Background
Luna is an occupational therapist working with Rumel, a client trying to return to work after a traumatic incident. Rumel witnessed a pedestrian struck by the bus he was riding in. Rumel is now uncomfortable travelling by bus. He does not drive or own a car. He is working with Luna to manage his post traumatic stress disorder (PTSD) and has agreed to participate in exposure therapy.
Luna plans to meet Rumel at a bus terminal as part of the occupational therapy intervention. Rumel asks Luna if he can meet her at the clinic instead, and then they can drive to the location together. Luna is determining if she can use her vehicle to transport clients to a place for therapy purposes and reaches out to the College.
Practice Discussion
- Luna called the College and spoke with the Practice Consultant. They discussed:
- Concerns regarding safety, risk and liability for the client and the occupational therapist.
- Professional boundaries,
- Trauma informed practice,
- the expectations of the employer and third-party payers,
- personal and corporate vehicle liability insurance,
- any conflicts of interest that might arise (for example, managing reimbursement costs for travel), and
The practice consultant pointed Luna to the Standard for Professional Boundaries and the Prevention of Sexual Abuse, where the following indicators applied:
2.3 Maintain professionalism by limiting excessive sharing of personal information and consider how communication is being interpreted.
2.4 Avoid creating situations where dependencies develop between clients and the occupational therapist.
Luna understood that it was important to assist the client to consider alternate options (taxi or other ride services. Luna recognized she must mitigate all risks to the client and herself. Luna used the College decision-making framework and started a list of questions to work through to support her decision-making:
- How does the client access other appointments?
- Is the client able to arrange their own transportation?
- What processes are in place if a crisis or trauma is triggered during transportation?
- What happens if there is an accident while the client is being transported?
- What alternate treatment approaches might be considered in the event there is no taxi or ride services available?
Considerations
- The implications of transporting clients in personal vehicles
- Application of the Standards of Practice
- Decision-Making Framework
- Risk management
Outcome
- Based on the discussion, with the practice consultant Luna determined that it is not advisable to give the client a ride in their personal vehicle.
Conclusion
Occupational therapists are expected to take all reasonable measures to minimize risks in their practice. Transporting clients in personal vehicles carries an extremely high-level of risk.
In rare cases where an occupational therapist, through employment is required to transport a client, organizations will often have specific policies that clearly define what to do when therapists are asked to transport clients using their vehicles with established procedures, insurance requirements and protocols in an emergency. Documentation is important and should include the organization's policy about transporting clients, if applicable, and the rationale for transporting clients.
If the organization does not have policies or the occupational therapist works independently, develop a policy which includes what you do when asked to transport a client. The decision-making framework can assist with complex decision-making to identify available options to mitigate risks.
College Resources
Contact
If you have any questions about this case, or have any ideas or requests for future cases, contact the Practice Resource Service: 1-800-890-6570/416-214-1177 x240 or [email protected].
Want more case studies?
Sign up to stay up to date and receive the latest cases when they’re released.
← Back to Case Study Archive