General Principles of Ethics
"Individuals
in the caring professions sometimes have a childhood youth in which
caring for others and sacrificing self was a way to sustain oneself.
Not infrequently, this has led to a caring-for-others-career.
Excessive caring for others, at a great cost to oneself fits the
definition of co-dependency."
Thomas Skovholt "The Resilient Practitioner" |
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Ethics is
defined by Webster as the study of standards of conduct and moral judgment;
this system or code of morals of a particular person, religion, group,
profession, etc.
Since each person is unique with their
own experiences and beliefs, ethics can be difficult to define. There is
no concrete answer. As a professional, we are responsible for the
comfort and safety of our clients. We can serve them best when we
understand their needs and rights. We can serve them best when we
have examined ourselves and worked through our own issues. We can serve
them best when we focus on the development of ourselves. We can only
guide the client
to places that we have been willing to go ourselves.
The healing process can begin only when we realize that we are just facilitators
in the process itself. The healing is the responsibility of the client
alone. They must be given the information to determine what is right
for them and what they are going through.
Informed Consent
Clients need to be able to make a decision
as to whether they want you to work on them and what they want you to do.
This is informed consent. They must be given enough information,
such as : what are the goals and purpose of the session, what are the possible
consequences of the treatment, what risks are involved, what are
the possible benefits of a treatment, how much time will the treatment
take, how much money will the treatment cost and how will it be paid for.
With this information, a client will be able to determine if they want
the treatment for themselves or do they refuse the treatment.
Right of Refusal
Clients have the right to refuse the service
for any reason at any time. If they determine that the session should
be stopped right in the middle, their needs must be respected. Be
aware that a session interrupted before completed may also cause a problem
in the financial agreement. Does the client owe for the whole time?
This same right also applies for the practitioner.
You can end a session at any time, for any reason. The bottom line is to
work on only people who are nurturing to you and do not drain your energy.
If your mother just died of lung cancer it may not be advisable to work
on someone who smokes.
Confidentiality
A clients information, both written and
verbal belongs to the client. Conversations that occur during a session,
should not be repeated or included in the chart notes unless it is describing
their physical condition. A client may also not want to be approached outside
the treatment clinic. If you see a client walking down the street
and stop and say hello, this may violate their right of confidentiality,
as they may not want it be known that they are seeking treatment.
Boundaries
A Boundary is a space within a perimeter
that may be a physical, emotional or mental space. The emotional
(mental) space is determined by past experiences, values and morals. The
physical space is the actual physical limits of space that is
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needed by
each person to feel safe and secure. Boundaries can be communicated
by verbal conversations or body language. Some people, especially
those with a history of abuse of some sort, may not be aware of their boundaries
let alone able to maintain their boundary. Boundaries may be determined
before a session to ensure the clients comfort.
Boundaries are often difficult to determine.
What may be good for one person, may not be appropriate for another.
It is important to explore boundaries and constantly readjust limits to
accommodate each individual.
When boundaries are crossed, respect may
be lost in the relationship.
There are a main types of boundaries we
deal with include: Legal boundaries, professional boundaries, and personal
boundaries.
Legal boundaries are those that
of course deal with the law and the rules and regulations that are set
up by each state, city or county. Your scope of practice is defined
legally. Your scope of practice is the limits or boundaries that apply
to your practice. This may include areas you can work on and what
you can or can not do. This will determine if you can do things like make
diagnosis's, do physical adjustments, work in the mouth or other body cavity
and sell vitamins and other related items.
The laws vary so much that it is impossible
to discuss here. Make sure you contact your local authorities to
determine what your legal boundaries are and that you work within the law.
Professional boundaries are
determined by many things such as your type of practice, your business
rules and practices.
Personal boundaries are just
that- everything that determines your safety zone. They may be influenced by past experiences,
beliefs and values. Boundary violations usually begin quietly,
little by little, and without many problems. When you go through the
process of looking at your values and needs and set
your framework, boundary violations can be minimized. Recognizing
your own boundaries will be based on your values and needs. There is no
right or wrong here - only what is what is important to you.
Transference occurs when the client
makes the professional relationship, personal. Indications of transference
are things like the client brings you additional gifts or asks to see you
for lunch or outside the treatment. Personal conversation can also be an
indicator. What you do depends on each situation. This can
occur when a client is lacking in sufficient resources to take care of
themselves. Unresolved needs, feelings and issues are transferred
to the helper or caretaker.
Counter-transference occurs when
the therapist is unable to separate the therapeutic relationship from their
personal feelings surrounding the client. Some of examples of this
is when a therapist feels inadequate if the client is not making progress
or excessive thinking about the client after the treatment is over.
This occurs usually when the therapist plays the helper or fixer role.
We begin thinking that we can get rid of the persons pain when we really
don't do anything but facilitate the clients growth for their own healing
of pain. We begin to think that only we can fix the problem
and we have all the correct answers.
Boundary violations usually begin quietly,
little by little, and without many problems.
We will discuss in www.massagepracticebuilder.com
, the many real life
boundary issues and cross over areas. A successful massage practice is built on
knowing your needs and creating boundaries to fulfill them.
It is important to think of your practice
as one of service to the client.
How can you serve that client best?
Knowing the basic principle of ethics is just the
beginning to building a successful practice.
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