Dual relationships exist whenever a therapist interacts with a client in any capacity beyond the one role as therapist, for example, also being their client’s teacher, consultant, business partner, or sexual partner. If you perform a role other than therapist for your client, it may introduce desires and goals that are yours rather than the client’s and can risk the possibility that you will place your needs above theirs. Maintaining unselfish judgment is critical to your role as an effective, professional therapist.
Why Should You Avoid Dual Relationships?
Dual relationships seriously risk distorting and/or eroding the therapeutic relationship. While they nearly always prove damaging to both the therapist and the client, dual relationships tend to be much more detrimental to the client, provoking such negative effects as:
- Interfering with or critically limiting the effective handling of such significant therapy relationship variables as transference.
- Exploiting the power differential inherent in the relationship between the therapist and their client to seduce or intimidate the client into a dual relationship. Addressing such exploitations can be much more problematic for the client than confronting problems with other issues, such as fees, since they must overcome both the power differential and transference to express and assert their own needs.
- Closing the door to the client pursuing needed therapy in the future.
Dual relationships usually have subtle, gradual, and innocuous beginnings and can be the consequence of the therapist’s inattention to the dynamics of the therapeutic relationship, or it could even stem from a genuine desire to provide additional help to the client. Dual relationships can also arise from a client’s own manipulation prompted by transference, pathology, or other issues.
Types of Dual Relationships
The many possible types of dual relationships can be simplified into the following three categories:
Examples of double roles include providing therapy for friends, social acquaintances, or business contacts; being a client’s therapist and their teacher, dissertation advisor, or research supervisor; having a sexual relationship with a current or former client; conducting any kind of business relationship with a current or former client (e.g. mentor, partner, co-author, consultant, lender, debtor, etc.); providing psychological services to children of friends, colleagues, employees, or frequent social contacts.
The term double professions applies to situations in which a therapist serves in a second professional capacity for their client, for example, practicing law, medicine, or financial advising without a license.
Double Financial Relationships
This type of dual relationship is defined by trading or bartering therapy for legal or professional services, goods, or discounts whether it’s determined by a dollar-for-dollar value or task-by-task basis.
Unavoidable Dual Relationships
Dual relationships are unavoidable in small communities, rural areas, or in the military. The APA ethics code addresses the issue of conflicting roles and recognizes that “in many communities and situations it may not be feasible or reasonable” (APA, 1992a, Section 1.17A) for a therapist to avoid nonprofessional or conflicting encounters with clients. While the code does not forbid dual relationships, it does hold the therapist responsible for carefully and diligently keeping such multiple relationships harmless.
What If You Recognize Dual Relationships In Your Practice?
If you recognize, or even if you suspect, you are in the throes of conflicting or potentially risky dual relationships with a client, consider the following recommendations:
- Act immediately. Do not wait for the client to bring up the problems that have developed.
- Document all interactions with your client and detail how you think the dual relationship developed.
- Seek consultation about the precise dynamics of dual relationships and how to end such a dynamic with the least amount of harm to the client.
- Arrange for an independent evaluation of the patient to determine whether the patient has been harmed and to develop future treatment recommendations.
- Consult your client about their receptivity to getting a mediator to devise a mutually agreeable constructive solution which works toward restoration of a healthy therapeutic relationship or, in the alternative, develop a means to terminate without harming the patient through abandonment.
NOTE: Every effort has been made to ensure that the information provided by 4therapy.com is accurate and up-to-date, however, it is important to remember that laws vary from state to state and local legislation can add further variations. We strongly urge you to stay current with your state and local laws.