Chapter 8

Dual Relationships (4 problems)

Can be problematic because
1- can be difficult to recognize
2-Potential outcome ranges from a wide continuum from extremely harmful to benign and even beneficial
3-There is little consensus among professionals regarding the propriety of dual relationships

Potential Harm for dual relationships (4)

1- is always present in a dual relationship due to loss of objectivity
2- The power differential makes it impossible for the client to truly give equal consent to an extra-professional relationship
3-Counselors may unintentionally or unconsciously exploit

Determining the risk of harm (3 Factors)

1- Incompatible Expectations
2-Divergent Responsibilities
3-Power Differential

Incompatible Expectations

When the 2 roles of the counselor become confused for the client i.e. understanding counselor conflicts with role as friend or boss

Divergent Responsibilities

The responsibility as a counselor may conflict with the responsibility as a supervisor

Power Differential

The counselor holds the power

Benefits of selective dual relationships (4)

1- A power differential is not always associated with harm or exploitations
2- Many hierarchical relationships (parent/child) flourish and contribute to growth and development
3-Rigid adherence to boundaries can weaken therapeutic alliance
4- Dual relatio

Boundary Crossing

is a departure from a commonly accepted practice that occurs to benefit a client. i.e the boundary is shifted to meet the need of a particular client at a particular moment

Boundary Violation

is a serious breach that causes harm. i.e. this is from an ethical standpoint

Bartering

is a specific boundary issue. It is not prohibited, but discouraged. counselors who engage with this practice are usually motivated by a desire to provide service to those whose financial resources are limited. This is admirable

Types of Bartering (3)

1-Quantity of the exchange of services
2- Quality of the exchange of services
3- Exchange of goods

Problem with quantity of the exchange of services

The hour-to-hour exchange rate is not typically equal which can put a client even further behind in payment and they can become resentful

Problem with Quality of the exchange of services

What if either party is unhappy with the quality of the work? or the client is unhappy with the counseling services? Feelings of resentment on either end can impact the relationship

Problem with Exchange of goods

Issues of quality arise as well as the quantity of hours of counseling is equivalent to the value of the goods. What criteria should be used to make the determinations?

1st Criteria for Bartering

The relationship is not exploitative or harmful and does not place the counselor in an unfair advantage

2nd Criteria for Bartering

The client requests it

3rd Criteria for Bartering

Such arrangements are an accepted practice among professionals in the community

Post-termination friendships

There are no code of ethics guidelines on this nor consensus in the community

Things to consider before pursuing a friendship w/ former client

1-Time passed since termination
2-Transference and counter transference issues
3-Length and nature of counseling
4-The client's issues and diagnosis
5-Circumstances of termination
6-The clients freedom of choice
7-Whether any exploitation may have occurre

Diversity considerations in social relationship

Counselors of color may have difficulty not counseling friends or close acquaintances. The concern about dual relationships is not widely shared in the African American Community, where helpers play multiple roles

Accepting Gifts from clients

There is a fine line between maintaining ethical boundaries and attempting to not have the clients feel rejected or hurt. Minimize this by having a general policy of not accepting gifts in informed consent document

Self Disclosure

it is important to learn the skill of self-disclosure and be able to articulate your rationale for using it in the counseling process

Ethical Self Disclosure

Is done for the clients benefit within the context of the therapeutic process

Unethical self-disclosure

1-Used to counter feelings of isolation
2-Used improperly or excessively can lead to role reversal
3-Topics that are not appropriate
-current stressors
-personal fantasies or dreams
-social or financial circumstances

Asian Americans and Self Disclosure

Asian cultures consider self-disclosure to strangers is a violation of familial and cultural values. They may need counselor self-disclosure to establish a relationship in order for them to share

Sexual Relationships

DO NOT DO IT, violates Hippocratic Oath

Therapist-patient sex syndrome

with reactions similar to those of victims of rape, spouse battering, incest and PTSD they experience:
-a deep ambivalence toward the offending counselor
-trapped between dependence on and fear of separation from the counselor
-a longing to escape from hi

Civil Law Suits

Malpractice, negligent infliction of emotional distress, battery, intentional infliction of emotional distress, fraudulent misrepresentation, breach of contract, breach of warranty, and spouse loss of consortium (love, companionship, and services)

Criminalization of sex with clients

losing a case to an accusing client now may have jail time as some states have passed laws making it illegal for Mental Health Professionals to have sex with their clients

Intrusive advocacy

pushing your client toward accusing the offender. You should guard against doing this, your job is to provide counseling services, avoid imposing your own values, and to assist clients in meeting their personal goals