Tips for giving and receiving gifts from clients

Some tips for gift giving and receiving:

• Clinically and ethically appropriate gifts from clients should generally be inexpensive.
• Appropriate therapists' gifts to clients may include:
  • A symbolic gift (e.g., a card that has meaning to the client)
  • A gift that serves as a transitional object (e.g., a rock from the office rock collection)
  • A clinical aid (e.g., a note from the therapist with a specific saying, as a way to help a client who is dealing with anxiety)
  • Therapy-related educational materials (e.g., a CD on mood swings for a patient who was diagnosed with bi-polar disorder)
  • An affirming or acknowledging gift (e.g., a small or symbolic graduation or wedding gift) following social convention 
  • A supportive, reassuring gift (e.g., giving a flashlight to a child-patient who is going on his first overnight camping trip) 
  • An affirmation of the relationship (e.g., a small/symbolic souvenir from a trip abroad) 
• Gifts can be appropriate or inappropriate in regard to their type, monetary value, timing, content, intent of the giver, perception of the receiver, and their effect on the giver or the receiver.  
• Therapists do not need to always explore the meaning of the gifts with clients. Sometimes just a simple "thank you so much" is sufficient. 
• Timing of gifts is important. While an appropriate present at termination is common, a present at the very beginning of therapy may need more careful examination.
• Examples of unethical and clinically inappropriate gifts include: 
  • Gifts for referrals of new clients 
  • Investment or stock market tips or financial loans 
  • Excessive gifts, gifts from a client who has a history of buying love 
  • Expensive gifts from wealthy clients
  • Gifts with sexual connotations 
• Sometimes inexpensive gifts can be unethical if they are inappropriate or offensive.
• Therapists should consult with experts when they receive gifts in a client's will upon the death of the client. 
• Document all gift exchanges in the clinical records. If possible, greeting cards, paintings, poems, etc. could be part of the clinical records. Articulate, briefly, who gave the gift, exactly what the gift was, what the response to the gift was, and any related discussions with the client. When appropriate, add a clinical note in regard to your thoughts and interpretation of the meaning of the gift. 
• Consult in complex cases and document the consultation in the clinical notes.

Taken from Zur Institute training on Gifts in Psychotherapy
www.zurinstitute.com/giftsintherapycourse.html