Professional Boundaries for Natural Medicine Practitioners - Case Study Example

Year: 2008 Title: Critical Analysis of the Client-Practitioner Relationship Case Studies Michael Wacheke Date: 29th October 2008 Case Study 1: A case of professional boundaries. Michael, who is a practitioner at the naturopathic clinic that Julia attends for dietary sessions, should not tell Julia about his personal life. He should not also accept to catch up with Julia after work. This would be crossing professional boundaries and since Michael has known Julia through his profession, he should only maintain the client-practitioner friendship. This friendship should only involve talking about Julia’s weight loss and Michael should be concentrating on her health progress only. Michael should be formal in the way he speaks to Julia and since they are in a formal setting, it will be hard for Julia to start a discussion on the personal and social issues (Voloudakis 2000). This is because social relationships cause undue discomfort and they affect the professional relationship (Benjamin & Moe p.156). The main ideas that are involved in this issue are mainly the maintenance of a dual relationship and the commitment to professional work as well as to the social relationships. This revolves around the levels of trust and how trust is affected when the client knows more about the practitioner. It also involves a balance between the level of care that should be shown by the practitioner to the client and the quality of the service delivered after the client and the practitioner are socially involved. How should the practitioner respond to Julia’s advances? He should respond in a friendly but stern manner telling the lady that he can not go past his professional boundaries to catch up with Julia after work. This response should be polite to avoid disappointing Julia. It should be in a way that will make Julia continue with her dietary session attendance at the clinic. It should be stern to show Julia that Michael is serious with his work and he does not intent to have any relationship beyond the consultations at the naturopathic clinic. He should also discuss about his relationship with his clients to avoid such occurrences. Confronting the issue is the best way to avoid a similar occurrence later on. It is an open way of solving the problem and since it is done in a friendly manner, it does not affect the professional relationship between the practitioner and the client. It is also important that the practitioner creates a level ground where the client is free to make suggestion that involve professional practice and this gets rid of the fear that both parties could be having of being misinterpreted (Gottfried 1998 p. 103). What are the issues around maintaining professional boundaries and dual relationship for natural medicine practitioners? The issues that exist around maintaining professional boundaries and dual relations for natural medicine practitioners are mainly based on extreme levels of trust. These are cases where the medical practitioner is exposed to too much of the client’s personal life which leads to the practitioner getting hooked to it. This could first come sympathetically when the client discloses discomforts that they have experienced in their personal life. While the practitioner is trying to help the client to come into terms with the situation by accepting and forgetting their past, they also become involved. This makes them to call and check on the client and to email the client which shows extra levels of concern. This is very dangerous in a client-practitioner relationship since it should only be professional. When the practitioner calls the client or discusses social issues with the client, they send the wrong signals to the client and this affects the professional relationship and it could later result to hurting the client. The other issue that affects maintenance of the professional boundaries is personal interests. In this case, Julia is a model so she could be really attractive. If Michael gets distracted by his personal interests like having an attractive lady for a close friend, they could end up having a social relationship just as Julia’s moves are suggesting. This will in turn affect their professional relationship since instead of spending more time on the dietary issues and the abnormal weight loss they will be discussing social issues. This will eventually affect Michael’s professional attention to Julia and it could result to non-performance. There are exceptional cases where a social relationship could improve the professional attention towards the client since the practitioner does not want to lose the credibility they have from the client. Such cases where there are dual relationships require high levels of maturity and both parties should always communicate to ensure that there exists trust (Benjamin & Moe p.156). Critically discuss academic literature around issues of professional boundaries and dual relationships in relation to this case In the book Social Work Practice by Gottfried, the author talks of various things that could affect the professional client-practitioner relationship and in this case, when Julia and Michael become social friends, there are fears that arise and these kill or weaken the professional friendship. This is a negative effect of having social relations with clients. A research conducted by the American public health association gives an in-depth report on the issues of mutual participation models and the effects on both the practitioner and the client made Michael Voloukadis to write a paper on the same. He recommended that formal attire, language and the setting do not give room for mutual participation of the client while the practitioner is attending them. Instead, the discussion revolves around the client understanding their health condition and the treatment both mental and physical and also on the research. The client would participate in making suggestions of the next treatment sessions (Voloudakis 2000). I suggest that Michael should confront the issue. He should politely discuss the effects of getting socially involved with a client. These include poor professional follow-ups since when they become socially close, Julia might decide to hide some medical problems she is facing for the sake of their relationship. Discussion is the only way that Michael will be doing ethical practice of his duties and since he will confront the issue in a friendly manner, Julia will appreciate the concern and when she is made to understand and to see the social and professional boundaries she will be at ease to tell Michael any professional problem that she faces and also any progress. Case Study 2: Case of anger management. Terry is an unappreciative client who does not consider that the musculoskeletal therapist is going out of his way by accepting to attend to him even when he arrived twenty minutes later. He is rude since he argues his case of improper treatment in a provocative manner that suggests that the musculoskeletal therapist is not as professionally fit as his previous therapist. Though the musculoskeletal therapist is in line of duty, they have gone an extra mile in treating a patient who arrived late for their appointment. The anger in this case is mostly as a result of the doctor’s prior refusal to attend to Terry. It gives Terry a bad attitude towards the therapist such and he prejudges that the professional performance of the therapist is also that strict. This raises the anxiety in Terry and when the massage starts, he is not patient enough to wait for the massage to end, instead he complains when it is going on and even accuses the therapist of poor treatment. On the other hand, the therapist’s attitude is right at first when he allows to treat the patient after some negotiations. When the patient becomes, stubborn the therapist is angry since they are making a time sacrifice in treating a client who is not appreciating. The main issues here are the delivery of quality service on unappreciative clients and the anger management of both the client and the practitioner. How should the therapist proceed in this situation? The therapist should ignore the patient and proceed with the treatment though they should work faster so that they can catch up with their schedule. The therapist should try and make the client understand that in medical practice; musculoskeletal therapists undergo the same training hence their treatment is the same. He can also try calming Terry by explaining the treatment process and by sharing information on how the massage works and how treatment is administered; Terry is likely to stop complaining. He could also give Terry something to distract his attention from the treatment like a soft drink or a magazine and when Terry’s temper has cooled down, he can start a friendly discussion. The therapist should confront the issue of poor treatment and solve it instantly to stop the client from undermining their work. It calls for the skills for working while facing differences between the client and the practitioner (Gottfried 1998 p. 103). How might the therapist manage their own anger? The therapist should control their anger by understanding that the client is bitter. They should not be affected by the client’s attitude. They should face the anger positively by treating Terry in a way that they will feel relieved after the session. This could change Terry’s attitude towards the therapist. The therapists should avoid the feeling of frustration which is common in most of the patient therapies. The issue of time and appointments is set by the institution where the therapist works. It is not in his control to change the policies hence when the client is angry and they could not make to go for the appointment on time, they therapist should ignore such a matter (Munson 2002, p.292). When one party is feeling vulnerable, it is wise to get rid of such a feeling by creating a connection that is shared by both the client and the practitioner and this improves the service offered by the practitioner. This will make the client feel that the practitioner is caring about their condition. It also allows the client to give the practitioner a chance to perform and they can later judge the service after the practitioner’s performance and completion (American Psychiatric Association 2004). How might the therapist assist Terry to manage his anger at the time of the session and also in the future? The therapist should tell Terry to wait until the session is through and then he will judge the treatment from his results. This will make Terry’s anger reduce with the hope that he will feel better. The therapist should also create a good rapport with Terry like discussing a favourite topic that also interests Terry. The therapist should address the issue about anger and also inform Terry of the effects of anger like the Early Cardiovascular disease. Terry is prone to such a disease at his early age if he continues having that attitude. Since anger is natural, the control is also natural and it should be addressed by both the practitioner and the client and in this way the can avoid the effects of anger like Early cardiovascular disease. If the anger is excessive it is also advisable to check in for an anger management therapy (Liebert 1994 p. 359) Critically analyse the academic literature around anger management and relate the findings to this case. In the Ethics of Touch by Benjamin and Moe, the authors give a balanced approach to the issue of angering and undermining clients. They offer tips that the practitioner should use while handling a client to reduce the anxiety and the tension that is usually in a patient’s mind. These include introducing the client to the practitioners operation step by step by informing the client on how the practitioner handles interruptions and also talking about the process that will take place and this reduces the anxiety of the patient. It also creates a free environment between the client and the practitioner. In this case, if the therapist too sometime to discuss the treatment with Terry, maybe they would have had a better session. The book insists in communication between the client and the practitioner before and while conducting the procedure. If the therapist talked about the massage with Terry, Terry would have waited until it was over before complaining. This means that Terry would not have uttered the undermining words to the therapist like he did and so the therapist would not have been angered. It also insists on the alertness of a practitioner on any hindrance that would affect the relationship of the client and the practitioner and anything that would make the client change their attitude towards the practitioner. I suggest that the practitioner should always be ready to face angering situations when at times the client undermines them. They should try and make the client to understand their profession and the practises and an orientation is a good way of solving the problem. References Michael Voloukadis 2000, mutual participation models and the client-practitioner relationship: a public health research dilemma, available from: http://apha.confex.com/apha/128am/techprogram/paper_8656.htm B E Benjamin and C S Moe 2004, The Ethics of Touch, Lippincott Williams and Wilkins, Philadelphia K S Gottfried 1998, Social Work Practice, Pine Forge Press, California C E Munson 2002, Handbook of Clinical Social Work Supervision, Haworth Press, Haworth American Psychiatry Association 2004, Practitioner Relationships and Quality of Care for Low-Income Persons with Serious Mental Illness, available from: http://www.library.uwa.edu.au/education_training_and_support/guides/harvard_citation_style M A Liebert 1994, Alternative and Complementary Therapies, Mary Anne Liebert Inc P. 359. Read More