Conflict of Interest

The issue of conflict of interest is central in all therapeutic practice and service delivery in the human services field. Practitioners must know how to manage themselves and the situation when they have an ‘interest’ in a client related matter. 

In the Bower Place Complex Needs Clinic this is especially important as clients agree to be recorded and observed so they need to be 100% confident that observers to the consultation unequivocally have their best interests at heart. It is crucial that all those involved in the therapeutic process, as either practitioners in the room or observers, have no additional undeclared interest in the matter or the client. 

What is an interest? An interest is when you have a pre-existing relationship or knowledge of any kind with or about the client or someone closely connected to the client. 

An ‘interest’ is best thought about through the eyes of the client; how might your knowledge in this matter look from the client’s point of view? Imagine if you were the client or in the client’s position? Would you want someone with your knowledge about them observing the consultation and hearing the confidential information you disclose?  

To manage such an ‘interest’ it must be declared to either the CNC Manager, the teacher or practitioner for that case for them to decide whether your ‘interest’ constitutes a ‘Conflict of Interest’. 

What does it mean to have a ‘Conflict of Interest’? It means that your ‘interest’ in this matter conflicts in some way with the client’s interests in this matter. It may simply mean that you know this person and interact with them in a casual way, as a parent at your child’s school or a distant neighbour. However in being involved in their therapy you would then possess knowledge about them that they would not have otherwise shared and in knowing this your relationship with them will be effected. If the interest is not declared you will have as secret from them of which they are unaware.  

The CNC Manager, teacher or practitioner must decide whether this ‘Conflict of Interest’ is in fact ‘fatal’ meaning that your ‘interest’ in this matter makes your ongoing involvement impossible from the point of view of your therapeutic practice or case management. 

Impossible means that your involvement directly contradicts the express aims of therapy or case management in this matter. If this is the case you would need to remove yourself from the observation room and seek from your teacher specific instructions about your immediate actions and activities, especially if the client has already arrived. 

The general CNC position about any matter where there is a ‘Conflict of Interest’ is for this to be addressed directly with the client. This not only satisfies our requirements for total service delivery transparency but it also shifts responsibility for the resolution of this ‘Conflict of Interest’ into the hands of the client. This move underscores the significance of the relationship between ‘responsibility’ and ‘authority’ in the change process. Investing ‘responsibility’ and ‘authority’ in the client sharpens everybody’s thinking. In some cases, the conflict may be so clear and obvious that the CNC Manager, teacher, or practitioner will decide and ask the student to leave the session. 

Clients are often less troubled by ‘Conflict of Interest’ issues than we are and are less likely to declare a ‘Conflict of Interest’ fatal to their process. They are much more likely to be inclusive of that person rather than exclude, especially when the conflict involves knowing that person socially or as part of their school or helper system. Many clients welcome having someone present who can validate them and their account of life. Clients often want that person with the ‘Conflict of Interest’ in the consulting room so they can interact directly with them so therapy becomes a shared experience rather than a hidden observation. Under such circumstances the practitioner must also exercise their authority in relation to the therapeutic process and the role of the person with a ‘Conflict of Interest’.  

The central distinctions to be considered are:
1. Does the ‘Conflict of Interest’ come from a close relationship or does it appear out of a fracture in relationships?
2. How are relationships likely to be altered by the student or practitioner with the ‘Conflict of Interest’ continuing to participate in this process?
3. How strong is the client’s move toward inclusion and what would be their response if the practitioner and the CNC decided that this ‘Conflict of Interest’ could not easily be remedied?