Factors associated with acceptance and decline of client gift giving.

Abstract

Client gift giving is an interesting interpersonal event, and scholars have considered the ethical and clinical complexities involved in receiving gifts from clients. Attention to the cultural relations of client gift giving invites a more nuanced discussion of psychologists' decisions to accept or decline client gifts. In recognition of how cultural issues affect the therapeutic relationship, the American Psychological Association has instituted guidelines regarding multicultural competence and has urged psychologists to practice in a culture-centered manner. This article reviews the ethical decision making of 40 licensed psychologists to accept or decline gifts from clients. Results indicated that psychologists were more likely to accept gifts from clients when the gift was inexpensive, informed by cultural context, and presented with gratitude for good work at the end of psychotherapy treatment. Psychologists were more likely to decline gifts that were expensive, were presented during treatment rather than at the end of treatment, and had sentimental or coercive value. Two psychologists indicated they would not accept client gifts because they perceived gift acceptance to be a violation of their code of ethics.

Clients’ experiences giving gifts to therapists.

“…We note, however, that some literature (Brown & Trangsrud, 2008;Knox et al, 2003;Kritzberg, 1980;Spandler et al, 2000) has suggested that gifts given during therapy (and not at termination) may be viewed by therapists as more problematic than those given at the end of therapy. Here again, then, emerges an intriguing difference between clients' and therapists' perceptions, although we acknowledge that the findings did not arise from matched therapist-client dyads: Clients saw no inherent difficulty in a nontermination gift, instead viewing it as an opportunity to express their appreciation for the therapy endeavor (Hundert, 1998); many therapists, in contrast, apparently consider such gift-giving timing troubling.…”

“…The nature of the reported gifts is consistent with those noted by Knox et al (2003) and Spandler et al (2000), who also found that clients frequently gave handmade gifts. We note that when clients were directly asked why they gave gifts to therapists, simple appreciation was the predominant reason, a finding empirically echoed in Knox et al (2003) and theorized in Brown and Trangsrud (2008). Intriguingly, then, clients' reports of their reasons for giving gifts appear to differ markedly from those offered by therapists.…”

“…Gerson and Fox (1999) surveyed 600 forensic professionals (MA, MD, MSW, PhD, PsyD) whose work demanded familiarity with the law (e.g., civil, competency, criminal, custody, workplace); respondents disapproved either somewhat or absolutely of five types of gifts (e.g., food, tickets to an event) and were neutral toward accepting a cupcake on a patient's birthday. In their study, Brown and Trangsrud (2008) found that 40 licensed psychologists were likely to accept client gifts that were inexpensive, reflected a cultural context, and were given at termination to express gratitude for successful accessed by following the link in the citation at the bottom of the page.…”

‘Not a neutral event’: Clinical psychologists' experiences of gifts in therapeutic relationships

“…Although gifts are mentioned within larger surveys of therapists' ‘boundary’ behaviours (Borys & Pope, 1989; Glover, 1955; Pope, Tabachnick, & Keith‐Spiegel, 1987), very little empirical research has been conducted solely into client gifting in therapeutic relationships (Knox, 2008). Only two such studies were identified: Knox, Hess, Williams, and Hill (2003) and Spandler, Burman, Goldberg, Margison, and Amos (2000), in addition to a study of therapist responses to hypothetical gift scenarios (Brown & Trangsrud, 2008). Research on gifting to other health professionals is not covered here for the sake of brevity (e.g., Drew, Stoeckle, & Billings, 1983).…”

“…In contrast to the surveys of therapists' past behaviour in relation to gifting, Brown and Trangsrud (2008) asked participants to respond hypothetically to vignettes. The therapists reported hypothetical acceptance of gifts that had a connection with the giver's cultural heritage or those offered at the end of therapeutic contact as thanks, but refusal of expensive gifts, those presented during treatment (rather than at the end), or those that appeared to have a coercive purpose.…”