Dual and Multiple Relationships and Boundaries

Case study 14 is an illustration of a clinical situation that has a potential harm in terms of loss of objectivity and conflict of interest. Teresa being a professional counselor is entangled in a multiple relationship with her client. The ethical concern is on maintaining the boundaries. The potentiality of Teresa crossing them is high and precautions have to be taken.

According to Herlihy and Corey,( 2006), boundaries get crossed if there is divergence from acceptable practices thus putting the client at a risk of harm. Another ethical concern is on whether Teresa will adhere to the code of ethics as expected of a professional counselor without compromising to some temptations.  Another concern is on how effective Teresa will be as a counselor in the way she handles Chris’ problem because the potentiality of her being influenced by the fact that Chris’ mother is her best friend, is high.

Barbara Herlihy and Gerald Corey, (as cited from Knapp and Verdecreak, 2003) state that a sexual dual relationship is an absolutely harmful situation that should be avoided by all means because the repercussions severely affect individuals negatively. However the situation in the case of Theresa and Evelyn’s son, Chris has a low potentiality of harm especially if Teresa takes some important pre-cautions.

Compared to sexual-dual relationship, counselors are also harmed or get stressed because circumstances force them to play different roles simultaneously and juggling between them can be very difficult. Gerald, Marianne and Patrick ( as cited from Lazarus and Zur, 2002) state that some multiple relationships are not harmful and are unavoidable. This can be explained by the fact that none of the codes of ethics deem non-sexual relationships unethical.

This situation has a possibility of having a negative impact for instance impairment of judgment by the counselor because of the aspect of friendship between Theresa and her clients mother, alongside this is the possibility of Chris not being open enough to talk about everything that bugs him for fear of disclosure to the mother by his counselor. He may want to hide some information to protect him from the Teresa who is the mother’s friend. Efficacy in this case is questionable in the end, resulting in the client not getting the help he needs.

My recommendation for Teresa would be to find another independent colleague to do the counseling. One who does not have  affiliations of any kind to both Chris and the mother. I would advice her to strongly advise Evelyn that the potential harm or risk is more intense than the hustle that comes with the 3km that she would have to do when  driving Chris to another counselor.

This case can be ethically resolved by the following steps;

a)      Teresa has to weigh the potential harm that exists if she takes on the counseling.

b)      Upon commencement of the counseling session, Teresa should call upon her supervisor or colleague at work to supervise how she handles the counseling.

c)      Another consideration is that Teresa should explain about the risks to both Chris and his mother so as not to lose her friendship to Evelyn and to make it clear why she cannot counsel Chris.

She should ask herself whether

According to (Gottlieb and Younggren) as mentioned by Gerald, Marianne and Patrick, Teresa should establish the necessity of entering into a professional relationship since the friendship relationship still exists. Secondly, she should find out any potentiality of harm to the client in the event that she enters into a multiple relationship i.e. both the friendly one and the professional one. Teresa should determine whether the dual relationship is going to add value to the situation and if it will influence the manner in which she will analyze the problem.

Thirdly she is obliged to let the parties at stake know the risks that come with multiple relationships and let the client to have a participatory role in the decisions made. Having done all these and there being no risk of harm Teresa should put every thing in writing showing consent by the client where the latter even appends his signature. Finally the counselor should consult with her colleagues who support the decision.

In circumstances where a non professional relationship is unavailable the counselor should make sure that he does not cross boundaries or rather he just holds on to practices that are beneficial to the client. He should let the clients know about the pros and cons of dual or multiple relationships and should be prepared to face arising conflicts and discuss about the same with clients.

The counselor should be alert incase he finds out that he might give an impaired professional judgment or foresees  harm, in which case he should reach out to other professionals for advice on how to handle any problematic situation. Dual relationships need to be documented. The last option would be to recommend counseling services from another professional. Herlihy and Gerald, citing St. Germaine (1993), suggest the above procedures to protect the client from the harm.

As I disseminate my duties I will always make sure that I avoid dealing with clients with whom I have existing relations like friends, relatives and business associates. In line with this I would strictly maintain boundaries by refusing to receive gifts from clients, or exchanging goods and services for the services I render (Gabbord, 1994, 1995, 1996; Gutheil and Gabbard; 1993). Finally, I would always refer to the code of ethics and see to it that I don’t breach any of them. I would always keep it professional through documentation and filing of proceedings for further

reference.

References:

Barbara, H., & Gerald, C. (Eds.). ACA – Ethical Standards Casebook: (6th Edition).
Gerald, C., Marianne, S, C. & Patrick, C. (Eds.). ISSUES AND ETHICS IN HELPING PROFESSIONS: (7th Edition.)