COTBC’s Patient Relations Program is anchored on the principles of trust and respect, two elements that are basic to any therapeutic relationship.
COTBC’s Patient Relations Program helps both patients and occupational therapists understand the need for these professional boundaries, as well as how to consistently maintain them.
Trusting Your Occupational Therapist
You should trust that your occupational therapist is using their professional knowledge, skills, and abilities to provide you with safe, effective, and ethical care. However, sometimes it’s difficult to know what to expect. The occupational therapist may have explained the proposed care, and answered questions, but it may be all new to you.
You have the right to understand what your occupational therapist is recommending and why. It’s okay to ask them. You can also ask them to stop their care or services at any time.
Showing Respect for Patients
Occupational therapists must recognize your vulnerability and not take advantage of it to meet their own needs. It is the occupational therapist’s responsibility to act in your best interests at all times. They must do this by maintaining professional boundaries.
This means that they only provide services that are within their role as your occupational therapist in the therapeutic relationship. They shouldn’t be doing things you would expect from a friend, family member, or someone else who might normally help you.
The Occupational Therapist’s Responsibility
Occupational therapists are responsible for anticipating, establishing, maintaining, and communicating appropriate professional boundaries with their patients. It is their responsibility to prevent boundary crossings and, where a boundary may be crossed, to take appropriate action to correct the issue.
Occupational therapists show respect for you by maintaining professional boundaries, safeguarding your autonomy and dignity, and acknowledging their own position of power. By doing so they earn and maintain your trust.
Examples of Inappropriate Conduct
The examples below show how easily professional boundaries can be crossed or become unclear. Have situations like this happened to you, either as a patient or as an occupational therapist?
As a patient…
“My occupational therapist suggested I contact her husband who is a real estate agent to help sell my condominium. It was such a relief as I have no family here to help me. A few days later when I told my son he was furious. I hadn’t thought how this might benefit the occupational therapist financially.”
— Occupational Therapy Patient
“I knew an occupational therapist personally and I wanted to hire them to help me with my rehab. They said they couldn’t because of our personal relationship and referred me on to another occupational therapist. I don’t understand why they didn’t agree to treat me. I was ok with it.”
— Member of the Public
As an occupational therapist…
“It felt like the client was always standing just a little too close to me. When he commented on the smell of my hair, I became even more uncomfortable.”
— Occupational Therapist
“I was going to the post office anyway. It seemed natural to offer to mail the client’s letters for her. The next week she asked me to deposit a cheque for her. The boundaries were becoming unclear.”
— Occupational Therapist
More Resources & Information
The College has many resources available to help ensure a safe and healthy therapeutic relationship.
These include the College’s Code of Ethics as well as practice standards for:
You can also explore the College’s library of other resources, including:
- Webinars on client autonomy, duty of care, consent, professional boundaries, and conflict of interest
- Case studies on conflict of interest and consent
- Information on the complaints process, including a video
- A College Communiqué titled Sexual Misconduct: What You Should Know
Your Voice Matters
COTBC’s Patients Relations, Standards, and Ethics Committee actively seeks to expand on these resources and make recommendations regarding educational programs and training for College staff and occupational therapists. By doing so, they meet the requirement under the Health Professions Act “to establish a patient relations program to prevent professional misconduct of a sexual nature” (s. 16(2)). COTBC’s Bylaw 21(2)(a) expands on this requirement and states that its Patient Relations Program includes:
- requirements for educational programs for registrants on professional misconduct of a sexual nature,
- guidelines for the conduct of registrants with their patients, and
- provision of information to the public regarding the college’s complaint and disciplinary process.
If you have questions, concerns, or suggestions about the College’s Patient Relations Program, or about any of the resources shared on this page, please email firstname.lastname@example.org.