BILL ANALYSIS Ó
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THIRD READING
Bill No: SB 578
Author: Wyland (R)
Amended: 4/25/13
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEVEL. COMM. : 10-0, 4/22/13
AYES: Price, Emmerson, Block, Corbett, Galgiani, Hernandez,
Hill, Padilla, Wyland, Yee
SUBJECT : Marriage and family therapists: unprofessional
conduct
SOURCE : California Association of Marriage and Family
Therapists
DIGEST : This bill specifies that engaging in a dual
relationship with a client that is likely to impair the
professional judgment of the licensee or lead to exploitation of
the client will constitute unprofessional conduct.
ANALYSIS :
Existing law:
1. Provides for the licensure and regulation of marriage and
family therapists (MFT) by the Board of Behavioral Science
(BBS).
2. Makes the violation of the Licensed Marriage and Family
Therapist Act a misdemeanor.
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3. Authorizes the BBS to deny, suspend or revoke the license or
registration of a licensee or registrant if the licensee is
guilty of unprofessional conduct.
4. Specifies acts of unprofessional conduct.
This bill:
1. Provides that unprofessional conduct includes engaging in a
dual relationship with a client that is likely to impair the
marriage and family therapist's professional judgment or lead
to exploitation of the client.
2. Defines "dual relationship" as a separate and distinct
relationship between a marriage and family therapist and
his/her client that occurs simultaneously with the
therapeutic relationship or following the termination of the
therapeutic relationship.
3. Provides that if a relationship occurs and cannot be avoided,
a marriage and family therapist shall take appropriate and
culturally sensitive professional precautions, including
documentation of the dual relationship, to ensure that
his/her judgment is not impaired and that the client is not
exploited. A violation of this subdivision shall not be
subject to Business and Professions Code (BPC) Section 4983.
Background
Various mental health associations have an enforceable code of
ethics. Within the code of ethics are various standards and
principles that are intended to guide the practice of mental
health treatment. Among these, are guidelines for engaging in
dual or multiple relationships. Below are excerpts from two
mental health organizations' code of ethics relating to the
practice of marriage and family therapy:
I. American Association of Marriage and Family Therapists 2012
Code of Ethics
Definition of Multiple Relationships. Marriage and family
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therapists are aware of their influential positions with
respect to clients, and they avoid exploiting the trust and
dependency of such persons. Therapists, therefore, make every
effort to avoid conditions and multiple relationships with
clients that could impair professional judgment or increase
the risk of exploitation. Such relationships include, but are
not limited to, business or close personal relationships with
a client or the client's immediate family. When the risk of
impairment or exploitation exists due to conditions or
multiple roles, therapists document the appropriate
precautions taken.
II. California Association of Marriage and Family Therapists 2011
Code of Ethics
Definition of Dual Relationships . Marriage and family
therapists are aware of their influential position with
respect to patients, and they avoid exploiting the trust and
dependency of such persons. Marriage and family therapists
therefore avoid dual relationships with patients that are
reasonably likely to impair professional judgment or lead to
exploitation. A dual relationship occurs when a therapist and
his/her patient engage in a separate and distinct relationship
either simultaneously with the therapeutic relationship, or
during a reasonable period of time following the termination
of the therapeutic relationship. Not all dual relationships
are unethical, and some dual relationships cannot be avoided.
When a concurrent or subsequent dual relationship occurs,
marriage and family therapists take appropriate professional
precautions to ensure that judgment is not impaired and that
no exploitation occurs.
Definition of Unethical Dual Relationships . Other acts that
would result in unethical dual relationships include, but are
not limited to, borrowing money from a client, hiring a
client, engaging in a business venture with a client, or
engaging in a close personal relationship with a client.
California Board of Psychology . Unlike the licensing groups
regulated by the BBS, the Board of Psychology includes in its
practice act the American Psychological Association's (APA)
definition of dual relationships which is located in the APA
Code of Ethics:
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A psychologist refrains from entering into a multiple
relationship if the multiple relationship could reasonably
be expected to impair the psychologist's objectivity,
competence, or effectiveness in performing his or her
functions as a psychologist, or otherwise risks exploitation
or harm to the person with whom the professional
relationship exists. Multiple relationships that would not
reasonably be expected to cause impairment or risk
exploitation or harm are not unethical.
BBS Disciplinary Standards . Currently, the BBS has the
authority to bring disciplinary action against a licensee for
violation of its practice act. This includes committing
unprofessional conduct. The BBS indicated that a licensee who
engages in an improper dual relationship is subject to
disciplinary action under BPC Section 4982(d) gross negligence
or incompetence and/or BPC Section 4982 (1) intentionally or
recklessly causing physical/emotional harm to the client. If
the dual relationship involved sexual conduct, the BBS has
authority to discipline per BPC Section 4982 (k) sexual
relations with a client. The BBS also indicated, that with the
exception of one recent case involving an MFT, the current
statutory authority to take disciplinary action against a
licensee has been sufficient.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local:
No
SUPPORT : (Verified 4/25/13)
California Association of Marriage and Family Therapists
(source)
ARGUMENTS IN SUPPORT : According to the author's office, this
bill defines the kind of dual relationships that would
constitute unprofessional conduct and provides the BBS with
another, more direct, section of law to enforce. The author's
office believes if licensees are to be disciplined for engaging
in an improper dual relationship, there should be a definition
of the kind of conduct that is prohibited. They note, "The
language used in the bill represents a summary of the
long-standing and well-accepted definition of an unethical dual
relationship as defined in the ethical standards of the
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profession."
The bill's sponsor, the California Association of Marriage and
Family Therapists, notes that "The BBS takes many disciplinary
actions against therapists for engaging in dual relationships
yet there is no provision in BPC § 492 related to unprofessional
conduct that specifically addresses or defines a dual
relationship. The BBS usually charges licensees who are alleged
to have engaged in a dual relationship with gross negligence or
incompetence, both of which are serious allegations that have
the potential to damage a practitioner's reputation and
professional standing. Therefore, there is a need to better
define dual relationships and clarify when those relationships
should be considered unprofessional conduct. SB 578 would
accomplish these goals."
MW:d 4/26/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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