Do therapists in India follow a code of ethics?

In the absence of a centralized code of ethics, it's up to a client to be informed about what is acceptable

Sriranjitha Jeurkar

Many countries across the world have a set of ethics or guidelines that are mandatory for therapists and counselors to follow. The code of ethics supports both the practitioner and the client by:

  • Laying out guidelines for the engagement

  • Helping both define the boundaries of the relationship, and

  • Establishing physical and emotional safety for both.

In India, though, there is no governing body or uniform rule of ethics that are in practice. This means that many people who begin consulting a therapist don’t know what due processes need to be followed, and what is not advisable.

White Swan Foundation spoke to some practitioners to understand what code of ethics or guidelines they follow in therapy.

In the beginning:

  • In the first session, your therapist will tell you what you can expect. They may ask you to fill in some paperwork to understand your medical or mental health history, and tell you about their approach.

  • In the first few sessions, your therapist may help you understand your situation and clarify your goals from therapy, so that both of you are aware of what you are working towards.

  • Your therapist will be clear with you about their areas of specialization. They will inform you that if they don’t have the skills or capacity to support you fully, you  may be referred to another mental health professional.

  • Therapy is often non-directive. You as the client have full autonomy over the therapist's decisions. The therapist functions as a reflection space or someone who supports you in gaining clarity.

  • Your professional will offer you an emotionally safe, empathetic and non-judgmental listening space.

  • All your conversations with your therapist are confidential. The therapist does not share them with anyone else - including your friends and family. However, if your therapist has enough reason to think that you are in a position where you may harm yourself or others, they may share this with your family or with other mental health professionals, for your safety. This is something your therapist will tell you, ideally in your first session with them.

As a helpline, we are aware that our only interaction with the client is through technology. We do not make diagnoses, screening, or recommendations on the phone. What we will do is suggest that the person consider consulting someone else who can help. We then connect them to on-the-ground services as required - therapists, special cells, legal aid, NGOs or hospitals.
Tanuja Babre 
program associate, iCALL Psychosocial Helpline, Mumbai

What’s not okay:

  • Any quick fixes suggested by therapist in the first couple of interactions. A therapist takes time to get the full picture and understand what the possible method of therapy and outcomes can be.

  • Being offered advice or ready solutions, or being told what decisions to take.

  • Being blamed, criticized or shamed for your emotions, your identity, your experiences or your choices.

  • Information or details about your conversations with your therapist being shared with your friends and family without your consent.

If you’re considering going into therapy, it’s important you keep this in mind and talk to your therapist if they’re doing something differently.

At the same time, it’s important to go with your own impression of whether your choice of therapist is working for you.

  • Do you feel safe enough to share with them after a few sessions? (Often, it takes a few initial sessions to build rapport.) 
  • Do you have a sense that they’re listening to you with openness?

At any point, if something feels uncomfortable, you have the right to speak up and ask your therapist to tell you why they’re doing what they’re doing. And if the discomfort persists, it may be time to evaluate whether this relationship is working for you and supporting you in addressing your mental health issues.

 

A big no for me is this: I don't provide documentation that I can't stand behind (I have been asked for letters on the first session to provide a diagnosis or at times say that I have seen the client for ongoing sessions when I haven’t done so) so that the individual can go back to work after a medical leave. This is a strict no-no in terms of protecting the therapist's own ethical responsibilities: Only report what you have actually done.

Dr Divya Kannan,
Clinical Psychologist, Bangalore

As a therapist, and someone who offers online counseling, I’m clear about what I can and can’t take on. Certain conditions such as schizophrenia have physical manifestations that need medication and perhaps other support as well. Then, I have to clearly state that online intervention by itself won’t work. I make sure to recognize my own limits and make referrals to other professionals if necessary.

Scherezade Siobhan,
Psychologist, The Talking Compass

Also read: What are the rules of engagement between a therapist and a client?