Managing Negative Feelings Towards a Client

Ideally our personal likes and dislikes should not enter into the professional/client relationship. (See my earlier blog on personal bias)  However, realistically that is not going to happen and from time to time we may have a client who evokes negative emotions. The client could be loud, overbearing, rude, insulting to us personally, constantly late and non-apologetic. They could remind us of someone for whom we have similar feelings. They could have a strong body odour, as example. Ultimately though it’s not what provoked these negative feelings, it’s what we do next.

Think of negative emotions on a sliding scale from mild irritation to profound dislike. In all likelihood, when feeling mild irritated or perhaps even more than mildly irritated, it may not be too difficult to keep these feelings from leaking into the relationship with our clients. However, we need to be alert to little clues that our irritation is not as well contained as we thought or hoped. Little clues could be such behaviours as consistently shortening the time that  we spend with this client, keeping the client waiting, delaying or not responding to messages, letting a bit of subjectivity creep into our documentation or charting, as example.

Recognizing that this is occurring is the first step. For once we recognize what we are doing, we can them move to rectify or correct. We may be able to do this on our own and perhaps from time to time we may need assistance.

Needless to say, profound dislike is at the top end of the negative emotions scale. When emotion is this intense the potential for harm to the client escalates for it is very difficult to keep this degree or depth of emotion in check. The impact on the client is best summed up by the lawyer of the “despised” client. In the article he stated, “It is impossible, in my view, to represent his interests when I despise him” and went on to say, “Even if I do my best to maintain my professional obligations to represent him professionally and vigorously, I know that sub-consciously I cannot do so because I want him to go down, so to speak.”

What Are Our Professional Obligations to Our Client?

So this brings us back to the question, do we have a professional obligation to “hang in for the duration”? If we feel mild irritation towards a client can we transfer them to another professional?  If we have intense negative feelings can we? Should we?

To answer these questions, we need to go back to one of the core ethical principles that frame our work, our fiduciary duty. That is, we have a duty to deliver the professional services that we promised our clients and within the expected professional standards. In part, this means that we treat all clients equally and in an unbiased, non-judgemental manner.  And we should be able to conduct ourselves in this manner with all clients. That would include clients whose behaviours or actions start to push our negative feelings up the emotional scale.

Ultimately, seeking transfer of a client is not to be taken lightly. Nor as a professional can we simply abandon our clients for continuity of care cannot be ignored. We need to weigh the impact of harm on the client should we continue against the degree or severity of our personal bias, our negative feelings. Consultation is critical as is knowing relevant laws, statues, regulatory standards and organizational policies. And from time to time, in the course of consultation a decision may be made that yes, in fact it is in the client’s best interests to transfer their care to a professional who is able to hold the client’s needs primary  while being “free” of personal bias.

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Professional Ethical Obligations

There is an increased dynamic tension between the professional and their client when the professional applies their skills and expertise in a for-profit environment. For there is an inherent conflict of interest or two “competing” interests – that of the client’s assessed needs and dollars. As such, the professional’s ethical obligation to ensure that their client’s needs come first is exceptionally high, and their recognition, understanding and acceptance of their ethical obligation and the reasons for it critical.

Obviously many professionals who work in the for-profit environment consistently manage this dynamic tension exceedingly well. Whether they are functioning as individual practitioners or are the owner/operator of an organization. This is not to say that they may not struggle from time to time however.  And needless to say, there may be a few who are not fully aware of the “competing” interests before them at all and unfortunately, a very few who are aware and choose to ignore their ethical obligation to their clients in favour of profit.

Establishing Professional Boundaries

So what tools are there to help manage this delicate balance?  While by no means exhaustive, here are a few.

• Education to increase awareness of the issues,
• The use of examples /scenarios that relate to and reflect  day to day experiences  so that theory is married to practice,
• Education on the applicable regulatory authority’s standards, guidelines  addressing conflict of interest as example,
• Development of a conflict of interest policy and corresponding procedures,
• On-going discussions to keep the professional’s ethical obligations and reasons for it explicit in day to day thinking and actions using such forums as supervision, team discussions, brown bag lunches and so forth,
• Consultation for professionals in private practice with no or limited access to supervision,
• Self-directed “study” for professionals in private practice,
• Consistent application of a decision-making framework to address real, potential or perceived conflicts of interest.

Whether working in a for-profit or not-for-profit environment, we need to be fully aware of our professional code of ethics and obligations. And in the for-profit world, I suggest that we need to be hyper alert to our ethical responsibilities given the inherent conflict of interest between protection of the public interest and profit.

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Managing Personal Bias in Professional/Client Relationship

Framing these concepts within our professional obligations both to protect the public interest and to ensure that our client’s needs are primary in the professional/client relationship, the introduction of our personal biases into that relationship becomes problematic. For when this occurs, our clients’ needs are no longer front and centre.

In fact, it is our personal interests that take centre stage. And whether our personal biases take centre stage for the duration of our professional relationship with the client or for only a brief moment in time, the focus is now all about us.  Unfortunately, the consequence of this shift may be potential harm to our client.

What Personal Bias Looks Like

So what could personal bias look like?  As example, it could be shortening  treatment time so you get to go home early, not addressing an issue with a “difficult” client so you do not have to deal with the resulting behaviour, influencing a client’s decision to the option that you feel is best, going along with a client’s request because you don’t want to hurt their feelings or because you don’t know how to say “no”, not agreeing with a particular organizational policy or standard  or part of the policy or standard and doing what you think is more appropriate  or abusing your clients for financial, emotional or physical self-gain.

Harm Caused By Personal Bias in Professional/Client Relationship

And what could be the harm caused?  As example, the client does not receive the amount of professional time “promised” resulting in lengthened recovery,  the unaddressed issue becomes a bigger issue with increased impact on client/family members/community, the influenced decision not yielding the results that the client expected or anticipated and the upset/angry client or family’s response being  “but you said…”, or agreeing to a client’s request  by stepping outside your professional strengths/skill sets with inadvertent harm caused because you are operating from a position of professional weakness.

Ultimately, we need to be aware that from time to time our personal biases may leak into our relationships with our clients. We may be tired, in a rush, have a difficult client, simply want to “help” a particular client for whom we feel sorry or we have strongly held religious, political, or other beliefs that interferes with our ability to be professionally neutral, as example. 

Recognizing Personal Bias: Assessing Professional Actions, Behaviours and Communication

So how will we know if this occurs? The following series of questions encourages critical reflection and can be used in a self-reflective mode or in discussion with supervisors and/or colleagues. The first is “Whose needs are coming first, mine or my client’s?”

Getting to the root of this question requires amongst other things a strong self-awareness of our personal values and beliefs in addition to our professional strengths and weakness. It requires an honest assessment of our professional actions, behaviours and communication. In other words is there a professional rationale for what we said or did that is grounded in theory and practice or are we attempting to justify what we said or did in an attempt to “get ourselves off the hook”.  

For one of the questions that we are trying to answer is, “What did I or what will I gain at my client’s expense, if anything?” And the final critical question we need to ask is, “If I have gained or will gain personally, at what cost to my client?” In other words, what is the harm caused?  

Can you think of a time in your own practice or area of work that your personal bias leaked into your professional/client relationship? What happened as a result? And what did you do?

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Understanding Professional Boundaries Policies and “Rules”

Both statements underscore a hard core reality in the professional/client relationship. That expected professional behaviours are articulated by laws, statues, regulatory bodies and organizations and the interpretation of these articulated professional boundaries are filtered through the professional applying them.

The expected professional behaviours could be the manner in which informed consent is obtained, the requirement to maintain confidentiality of client information and what limits, if any, there are to that confidentiality; defining  what constitutes conflict of interest such as receiving gifts from clients,  how and what constitutes documentation of the professional/client interaction and so forth.

Maintaining Professional Boundaries

So you may have one professional who follows “the rules”, one who may not know that particular “rule”, one who may like most of “rule” but not all of it, one who in a lapse of judgment inadvertently or purposefully ignores  or forgets “the rule” or one who purposefully chooses not to follow ”the rules” for their own particular reasons.

In other words, some element of who the professional is as a human being will have some impact on their interpretation of “the rules” that guide their professional behaviour. The degree of “leakage” of who the professional is as a person on the professional decisions that they make will vary; and may vary from time to time with the same professional dependent upon their fatigue, stress and any number of other factors. As a result and dependent upon the professional, the professional boundary may or may not be maintained to the degree expected or required. The “leakage” of personal views into the professional/client relationship introduces the boundary concept of personal bias.  

Human Factors That Comes Into Play In Professional/Client Relationships

Breaking it down a bit further, consider these human factors that come into play at any given point in any given professional/client relationship.

§  As the professional, do we know “the rules”?

§  Do we understand “the rules”,

§  Do we accept “the rules”?

§  Do we abide by “the rules”?

A weakness in any one or more of the four factors may compromise the application of the rule and therefore may compromise the professional boundary itself.  And of course the other factors that come into play are;

§  As the professional, do we recognize the times that we need assistance?

§  Do we feel comfortable in seeking that assistance?

§  And from time to time when we feel that “the rule” does not work well in practice, do we speak up in an appropriate manner to the appropriate person or body, if this is at all feasible?

Occasionally, we may feel that there are too many “rules”. And from time to time even, we may forget their purpose. This too is the human element.

However, as professionals our prime mandate is to protect the public interest. In other words, to ensure that there is a safe connection between us and our clients and to ensure that this safe connection pivots around the clients’ needs not our own.  And we need to maintain the public trust that we are in fact keeping their needs primary. (See June blog on the issue of trust). Therefore, we need to know ourselves and how our own human factor comes into play when it intersects with directives and guidelines that govern our professional behaviours.

© NCA Associates 2011

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Trust in Professional/Client Relationship

I speak, write and provide training on professional boundaries and have done for a number of years.  The article prompted the writing of this blog as I do not believe that we talk enough about the issue of trust in any professional/client relationship. Yet trust is fundamental to that relationship. Regardless of profession; whether you are a priest, physician, lawyer, allied health professional, teacher, firefighter or police as example.

Trust is an interesting dynamic. For one, it is usually implicit.  Generally, a client assumes that the professional is trustworthy by virtue of the position that they hold. And generally, there is an assumption that the professional will “do good and not cause harm” in the services that they provide.

However, trust is fluid as it is relational. So that we, the professional can have trust; we can lose trust; we can damage trust. And once lost, trust is difficult sometimes impossible to regain.  Trust can be lost as the result of grievous acts such as sexual abuse; and trust can be lost or damaged in the course of seeming simple day to day interactions with clients. Can you think of a time where you said or thought; “But I didn’t mean that” as a result of a client comment?

Relational Nature of Trust

Having trust; losing trust or damaging the trust can be broken down into a simple chain of events;

Our Intentions (our purpose, aim or objective) Our Act (what it is we do, say or imply) the Consequence to our client (impact, result or effect)

The difficult aspect of this fluid and relational nature of trust is that the intent of our actions and the impact experienced by our client may be very different.    

And real, potential or perceived, the impact experienced by the client becomes their reality. And from this interpretation of our intent, the client will like what we did or said; be upset by what we did or said; be shaken, devastated or angry by what we did or said, or be neutral or indifferent about what we did or said.  Some may choose to complain about our actions. Some may not.  Some may at a later point. Some may behave differently. Some may stop coming altogether. And we may never know why and as a result, we are unable to address; clarify; apologize or “fix”.

Maintain Trust

That being said, I believe that we need to take the implicit nature of trust and make it explicit in our professional thoughts.  In other words, we should be cautious about assumptions of trust.  Rather we should keep foremost in our professional thinking that clients give or place their trust in us. Their trust that we will “do good”; their trust that we will not cause harm; and the trust that we will keep their needs primary in the services we provide.  And we need to remain vigilant in our actions and our words that we maintain that trust.

© NCA Associates 2011

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