Therapeutic Relationships
- The therapeutic relationship is the relationship between a regulated member and a client.
- The therapeutic relationship is different from a personal relationship:
- The client’s needs must be considered first and foremost.
- The therapeutic relationship has three key components:
- An inherent power imbalance between the regulated member and the client,
- A foundation of trust, and
- Respect for all clients and their autonomy.
- Boundaries set limits on the therapeutic relationship to avoid crossing into a personal relationship.
- It is the responsibility of the regulated member to establish and maintain professional boundaries with clients.
- Boundary crossings are any behaviours that compromise the professional nature of the therapeutic relationship.
- Boundary crossing can have serious impacts on the therapeutic relationship.
- Examples of boundary crossing include giving and accepting gifts, treating family and friends, and unprofessional behaviour on social media.
- Regulated members should take steps to address suspected boundary crossing, including reflecting on how the boundary crossing occurred, taking steps to re-establish or terminate the therapeutic relationship as necessary, and documenting the actions that led to boundary crossing and steps taken to address the boundary crossing.
- Clients may challenge professional boundaries; it is the responsibility of the regulated member to take steps to ensure boundaries are explicitly expressed and maintained.
Trauma Informed Service Delivery
- Trauma is defined as an event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening, with lasting effects on the individual’s functioning and mental, physical, emotional, or spiritual well-being.
- ACSLPA regulated members do not provide services to treat trauma directly or specifically. However, they can incorporate trauma-informed practices into their service delivery.
- Trauma is common and often undiagnosed.
- Individual, contextual, and environmental factors impact the effects of traumatic events on an individual.
- Members of marginalized groups have a disproportionately higher prevalence of trauma than the general population.
- There are many types of trauma: natural or human-caused; individual, group, community and mass trauma; interpersonal trauma, developmental trauma, political terror and war; and retraumatization.
- The experience of trauma can have immediate and long-term effects on an individual’s emotional, physical, cognitive, behavioural, and existential domains of life.
- The effects of trauma may show themselves in clinical interactions with clients.
- Trauma informed care considers the pervasive nature of trauma and promotes environments of healing and recovery rather than services that may inadvertently retraumatize.
- There are five core principles of trauma-informed care: safety, choice, collaboration, trustworthiness, and empowerment.
- When responding the trauma disclosure or reactions, practitioners should be mindful of: maintaining confidentiality, acknowledging and checking in, listening and validating, and maintaining their scope of practice and referring when appropriate.
Professional Communication
- According to the national Competency Profiles for SLP and Audiology, regulated members are expected to:
- Communicate respectfully and effectively using appropriate modalities, and
- Establish and maintain effective collaborations to optimize client outcomes.
- Communication practices are regulated under the ACSLPA Standards of Practice and Code of Ethics.
- It is the responsibility of the regulated member to be aware of the minimum requirements for practice with respect to communication.
- Ineffective professional communication is a major source of complaints to the College.
- Professional communication is particularly important for
- Obtaining informed consent for services
- Providing client-centered services
- Collaboration with clients and any others involved in care
- Fees and billing
- Written communication
- Terminating services