Practicum/Ethics Monday: Multiple Relationships

All counseling ethics codes address the potential problem of multiple or dual relationships (when counselors have other relationships with their clients or former clients (e.g., counseling a friend or a child of a friend, having a former client as a business partner, etc.). Some codes make it appear that dual relationships are either always or likely wrong and so should be avoided. The AACC code is a bit more liberal in that it (rightly) defines the problem as increasing the problem of exploiting or harming the client. However, this code explicitly defends the biblical nature of dual relationships since we are all brothers and sisters of the same body. Other codes have recognized that it is not possible to always avoid dual relationships. But all codes remind the counselor that it is their duty to defend the healthiness of any dual relationship. In essence, it will be “guilty until proven innocent.”

There are 3 forms of dual relationships (sexual and client; nonsexual social and client; financial and client). Not every dual relationship is with the client (e.g., a counselor has a relationship with the mother of a teen client, a client is under discipline at your large church where you provide consultation to the elders). Dual relationships may happen AFTER counseling is over (begin a friendship with a former client). Finally, it is not merely harm or exploitation that may be the negative outcome of a dual relationship. A counselor may find that a dual relationship hinders or decreases her effectiveness to provide adequate care. [See Lamb et als article in the 2004 Professional Psychology: Research & Practice (35:3), pp 248-254 for a study on these issues].

This last one is the one I want to hang out with for a bit. I had a former client who I had known and highly respected before we started counseling. At the beginning we explored the potential harm that might come from this dual relationship. Both of us deemed that we could manage the slight dual relationship. And I think we did well and the client found the counseling helpful. However, there was a period in the counseling where the client became severely depressed and suicidal. I found myself less willing to hospitalize because I had an image of this client in my head that was much more stable than was actually true. Now, I never like or want to hospitalize. Most psych hospital stays provide protection but little more in the way of healing. But, I know I would have been much quicker to pull the trigger (bad pun I guess) if I hadn’t previously formed an opinion of health before starting the counseling relationship. We should not forget the possibility of reduced effectiveness in dual relationships.

Let me take this one step further. You may have a client who shares your same faith or doctrinal positions, graduated from the same school (but a different time). Any of these connections MIGHT cause you to be less effective in your work because of bias, groupthink, etc. These are not reasons to NOT counsel them but things to keep in mind. Reduced effectiveness because of dual relationships should not be neglected just because we are too busy talking about the rare counselor who decides to have sex with his clients.