The modern mental health professional must attempt to balance commercial versus ethical standards when it comes to marketing strategies and advertising one’s professional services.
There are inherent challenges related to being both a service provider and in many cases a business owner. This is particularly challenging if the mental health professional also practices other specialties such as a coaching (i.e. life, executive, health & wellness coaching).
Some therapists engage in specialties as wide ranging as financial therapy to subtle energy work. When we add new specialties, we must look into the ethics of that specialty area as well as to our own professions’ code of ethics.
I am a board certified coach as well as a licensed professional counselor. In my practice as a coach, my counseling code of ethics supersedes my coaching ethics. In other words, where there is a conflict…I always lean toward counseling ethics as the standard of practice.
The stakes are higher with regard to licensure and the responsibility I have as a person licensed by the state of Georgia to practice.
If you are a licensed or pre-licensed mental health practitioner, I highly recommend that you continue to stay informed about your ethical codes. Below are the links to the national ethical guidelines for several allied professions.
- The American Counseling Association’s 2014 Code of Ethics;
- The National Association for Social Workers Code of Ethics (revised 2008);
- The American Association for Marriage and Family Therapy Code of Ethics (revised 2012); or
- The American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (amendments 2010).
Of course there are many more ethical guidelines including substance abuse specialties, group therapy, christian counseling… too many to mention in this post.
Suffice it to say that if you have a license by your state to practice, you should be familiar with your state ethical codes as well as those codes that were most likely taught as part of your foundation in your graduate school ethics course.
If you are a licensed counselor, licensed social worker or licensed marriage and family therapist in the state of Georgia your state code of ethics can be found under the Rules and Regulations of the State of Georgia- Chapter 135-7.
Business ethical practices and professional ethical practices or standards may vary widely and lead to dilemmas centering around what Dr. William Doverspike describes in his book Risk Management: Clinical, Ethical, & Legal Guidelines for Successful Practice as “five common ethical dilemmas,” I refer to them as the “5 E’s”.
- Ethics versus Easy (Ethical actions can be more complex… whereas unethical actions are often easy.)
- Ethics versus Economics (Being ethical may not lead to immediate financial gain, but being ethical has long term benefits.)
- Ethics versus Expediency (Ethical actions can take longer to determine. When we move forward too quickly we may be acting from a sense of what appears to be practical, so we can put it behind us.)
- Ethics versus Extra-version (Our ethics can be challenged when faced with charming personalities. We must strive to maintain objectivity in our decisions and/or rationality in our actions.)
- Ethics versus Entertainment (Our ethics require us to put client privacy and safety above the entertainment value of their experiences and selves.)
I’ve recently learned from correspondence with Dr. Doverspike that in the 2015 edition of this text he added a 6th “E.” 6. Ethics versus Egocentrism. The latest edition of the book is available for purchase.
All too often, we are compelled to continue with or engage in practices that are not necessarily encouraged by our ethical codes. In my experience, these incidents stem from misinformation based on practices demonstrated by others one has worked for or others that one has observed in the field.
In other cases, the unethical practice is a borrowed practice from another industry and thus applied inaccurately or ineffectively in mental health.
The ethical concerns I am most interested in addressing involve the following:
- Offering payment, incentives or discounts for referrals from colleagues or clients.
- Misrepresenting ones credentials (academics, experience, or licensure level) to increase one’s appeal to the public or to colleagues.
- The use of testimonials to market one’s services.
As my interest lies primarily with Counselors, Social Workers, and Marriage and Family Therapists, I will focus largely on those three professional identities.
1. Offering Payment, Incentives or Discounts for Referrals:
- The ACA Code of Ethics states in code A.10.b Unacceptable Business Practices- Counselors do not participate in fee splitting, nor do they give or receive commissions, rebates, or any other form of remuneration when referring clients for professional services.
- The NASW Code of Ethics states in code 2.06 (c) Referral for Services- Social workers are prohibited from giving or receiving payment for a referral when not professional service is provided by the referring social worker.
- The AAMFT Code of Ethics states in code 8.1 Financial Integrity- Marriage and Family therapists do not offer or accept kickbacks, rebates, bonuses or other remuneration for referrals. Fee-for service arrangements are not prohibited.
If you have a related specialty that employs more commercial or business ethical standard,it is vital that you consider that “wherever you go and whatever you are doing,” you still maintain a professional license as long as you maintain a professional license.
That being said, even if you warn people that you are not practicing in the context as a therapist, it does not mean those ethical guidelines no longer apply to your practices. Nor does it mean people will not still view you that way.
2. Misrepresenting One’s Credentials
- The ACA Code of Ethics states in code C.4.d. Implying Doctoral-Level Competence– Counselors clearly state their highest earned degree in counseling or a closely related field. Counselors do not imply doctoral-level competence when possessing a master’s degree in counseling or a related field by referring to themselves as “Dr.” in a counseling context when their doctorate is not in counseling or a related field. Counselors do not use “ABD” (all but dissertation) or other such terms to imply competency.
- The NASW Code of Ethics states in code 4.06 (c) Misrepresentation Social workers should ensure that their representations to clients, agencies, and the public of professional qualifications, credentials, education, competence, affiliations, services provided, or results to be achieved are accurate. Social workers should claim only those relevant professional credentials they actually possess and take steps to correct any inaccuracies or misrepresentations of their credentials by others.
- The AAMFT Code of Ethics states in codes 9.5 Educational Credentials- Marriage and family therapists claim degrees for their clinical services only if those degrees demonstrate training and education in marriage and family therapy or related fields. 9.8 Correction of Misinformation- Marriage and family therapists correct, wherever possible, false, misleading, or inaccurate information and representations made by others concerning the therapist’s qualifications, services, or products.
Recently I’ve noticed an increase in people listing Marriage and Family Therapy Certificate behind their name. I understand that to mean that the person has completed the MFT courses that support them in pursuing a MFT associate or full license.
However, due to the wording it could be perceived as a MFT certification. A certification is an entirely different matter than completion of coursework related to MFT theory and practice. Furthermore in this context, it could be misconstrued as a professional license by professionals and by the public.
I believe it is vital to be honest with colleagues and with the public about one’s credentials. This means taking steps to address information in your credentials that could be misconstrued.
3. The Use of Testimonials to Market One’s Services
- The ACA Code of Ethics states in code C.3.b. Testimonials-Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial.
- The NASW Code of Ethics states in code 4.07 (b) Solicitations- Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client’s prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.
- I did not find a specific AAMFT standard regarding the use of testimonials. To see an overview of Principle VIII Advertising view the AAMFT Code of Ethics.
It is not at all unusual to see client testimonials used for marketing all types of services. I have seen them in hospitals with images and quotes from the patient or patient’s family. The key component to using testimonials ethically is that you don’t solicit them.
Which means you should not ask clients for them. You may feel the client is perfectly empowered to say “no.” However, due to the power differential in the therapeutic relationship, the client may very likely not feel comfortable saying “no” to their therapist.
It may be more complex.
It may cost more money.
It may take longer.
It may be less exciting.
It may be less entertaining.
And lastly, it may not be about you. Doing what is ethical is about what is best for the client.
Copyright © 2015 Ruby Blow. All rights reserved.
American Association of Marriage and Family Therapy (2012, July). Code of Ethics. Alexandria, VA: Author. Retrieved from https://www.aamft.org/iMIS15/AAMFT/Content/legal_ethics/code_of_ethics.aspx
American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author. Retrieved from http://www.counseling.org/resources/aca-code-of-ethics.pdf
Doverspike, W.F. (2008). Risk Management: Clinical, Ethical, and Legal Guidelines for Successful Practice. Sarasota, FL: Professional Resource Press, Inc.
National Association of Social Workers. (approved 1996, revised 2008). Code of Ethics of the National Association of Social Workers. Washington, DC: Author. Retrieved from http://www.socialworkers.org/pubs/code/default.asp