Are Gifts for Therapy Clients Ethical?

Practitioners don’t often discuss gifts for therapy clients, but does that mean you should give something special to your clients or accept anything from them?

You’re a very giving person. If a friend invites you to their home for dinner, you bring a nice bottle of wine. You’re the very first person to donate—both financially and your personal time—to your children’s school events, and now, you’re considering purchasing small gifts for therapy clients in your private practice. Your heart is in the right place. You’re proud that they’ve been working so hard on their goals, and you want to give them something tangible to use as a motivator to keep them meeting any outcomes.

But you’re worried a purchased gift may be unethical. Would something homemade be fine to give? There’s nothing wrong with sharing your freshly baked chocolate chip cookies, right? Maybe, if you get the same small token for all clients, gifting will be ethical. But, wait. Before making any decisions about whether to give—or just as importantly, whether to accept—gifts in your private practice, consult your association’s ethical guide.

What are gifts for therapy clients?

Gifts come in many different shapes, sizes, or appearances. For example, they may be symbolic, such as a donation to a charity in your client’s honor (keeping it confidential of course) or they may be concrete, such as music or a book. Gifts may be simple, like homemade cookies or grandiose, such as tickets to a sporting event. Also, remember that anything can be interpreted as a gift, which is why it’s important always to consider intention when giving anything to a client. A simple mix CD that you think will assist as a therapeutic tool may be seen as a personal gift in their eyes.

Gifts for referrals

If you’re worried about a waning list of active clients, but don’t think your marketing strategy is up to par, you might consider giving gifts to individuals who successfully refer new clients into your practice. Stop. Don’t do it. Gifts to a business or individual who refer new clients to your practice are viewed as unethical transactions.

Zur Institute states, “Gifts made in response to referrals of new clients have also been frowned upon and viewed as unethical conduct and a conflict of interest that should be avoided.”

Consult the Associations’ Codes of Ethics Regarding Accepting Gifts

In an issue of the American Psychological Association’s (APA) Monitor, Ethics Committee member Neil Massoth, Ph.D. states that the ethical code does not explicitly say whether gifts are appropriate, though it does provide some guidance. He suggests referring to Standards 3.06 and 3.08 when considering whether accepting a gift would do harm. Similarly, it’s important to consider cultural factors, referring to Principle E on respecting the dignity of others.

Similar to the APA, the Code of Ethics for the National Association of Social Workers does not directly address gifting in a therapeutic relationship. However, in an article for Social Work Today, Frederic G. Reamer discusses the implications and ethical responsibilities social workers have regarding gifting, but suggests documenting everything, regardless of whether or not the gift was accepted (or given by you). He also suggests that social workers in group practices consult with their peers. If they do decide to accept a gift, show appreciation on behalf of the entire group.

The American Counseling Association addresses gifts directly in their Code of Ethics. Section A.10.f. States, “Receiving Gifts: 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, the client’s motivation for giving the gift, and the counselor’s motivation for wanting to accept or decline the gift.”

Standard 3.9 of the American Association for Marriage and Family Therapy Code of Ethics addresses gifts directly. “Marriage and family therapists attend to cultural norms when considering whether to accept gifts from or give gifts to clients. Marriage and family therapists consider the potential effects that receiving or giving gifts may have on clients and on the integrity and efficacy of the therapeutic relationship.”

Before deciding whether or not your private practice will give or accept gifts, it’s best to consult with your associations’ code of ethics. You’re also encouraged to check your state laws, as some states may impose legal limits on the dollar value of gifts a therapist might give or receive. Then, be sure to document any situation in which a gift is involved, regardless of whether or not you’ll accept or give the gift.

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What your your thoughts on gifts for therapy clients – or from clients? Share your thoughts in the comments.

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