselors are guided by virtue ethics, including client beneficence and equity, in that all clients deserve fair and similar treatment. They also ensure that all actions, including potential gift-giving, enhance therapeutic work and the counseling relationship (Moleski, 2005). Some gifts, such as books or other psychoeducational materials, could be appropriate boundary crossings (Brown, 2008). Outside of giving the gift, the counselor considers the impact of the boundary crossing and what message it sends to the client (Brown, 2008). They contemplate fairness and equality among clients. Would they do the same for all clients if they give a gift? For example, a counselor learns that a client’s bike is broken, and they need funds to fix it. The counselor considers giving the client $25 to fix their bike, which seems no big deal. However, the counselor quickly realized that giving each client in their caseload the same funds to fix their bike would total nearly $900! This is an excellent example of the importance of equity in client treatment. Additionally, they evaluate their intention for giving the gift, which in this example could be their need to feel good about themselves or like a savior.
Case Example: Gift Giving
Maya, a licensed mental health counselor, has been working with Yuko, a 40-year-old client originally from Japan, who is navigating a major life transition. After several months of successful therapy, Yuko offers Maya a beautifully wrapped gift as a token of appreciation for her support. In Yuko’s culture, giving gifts is a common way to express gratitude and maintain harmony in relationships. However, Maya is aware that the ethical guidelines for counselors generally discourage accepting gifts from clients, as it could complicate the therapeutic relationship and blur professional boundaries. Maya is now faced with an ethical dilemma: should she accept the gift, considering the cultural significance for Yuko, or respectfully decline to maintain the ethical standards of her profession?
Key Takeaways
- Bartering arrangements between counselors and clients introduce dual relationships and should only be considered when they are equitable, culturally appropriate, and in the client’s best interest.
- Receiving gifts from clients requires careful consideration of factors like cultural significance, intent, value, and potential impact on the therapeutic relationship.
- Counselors should use ethical decision-making frameworks, document their rationale, and consult with colleagues or supervisors when navigating complex situations involving bartering or gifts.
- Cultural competence is critical when assessing gift-giving practices, as refusal could harm the relationship or cause cultural offense.
- Counselors must prioritize client welfare, maintain professional boundaries, and ensure that actions align with ethical and legal standards.