Responding Professionally to Clinical Conflict and Ethical Dilemmas

Transcription

1 World Massage Conference Presents: Responding Professionally to Clinical Conflict and Ethical Dilemmas with Pamela Fitch Photo credit: Ima Ortega This seminar is based on content from Chapter 5, Talking Body Listening Hands. Cover photo: Ima Ortega Learning Outcomes At the end of this seminar, participants will be able to: Describe common causes of treatment room conflict Assess treatment room risks and safety issues Respond professionally when faced with conflict or ethical dilemmas 1

2 Key concepts: Ethical dilemmas Treatment room conflict Aggression and abuse Professional responses Apology and assertion Point to ponder: What kind of situations would challenge you in practicing professionally, regardless of personal beliefs? Common sources of treatment room conflict Thoughtlessness Assumptions Transference Expectations for sex Karen Munro Caple. 2

3 Treatment Room Conflict Causes Ethical Dilemmas Conflicting situations Challenge a commonly understood code of conduct No easy or right answer What makes ethical dilemmas challenging? Conflicting beliefs Hidden values Charged emotions Unacknowledged power differential Personal reactions and professional role Personal reaction depends on Beliefs, values and attitudes towards conflict. Professional response depends on acceptance of role. Photocredit: Ima Ortega 3

4 When faced with treatment room conflict Avoid exceptions to rules Beware of client games and manipulation Use plain language in addressing conflict The consequences are far more serious when therapists cause treatment room conflict Therapists put clients at risk when they: Indulge in countertransference Ignore boundaries and power differential Manipulate clients Abuse client trust Common responses to conflict Passivity Passive Aggression Aggression 4

5 Clients who are passive Say little Give no feedback May assume that the therapist knows more than they do May blame themselves for what occurs in the treatment room Photo credit: Ima Ortega Therapists who are passive: Simply agree that a treatment is poor Do not reflect on the reasons why Give the impression that they don t care Techniques that work: Apology I m Sorry. I was wrong when I I d like to make it up to you. 5

6 Passive aggressive responses I m fine! Passive aggression perpetuates secrets and lies It leaves the other person bewildered Supports gossip Passive aggressive clients May attempt to control therapists by Appearing annoyed yet say nothing Denying they are annoyed when asked 6

7 Passive aggressive therapists Increasing pressure Massaging more aggressively Suddenly behave coldly without explaining why When YOU behave passive aggressively Get some help : Counseling Coaching Psychotherapy Peer supervision Challenging passive aggression USE AN I STATEMENT: When you I felt. What I would like you to do is. 7

8 Aggression The act of initiating or attacking another person with intent to dominate, hurt or harm Explicit threat of consequences Most common form of treatment room aggression When clients: Seek sexual favors or sexual games Expose themselves Touch therapist Photo credit: Ima Ortega Point to ponder: If a client becomes aggressive, how will you get out of the treatment room? 8

9 Assessing Treatment Room Risks When clients threaten or intimidate If clients deliberately touch or grab you Avoid being cornered make sure you have an escape route 9

10 If clients obsess, follow or stalk Document behaviour Seek professional legal and security advice Report unwanted attention to the police Take precautions for your own safety If clients appear high, drunk or disorderly Leave the area of threat Avoid getting cornered If the client is aggressive, call the police When faced with client aggression Refuse treatment Speak clearly with authority 10

11 If aggressive behavior persists Discharge the client Report criminal behavior to the authorities Techniques that work: Assertion Describe Situation Explain Why It s A Problem Assert Your Position 11

12 References and Resources: Cartoon: Karen Munro-Caple. Used with permission. Photos credit: Ima Ortega. Used with permission. Fitch, P. (2015) Talking Body Listening Hands. Saddle River, NJ: Pearson. alking-body-listening-hands-a-guide-to- Professionalism-Communication-and-the-Therapeutic- Relationship/ page Talking Body Listening Hands, First Edition Pamela Fitch Copyright 2014 by Pearson Education, Inc. All Rights Reserved. 12