Ethical Rules in Therapy: Client Rights and What a Therapist Should Not Do

What are the ethical rules in therapy? Read in plain language what to expect through confidentiality, informed consent, boundaries and client rights.

For someone starting therapy for the first time, many things can feel uncertain. What is discussed in a session, what should the therapist know and what should they not? How much can your therapist tell you about their own life? Can you send messages outside sessions? If you run into each other in the street, should they say hello? The answers to most of these questions lie in the principles known as the ethical rules in therapy. These principles are shaped not by the therapist's personal preferences but by standards set by professional bodies and by legal regulations, and their purpose, above all, is to protect the client. In this article I explain in plain language why ethical rules in therapy exist, what the core principles are, what your rights are as a client, and the boundaries you may wonder about where your therapist is concerned.

Why Do Ethical Rules in Therapy Exist?

Therapy is a special relationship in which a person shares their most vulnerable sides. Trusting the therapist, the client often tells them things they have never told anyone. This trust is the basic condition for therapy to work. But at the same time it creates a natural imbalance of power in the relationship: the therapist knows a great deal about the client, while the client knows comparatively little about the therapist.

Ethical rules exist to prevent this imbalance from being used against the client and to ensure that therapy proceeds on a safe footing. Professional bodies working in the field of mental health publish codes of ethics consistent with the principles of international organisations. These codes define the core principles that guide therapists' professional conduct.

The main aims of ethical rules are:

• To protect the client's safety and wellbeing
• To respect the client's autonomy and decisions
• To ensure that therapy stays focused on the client's needs
• To ensure that the therapist works within the limits of their competence
• To protect trust in the profession and in therapy

What Are the Ethical Rules in Therapy? Core Principles

Although the codes of ethics of different professional bodies differ in detail, the ethical rules in therapy are shaped around a few core principles.

Confidentiality

Everything discussed in therapy is confidential. Without your written or verbal consent, the therapist does not share information with your family, your employer, your school or any other institution. Session notes are stored securely.

Confidentiality has limited and defined exceptions: the life of the client or someone else being in serious and imminent danger, there being information that a child or someone in need of protection is being abused or neglected, and a legal obligation. These exceptions are usually explained openly in the first meeting. For detailed information, you can read the article on confidentiality in therapy.

Informed consent

Before starting therapy, you have the right to be informed about how the process will work, the approach that will be used, the length and frequency of sessions, the fee, cancellation terms, the limits of confidentiality and the fact that you can leave therapy whenever you wish. Understanding and accepting this information is known as "informed consent". Consent is not a one-off signature; it can be discussed again during the process whenever a new method or a change comes up.

Limits of competence

A therapist works only in areas in which they have been trained and are competent. When they encounter a situation outside their area of expertise, they refer the client to an appropriate professional. For example, psychologists do not prescribe medication; when it is thought that medication may be needed, an assessment by a psychiatrist is recommended. For the difference between these two professions, you can have a look at the article on the difference between a psychologist and a psychiatrist.

Respect and non-discrimination

The therapist adopts a respectful and equal attitude regardless of the client's gender, age, ethnic origin, faith, political views, disability, economic circumstances or lifestyle. They do not impose their own values on the client and do not judge the client's decisions.

Acting in the client's interest and doing no harm

Every intervention made in therapy should be for the client's benefit. The therapist avoids behaviour that could exploit the client, harm them or create dependency. Not continuing therapy for longer than necessary is also part of this principle.

Ethical rules are not a list that ties the therapist's hands, but an invisible framework that allows the client to speak safely.

Boundaries in Therapy: What Should a Therapist Not Do?

Boundaries in therapy keep the relationship professional and safe. Some boundaries may at first feel rigid or cold to clients; but each of them serves to keep therapy beneficial for the client. Within the ethical framework, some of the behaviours that are not expected of a therapist are:

• Forming a friendship outside sessions: the therapist does not become friends with the client on social media, go out for coffee with them or attend private invitations. This is not because they do not care about you, but so that the therapeutic relationship does not become muddled.
• Dual relationships: the therapist does not enter into a business partnership, commercial dealings or any other private relationship with a client. They also take care not to accept close relatives, friends or colleagues as clients.
• Seeking personal gain: the therapist does not obtain any financial benefit from the client beyond the session fee; they do not accept valuable gifts and do not use the client's information for their own interests.
• Bringing their own problems to the client: the therapist does not meet their own emotional needs through the client. If they share something from their own life, this is done only when it is thought to benefit the client, and it is kept brief. You can also read the article does a therapist talk about themselves on this subject.
• Making decisions on the client's behalf: the therapist does not make life decisions such as "Get divorced" or "Quit your job" for the client. They think through the options together and leave the decision to the client.
• Physical contact: physical contact is generally not part of therapy. Exceptional situations, such as during play when working with children, or a farewell that a client explicitly asks for and that is considered appropriate, are always handled with respect for the client's boundaries.
• Promising results: an ethical therapist does not make definite promises of outcome such as "You'll be better in three sessions"; they state openly that the course of therapy varies from person to person.

What Are Your Rights as a Client?

The ethical rules in therapy define not only the therapist's obligations but also your rights. As a client, you have the following rights:

1. The right to information: you can ask how therapy will work, which method is being used and why it is being used.
2. The right to ask questions: you can be curious about your therapist's training, experience and way of working, and ask about them.
3. The right to say no: you can decline an exercise, a piece of homework or talking about a subject. Saying "I don't want to talk about this right now" is entirely legitimate.
4. The right to confidentiality: you can expect what you share not to be passed on to others without your permission.
5. The right to end therapy: you can take a break from therapy or end it whenever you wish. Discussing this with your therapist helps with a healthy ending, but it is not compulsory.
6. The right to be referred: if your needs fall outside the therapist's area of expertise, you can ask to be referred to an appropriate professional.
7. The right to information about your records: you can find out how the records kept about you are stored and who can access them.

Do the Ethical Rules in Therapy Apply to Online Sessions Too?

Yes. Online sessions are subject to the same ethical principles as face-to-face therapy. However, the online process has some additional issues of its own:

• A secure platform: it is important that sessions are held on a secure platform that protects confidentiality.
• No recording: sessions are not recorded without the explicit consent of both parties. This rule applies to both the therapist and the client.
• An emergency plan: in online sessions, the therapist may want to know where the client is and someone who can be reached in an emergency. This is to ensure safety in a crisis.
• Privacy of the setting: the client choosing, during the session, a setting where others cannot overhear also contributes to protecting confidentiality.

In online sessions, practical matters such as the time difference, a dropped connection or a technical glitch are also expected to be discussed at the outset. For example, when it has been agreed in advance who will call whom if a session is cut off, and how a make-up session will be arranged, both sides know what to do in an unexpected situation. These small details help make the online process as predictable and safe as face-to-face sessions.

Ethics in Everyday Situations: Frequently Raised Examples

Ethical rules may seem abstract, but they often show themselves in small everyday situations. Below are some examples clients frequently wonder about:

What happens if I run into my therapist at the supermarket? This is quite likely, especially in small towns. Therapists usually leave it to the client to say hello first; that way the client does not have to explain to the people with them how they know the therapist. Whether or not to say hello is your choice.

Can I give my therapist a gift? On occasions such as a religious holiday or the end of therapy, a small, symbolic thank-you gift may be accepted by some therapists. Valuable gifts, however, are not considered ethically appropriate. When a therapist does not accept a gift, it is important not to take it as a personal rejection.

Can I message my therapist outside sessions? This depends on the arrangement made at the start of therapy. Many therapists keep contact between sessions limited, apart from appointment changes. The purpose of this is to keep therapy taking place within sessions and to avoid an expectation that the therapist is always reachable.

Can my therapist follow me on social media? Ethically, it is recommended that therapists do not connect with their clients on social media. This is to protect confidentiality and to keep professional boundaries clear.

What happens if someone in my family calls my therapist and asks for information? With adult clients, the therapist does not give information without your consent; they may not even confirm that you are their client.

Let's say a young university student wants to see the same therapist that their mother has been seeing for years, on her recommendation. The therapist gently explains that working individually with two people from the same family could create difficulties in terms of confidentiality and impartiality, and suggests a colleague to the young person. Although the young person feels rejected at first, they later realise that this decision was actually aimed at protecting their own space.

If You Think You Have Experienced an Ethical Problem

If you feel that something in therapy is bothering you, the first step is usually to talk about it openly with your therapist. Very often a misunderstanding or a difference in expectations can be cleared up by talking. Asking questions about ethical matters is an entirely legitimate thing to do in therapy.

However, if you believe your confidentiality has been breached, that the therapist has crossed boundaries or that they have behaved in a way that harms you, you always have the right to leave therapy. In such situations you can apply to the management of the institution the therapist is affiliated with or to the ethics committee of the relevant professional body, and seek legal support if necessary. If you ever feel you are in danger, do not hesitate to call 112 (emergency services).

It is also worth remembering that not every situation that makes you uncomfortable means an ethical breach. A decision the therapist makes to maintain a boundary, such as not accepting a gift or ending the session on time, can feel hurtful at first. Talking about these feelings in therapy both strengthens the relationship and helps you understand better why the boundaries exist.

How Is an Ethical Therapeutic Relationship Built?

In individual therapy, ethical principles are often present, invisibly, at every step of the relationship. In the first meeting, confidentiality, boundaries, fees and cancellation terms are discussed. As therapy progresses, goals are reviewed regularly, and new methods are tried with the client's consent.

In structured approaches such as cognitive behavioural therapy, this transparency is particularly evident: the therapist explains what the technique they are using is and why it is being suggested, and the client takes part in decisions as an active partner in the process. In approaches that place the relationship more at the centre, such as schema therapy, the therapist being warm and supportive within boundaries can create a safe experience of limited reparenting for the client; but this warmth too always stays within the professional framework.

To uphold ethical principles, therapists receive supervision, continue their professional development and consult colleagues when they face difficult situations. Knowing this framework as a client also helps you start therapy with more confidence and express yourself more comfortably during the process.

Frequently Asked Questions

Can a therapist record my sessions?

A therapist cannot make audio or video recordings of sessions without your explicit consent. If a recording is to be made for a purpose such as supervision or training, its purpose, how long it will be kept and who will have access to it should be explained to you in advance, and your consent obtained.

Can my therapist talk about their other clients?

No. A therapist does not share the identity of other clients or information that would make them recognisable. Sometimes they may give a completely anonymous and general example to explain a point; but such examples are presented in a way that makes no one recognisable.

Can my therapist object when I want to end therapy?

The therapist can share their view about ending therapy, for example by pointing out that there are subjects that have not yet been worked on. But the decision is yours. Within an ethical framework, the therapist respects your decision and, if necessary, directs you to other resources.

What do ethical rules say about fees?

The session fee and cancellation terms should be discussed openly before therapy begins. The therapist is expected not to ask for additional fees that were not discussed beforehand partway through the process, and to give advance notice of any change in fees.

• #professional ethics
• #client rights
• #confidentiality
• #therapeutic boundaries

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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