Like other aspects of the counseling profession, the topic of accepting gifts as a therapist can be a difficult one. Currently, there is no clear standard to which professionals must adhere. However, there are suggestions for us to consider. For example, the American Psychological Association does not provide guidelines for accepting gifts from clients (Knox, S., et al, 2009). Although the American Counseling Association (2014) provides limited guidance, they encourage counselors to consider the following factors when deciding whether to accept gifts from clients:
- Current therapeutic relationship
- The monetary value of the gift
- Customer’s motivation for giving a gift
- Your motivation behind wanting to accept gifts from customers
In addition, the American Counseling Association’s 2014 Code of Ethics mentions the importance of “recognizing that in some cultures small gifts are signs of respect and gratitude.” This is a key component to include in your decision-making process. For some, the acceptance of gifts is determined on a case-by-case basis, while some professionals may have strict policies regarding the acceptance of gifts. Considering the expectations of your work environment can also be a contributing factor. Continue reading to learn more about whether mental health professionals can accept gifts from their clients.
What is considered a gift?
Before we get into the different ways advisors can handle gifts, it’s important to understand what a gift is. Perhaps you’ve already thought of a situation or experience where you received a gift from a customer. If you’re considering something, take the time to think about the recommendations offered by the ACA’s Code of Ethics. Do you stand by your decision to accept or reject your client’s gift?
Gifts can be handmade items or notes or purchased goods that can range in monetary value. You might have a customer bring you a cup of coffee, give you a gift card, take a picture, or knit a scarf. Common times for clients to offer gifts include holidays and special occasions for the advisor, such as getting married or having a baby.
A 2009 study examined 9 situations in which clients gave gifts to their advisors (Knox, D., et al, 2009). The results of this study showed that most of the gifts given were of low monetary value or handmade. Additionally, these gifts are chosen and/or designed so that the client feels as if the consultant will appreciate or enjoy the item.
For this study, there was no evidence of malicious or manipulative intent behind the gift giving.
Can therapists accept gifts from patients?
If you find yourself wondering “can therapists accept gifts”, remember that there are no direct guidelines for Counselors when it comes to accepting gifts from clients. In the meantime, Consultants should take the time to review all relevant information when deciding whether to accept a gift.
Historically, there were three common responses when a client gave a gift to their advisor (Knox, S., et al, 2009). One option is to have a strict boundary where the therapist accepts no gifts. This may be the result of an employer policy or a personal boundary. Choosing not to accept any gifts may be done with the intention of maintaining professional boundaries.
The second option is to determine how to respond to small gifts on a case-by-case basis. When this happens, Consultants often take the time to learn what made the client buy the gift and what the gift means to them. Giving a gift can be a sincere way for a client to show their appreciation for the work they were able to do with the consultant. While there are some situations where gift giving may have an alternative motive that may be harmful, this does not appear to be a common reason for a client to give a gift. The bottom line is that while we may believe we know why a customer is offering a gift, the truth is that we don’t pretend to know their true motivation. This shows the importance of having an open and honest conversation with your customer.
A third position for clinicians may be to accept gifts more often than others when the gift is appropriate. This means that the factors identified by the 2014 American Counseling Association code of ethics are verified and will not harm the therapeutic relationship. Accepting gifts from clients can enhance the client’s sense of self and demonstrate the humane side of counseling.
What would be the effect of refusing a gift?
Therapists’ refusal to accept gifts can have a negative impact on the therapeutic relationship. For example, if you have a client with interpersonal problems and no healthy relationships in their life, they may perceive this as an act of rejection and non-acceptance.
It’s important to consider other personal aspects of your client to determine whether refusing a gift could do more harm than good. Looking at Counselors who work with children and teenagers, you may be given a drawing or painting by your client. It would be important to think about how the child or teenager would take this action and whether they would have the ability to understand the reasons for not accepting the gift.
If you’re thinking about turning down a gift from a customer, try to take some time to examine what’s bothering you. Does the gift have a high monetary value? Are you concerned about the motivation behind the customer’s gift? Interested in a gift that you don’t think is appropriate for a counseling relationship? Or are you worried about accepting gifts in your role as a clinician?
If you feel that the best practice in your situation is to decline the gift, it is important that you discuss this openly and honestly with your client. We’ve mentioned that this can harm the therapeutic relationship, so be careful with the words you use and how you explain your decision. You can express gratitude and appreciation that they are thinking of you and let them feel like they want to share the gift with you.
Understanding Your Personal Boundaries
If you like to take the initiative, before you find yourself in this situation, take the time to think about how you would act in a situation where a customer shares a gift with you. It can be helpful to talk to your colleagues and supervisors about their experiences and how they handled similar situations in the past.
Choosing to accept a gift from a client can sometimes feel like a tug of war in our minds. You may have been told at some point in your education or career that clinicians should not accept gifts. However, you can think of scenarios where accepting a gift could actually benefit the customer. As the ACA’s code of ethics states, in some cultures, gifts are a sign of gratitude.
Once you have an idea of what you feel your boundaries are for accepting a gift from a patient, you can begin to think about how you can incorporate those boundaries into your work.
This could be working on a professional statement reviewed during your first meeting or talking to your clients when you feel it would be appropriate.
When the day comes when the customer offers you a gift, you need to include it in your documents. Your notes can include what the gift was, how the customer presented the gift, your decision to accept or decline the gift, and any relevant conversations that took place.
Final Thoughts on Receiving Gifts from Clients in Therapy
Since consultants work with little or no rules regarding the acceptance of gifts, our professional judgment will be an invaluable tool in dealing with this situation. When we look at the three approaches counselors take to accepting gifts, the common theme is to discuss the gift with your client.
You have probably learned, and perhaps experienced, that the therapeutic relationship plays an important role in our client’s progress in treatment. Their relationship with us creates an environment where they feel safe to talk about their challenges and be vulnerable. Keeping this at the forefront of your mind will help you manage your gift-giving experience.
As always, if you are not sure how to proceed, ask your supervisor or colleague for support. We may understand our limits before we find ourselves in this situation, but we may feel differently when we are actually in this situation. Consulting with other professionals can help us balance our instincts and thoughts so we can determine how we want to move forward.
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Resources:
- American Counseling Association (2014). 2014 ACA code of ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf
- Knox, S., DuBois, R., Smith, J., Hess, SA, & Hill, CE (2009). Experiences of gift giving customers to therapists. Psychotherapy: Theory, Research, Practice, Training, 46(3), 350–361. https://doi.org/10.1037/a0017001
