Professional Boundaries: Navigating Dual/Multiple Relationships

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Professional Boundaries:
Navigating Dual/Multiple
Relationships
Dan Yearick, LPC-S
• Dual or multiple relationships occur when
professionals assume two or more roles
simultaneously or sequentially with a person
seeking their help.
• The ACA Code of Ethics (2005) does not use the
terms “dual” or “multiple” relationships, but
rather refers to these relationships as
“nonprofessional interactions”, which do
not include sexual or romantic relationships.
Respond to:
It is not always possible for counselors to
play a singular role in their work, nor is
this always desirable. It is likely that
counselors will have to wrestle with
balancing multiple roles in their
professional and non-professional
relationships.
Some potentially problematic issues related to
multiple relationships:
• Whether to barter with a client for goods or services.
• Whether it is ever acceptable to counsel a friend or social
acquaintance.
• Whether to interact with clients outside the office.
• Whether it is acceptable to develop a social or business
relationship with a former client.
ACA Code of Ethics (2005)
“A.5.c. Nonprofessional Interactions or
relationships (other than sexual or
romantic interactions or relationships)
Counselor–client nonprofessional relationships
with clients, former clients, their romantic
partners, or their family members should be
avoided, except when the interaction is
potentially beneficial to the client.”
ACA Code of Ethics (2005)
“A.5.d. Potentially Beneficial Interactions
When a counselor–client nonprofessional
interaction with a client or former client may be
potentially beneficial to the client or former
client, the counselor must document in case
records, prior to the interaction (when feasible),
the rationale for such an interaction, the
potential benefit, and anticipated consequences
for the client or former client and other
individuals significantly involved with the client
or former client.
Such interactions should be initiated with
appropriate client consent. Where unintentional
harm occurs to the client or former client, or to
an individual significantly involved with the
client or former client, due to the
nonprofessional interaction, the counselor must
show evidence of an attempt to remedy such
harm. Examples of potentially beneficial
interactions include, but are not limited to,
attending a formal ceremony (e.g., a
wedding/commitment ceremony or graduation);
purchasing a service or product provided by a
client or former client (excepting unrestricted
bartering); hospital visits to an ill family
member; mutual membership in a professional
association, organization or community.”
• What ACA’s Code of Ethics (2005) does
NOT say:
-That all dual or multiple relationships are
prohibited.
• What ACA’s Code of Ethics (2005) DOES
say:
-A sexual/romantic dual relationship is always
unethical.
-Counselors must avoid relationships that are
harmful, exploitive or can negatively impact the
professional relationship.
Current codes of ethics no longer prohibit
multiple relationships. Instead the
emphasis has shifted to avoiding the
misuse of power and exploitation of the
client, and to acknowledge that some
nonprofessional relationships are
potentially beneficial.
Boundary Crossing vs. Boundary
Violations
• Boundary crossing: A departure from commonly
accepted practices that could benefit a client.
• Boundary violation: occurs when a professional misuses
his/her power, which results in harm or exploitation to
a client. A violation is a serious breech that is unethical
and often illegal.
• A rule-based approach to ethics prevents
counselors being creative in decision making.
Counselors must use their best judgment in
situations to determine if there is a potential for
harm or a misuse of power.
• Therapeutic multiple relationships are those in
which the counselor’s commitment to the best
interest of his/her client outweighs risk
management strategies aimed at protecting the
counselor.
Moleski and Kiselica (2005)
• Boundary crossings are not unethical; rather,
they often embody the most caring, humane and
effective interventions”.
• Dual relationships are neither always unethical
nor do the necessarily lead to harm and
exploitation, nor are they always avoidable”.
Lazarus and Zur (2002), Zur (2007)
Key Themes Surrounding Multiple Roles in
Counseling
• Multiple relationship issues affect all of us in the mental health
profession, regardless of our work setting or clientele.
• The professional code of ethics caution us about the potential
exploitation involved in dual relationships, and current codes
acknowledge the complex nature of these relationships.
• Multiple relationships cannot always be avoided; they are not
necessarily always harmful.
• Multiple role relationships challenge us to monitor ourselves and
examine our motivations for our practices.
• Whenever we consider becoming involved in a dual or multiple
relationships, a wise course is to seek consultation from trusted
colleagues or a supervisor.
• There are few absolute answers pertaining to the resolution of dual
or multiple relationship dilemmas.
• Cautions against entering into dual or multiple relationships should
be for the benefit of our clients or others served, rather than to
protect ourselves from censure.
• In determining whether to proceed with a dual or multiple
relationships, we need to consider whether the potential benefit
outweighs the potential for harm. To the extent possible, it is good
practice to include the client in making this consideration.
Herlihy and Corey (2006b)
Questions to ask
• Is entering into a relationship in addition to the professional one
necessary, or should I avoid it?
• Can this relationship potentially cause harm to the client?
• If harm seems unlikely, would the additional relationship prove
beneficial?
• Is there a risk that the dual relationship could disrupt the
therapeutic relationship?
• Can I evaluate this matter objectively?
It is good practice to discuss with the client the potential problems of
entering into a multiple relationship and to actively involve the
client in the decision-making process as fully as possible.
Younggren and Gottlieb (2004)
Safeguards & Risk-minimizers
•
Set healthy boundaries from the outset.
•
Involve the client in setting the boundaries of the professional or nonprofessional
relationship.
•
Informed consent needs to occur at the beginning of and throughout the relationship.
•
Practitioners who are involved in unavoidable dual relationships or non-professional
relationship need to be aware that, despite informed consent and discussion of
potential risks at the outset, unforeseen problems and conflicts can arise.
•
Consultation with fellow professionals can be useful in getting an objective
perspective and identifying unanticipated difficulties.
•
When dual/multiple relationships are particularly problematic, or when the risk for
harm is high, practitioners would be wise to work under supervision.
•
As a legal as well as an ethical precaution, professionals would be wise to document
any dual relationships in their clinical case notes (Including actions taken to
minimize risk of harm).
•
If necessary, refer the client to another professional.
Situation 1
You have been counseling an adolescent
for several months. Unbeknown to you,
your daughter is in school with your client
and they are working on a project
together. Your client is the “friend of mine
who’s coming to dinner tonight so we can
work on our project together”. As your
client leaves your office after a session she
states, “See you tonight at supper.”
Situation 2
Every morning for the past year you’ve
stopped at Starbucks for coffee on your
way to work. Almost every day the same
barista makes your coffee. Although only
on a first name basis, you’ve come to know
each other fairly well; you’ve discussed
your children, weekend plans, etc. You
enter the waiting room and are both taken
aback when you discover that he is your
new client.
Situation 3
You receive a phone call from an attorney who has a
practice in the same town in which you practice. He
regularly refers clients to you. Although you aren’t
“friends”, you have used him in the past for legal advice
and help and attend the same church. He is currently in
the midst of a crisis and wants your professional help.
When you suggest to him that he might be more
comfortable working with someone other than you, he
asserts that he has little trust for people in the
community, but does trust you. He also states that with
his busy schedule it’s not possible to travel outside of the
county for weekly sessions.
Situation 4
You are a counselor in full time private
practice. You also teach as an adjunct
instructor at the local university. When
you receive your class roster you notice
that one of your students is a long
standing client.
Situation 5
You are working with a 19 year old male.
Although not the primary issue for which
he sought counseling, a year ago his best
friend died tragically. Your client has
never been to the grave site and believes
that he must. He is unable to go alone,
with other friends or family. He has asked
if you would go with him.
References
American Counseling Association. (2005). Code of Ethics. Alexandria, VA: Author.
Herlihy, B., & Corey, G. (2009). Boundaries in Counseling: Ethical & Clinical Issues.
Hobart, NY: Hatherleigh Publishing company, LTD.
Herlihy, B., & Corey, G. (2006b). Boundary issues in counseling: Multiple roles and
responsibilities (2nd ed.). Alexandria, VA: American Counseling Association.
Moleski, S. M., & Kiselica, M. S. (2005). Dual relationships: A continuum ranging from
the destructive to the therapeutic. Journal of Counseling and Development. 83(1), 311.
Younggren, J. N., & Gottlieb, M. C. (2004). Managing risk when contemplating multiple
relationships. Professional Psychology: Research and Practice, 35(3), 255-260.
Zur, O. (2007) Boundaries in psychotherapy: Ethical and clinical explorations.
Washington, DC: American Psychological Association.
Zur, O., & Lazarus, A. A. (2002). Six arguments against dual relationships and their
rebuttals. In A. A. Lazarus & O. Zur (Eds.), Dual relationship and psychotherapy
(pp. 3-24). New York: Springer.
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