Standard 1.7: Dual Relationships

Dual relationships can confuse both the registrant and the client. For example, the therapist or client may not know which relationship is happening at a particular time. If the registrant’s additional role carries authority over the client (e.g., as an employer), the client may feel the need to acquiesce to the registrant. Dual relationships may also affect the registrant’s professional judgment (e.g., the registrant might say things to a client who is also a friend that they would not otherwise say to a client). Due to the power imbalance between therapist and client, these risks exist even when the client requests or agrees with the dual relationship.

Students in some psychotherapy education programs undertake personal psychotherapy as part of their training. Due to risks involving dual relationships, undue influence, conflict of interest, and confidentiality, instructors should not provide students with therapy. Certain safeguards can reduce the risk; for example, ensuring that a registrant providing such therapy does not also evaluate those students’ academic or other performance in the program. However, a student’s therapist should be external to the day-to-day operation of the program.

Where a registrant provides psychotherapy as part of a small community, registrants employ clinical and ethical judgment, and implement various safeguards.

Some clients will explicitly seek out professionals within their own communities and with whom they share identities to ensure cultural competence and increased safety. This increases the likelihood of the client and RP intersecting outside of the clinical setting. Where a dual relationship is anticipated in advance (a new client is already known to the registrant from the community), RPs should mitigate potential issues by discussing the risks and benefits of the dual relationship as part of the informed consent process. Registrants should also have a conversation on what to do when the client and therapist encounter each other in the community.

Note: Sexual contact with former clients is covered elsewhere. This standard relates to non-sexual relationships with former clients.  In many cases, relationships with former clients are inappropriate and potentially damaging to the parties concerned. Despite this proscription, an outright prohibition of such relationships is unworkable, especially where a relationship may develop many years later, and the original client-therapist relationship was relatively brief.

The following are factors to consider before entering a relationship with a former client:

• • the likelihood of harm to the former client;
  • any power imbalance remaining over the former client;
  • the nature, length, and intensity of the former client-therapist relationship;
  • the nature of the emerging relationship;
  • the issues presented by the client in therapy;
  • the likelihood the individual will seek therapy from the registrant again in the future;

• • the length of time since the client-therapist relationship ended; and
  • the vulnerability of the client.

Ultimately, it is the responsibility of the registrant to assess the power and privilege they hold in relationships and determine the appropriateness of a dual role based on individualized factors.

Dual relationships can occur on social media and other electronic messaging platforms. Actions such as “liking,” “friending,” or “following” can constitute a boundary crossing and – whether the action is undertaken by the registrant or the client – could lead to a dual relationship.

Additional risks arise from participation in large groups (e.g., online discussion or support groups), where an RP may make disclosures without knowing that clients have access to the information.