Building Therapeutic Relationships with Clients: What to Consider.

When building relationships with clients, as regulated professionals, solo practitioners are in a unique position of trust, power and influence.



It is for these reasons that a great deal of responsibility and attention needs to be considered on the nature of the relationship you build with your clients.

Following are best practice considerations  based on the stage of such relationship:

Accepting Clients

Accepting or refusing clients must be based on the ability to provide safe, competent and ethical care based on the client’s health-care needs. 

As a regulated professional, make sure to practise within your standards of practice, but more importantly, within your individual competencies. There may be cases in which you need to care for someone in a collaborative way with another health care provider to meet the client’s need.

Refusing Clients

You have an obligation to provide safe, competent and ethical care to your clients.  The circumstances acceptable for refusing care provision are limited.

Any decision should be considered using an ethical problem-solving approach, as a way to consider the care factors that are relevant and to decide if it is within your scope of practice.

You cannot refuse a client if, for example, their care would be too time-consuming for you or the complexity of care that is within your competencies is too troublesome.  Refusing to enter into a therapeutic relationship because the client’s health issues are complex does not meet the standards of practice.

You may ethically and correctly refuse to accept a client when the required care is beyond your competencies or scope.

If a client requests written confirmation that you are willing to accept them as a client, you must provide this.  There is a right for clients to know why care is refused. Although, you must use your judgement to consider if revealing this information will threaten the mental or physical safety of the client or others.

Ending a Therapeutic Relationship

The therapeutic relationship is built on trust, respect and professionalism. The client must be aware that the nurse visit is professional and not social.  Outlining the therapeutic nurse-client relationship in writing at the start may help prevent possible conflicts.

You must have reasonable grounds to end a therapeutic relationship, such as:

The client

  • poses a risk to other clients, staff or yourself
  • is abusive
  • refuses to respect professional boundaries
  •  behaves inappropriately
  • Or you need to cease urgently due to illness or urgent circumstances.

When deciding to end a therapeutic relationship, you must notify the client or their representative.   Have reasonable grounds for doing so. Consider documenting the reasons on the client record.

Disclaimer: This information is provided in an attempt to heighten sensitivity, increase awareness, and enhance judgments on this topic. We encourage our audience to contact their regulatory body or legal advisor to learn more. CompanyOn does not represent or speak on behalf of any regulatory body. 

At CompanyOn, we’re committed to supporting our community of solo practitioners, no matter the stage of their enterprise. If there are topics you would like us to discuss as part of our newsletter, please send us know via our social media.

Related Resources:

British Columbia College of Nurses and Midwives

College of Nurse of Ontario

College and Association of Registered Nurses of Alberta

College of Licensed Practical Nurses of Alberta

College of Registered Nurses of Manitoba

College of Licensed Practical Nurses of Manitoba

Canadian Nurses Association

Canadian Nurses Protective Society

Canadian Association of Foot Care Nurses

Best Practices On Risk Management and Quality Assurance For Solo Practitioners

It is important for regulated solo practitioners to be committed to ongoing quality improvement and risk management of their practice. Ensuring the safe and effective provision of care services is paramount for the establishment, maintenance, and growth of any business.

One key step to accomplish this is committing to developing policies and procedures that address risks and quality assurance of your private practice

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