Barter

The Ethical Implication of Bartering for Mental Health Services: Examining Interdisciplinary Ethical Standards

“…Compounding this issue are the recent economic hardships and the increase in the unem-ployed that have resulted in many individuals in need of therapy but lacking the income or insurance to cover the expense of weekly therapy sessions. This has led some authors (Hill, 2000;Thomas, 2002;Zur, 2008) to contend that refusing to barter can be a form of discrimination that prevents all but the affluent from receiving the treatment they need.…”

“…Other authors (Croxton et al, 2002;Hill, 2000;Syme, 2006;Zur, 2008) mentioned the cultural implications of accepting barter. In some rural or agricultural communities, bartering with neighbors and with community professionals is common practice.…”

“…These precautions are consistent with the stipulations expressed in the ethical codes and are meant to protect both the client from potential exploitation and harm and the therapist from ethical or legal liability. Some of the general precautions include: 1) considering the potential complications as well as transference or countertransference issues that may arise prior to agreeing to the bartering arrangement (Zur, 2008); 2) engaging in open dialogue with the client about the risks and potential complications prior to an agreement (Thomas, 2002); 3) seeking agreement by both parties in the forms of a written contract outlining the bartering terms and an informed consent (Hill, 2000;Thomas, 2002;Zur, 2008); 4) involving the client as an active member of the negotiation process (Zur, 2008); 5) agreeing to revisit the dialogue openly at any point either party feels the terms of the agreement are not being satisfactorily met (Thomas, 2002); 6) declining barter opportunities with clients for whom present-ing concerns suggest the possibility of the presence of Borderline Personality Disorder (Zur, 2008); and 7) allowing the bartering arrangement to be openly and regularly scrutinized by the therapist's professional colleagues (Hill, 2000;Thomas, 2002).…”

“…bartering is both scarce and polarized, as most seem to think the practice either is ill advised and should be entirely avoided (Canter, Bennett, Jones, & Nagy, 1994;Gutheil & Gabbard, 1993;Woody, 1998), or has therapeutic potential that, when used sparingly, outweighs the risks (Croxton, Jayaratne, & Mattison, 2002;Hendricks, 1979;Hill, 2000;Syme, 2006;Thomas, 2002;Zur, 2008).…”