Patient Relations Program

COTBC’s Patient Relations* Program helps both patients and occupational therapists understand the need for professional boundaries. Understanding more about the therapeutic relationship and boundaries can help prevent emotional or physical harm to a patient. This includes harm caused by an occupational therapist’s professional misconduct of a sexual nature.

As a patient has something like this happened to you?

“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.” —a client

“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.” —a member of the public

As an occupational therapist has something like this happen to you?

“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.” —an 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.” —an occupational therapist

If you have experienced similar situations to these, likely a professional boundary was crossed or becoming unclear.

 

COTBC’s Patient Relations Program is anchored on the principles of trust and respect, two elements that are basic to any therapeutic relationship.

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

The examples above show how easy the boundaries can be crossed. It’s the occupational therapist’s responsibility to prevent these but if they do occur, to correct them. Occupational therapists show respect for you by acknowledging their own position of power, maintaining professional boundaries, and by safeguarding your autonomy and dignity. By doing so they earn and maintain your trust.

Where Can I Find More Information?

The following resources are available on this website.

The Code of Ethics

Occupational Therapy Practice Standards for:

Webinars on client autonomy, duty of care, consent, professional boundaries, and conflict of interest.

Case studies on conflict of interest and consent (TBD).

Information on the complaints process, including a video.

A College Communiqué titled Sexual Misconduct: What You Should Know

*The word “patient” is used here to support consistency with language presented in the Health Professions Act. In this instance, “patient” is synonymous with “client”.

 

Feedback Welcome

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.

Questions? Email practice@cotbc.org