By David Joel Miller.
Dual relationships get a lot of counselors and clients into trouble.
Having multiple relationships can mess up therapy.
The big obvious one is sex, we will talk about that one later, but there are a bunch of other dual or “multiple” relationships that can cause problems. Here are some examples.
The client doesn’t have money to feed her kids; can I pay her to clean my house?
This sounds harmless enough. Counselors want to help people, that is why they became a counselor in the first place. So they might try to help out. Maybe give the client a little money. What about bus fare home? What about hiring the client to do a part-time job around the house? All this sounds good until it goes wrong.
You give that client bus fare once. They tell some friends who all ask you for bus fare. You have to start saying no. Now you have to tell that first client no. Then they all complain to your boss. Why does client X get bus fare and I don’t? Why did you give it to me and then take it away when I did not do what you wanted? See how that good deed can come back to get you?
What about paying them to help you? They could mow the lawn or clean your house. What if the lawn mower goes missing right after they cut that lawn? What do you do if your jewelry is missing? Can you make a police report on a client? Doesn’t that violate confidentiality? How can you explain that away?
The client is new to the city and does not have any friends. The counselor invites them, to attend church with them. The counselor goes and picks the client up and takes them to church. What could be wrong with that?
You are their therapist; you have power over their life. They are in a week vulnerable position and you tell them they need to attend church and you are taking them to yours. Can they really say no? Will you withdraw care, stop seeing them if they say no?
What if their religious or spiritual tradition is one you do not approve of? Will you pressure them to convert? What if they consider your religion a “cult” will they be able to say no?
Think this doesn’t happen? Clients tell me, they have been told that their child protective services worker wants to be sure that their children are being raised in a “good Christian home.” Does that constitute bias? Can the client say anything if they risk having their children taken away or if they have a mental health issue or substance abuse problems? Could those problems be used against them?
Revealing your religious preference to a provider can result in discrimination, loss of jobs, denial of promotion, or even make you the victim of physical violence. That’s why in this day and age members of some religious traditions still need to use the “decline to state” response to the question about religious preference.
I am not saying that all discussion of religious or spiritual values should be off the table in therapy. People with a spiritual connection do better in recovery. What is a problem is when the therapist crosses the line from listening to the client about what the client believes, to doing a sales pitch or enabling the client to follow the counselor’s religion.
Encouraging them to practice a religious or spiritual tradition is a yes. Telling them they need to come to Zoroaster is a no.
Counselors do not have to stop going to church or another religious gathering place because their client attends, but they need be very careful about transporting or arranging to meet clients there. It is probably an ethical boundary violation to be seeing someone in therapy that you also sit in a religious service and socialize with.
Wow! That new client just told me about this great money-making deal.
Money and client relationships, what a dangerous mix. Yes, we have to think money. We need to get paid. But when we start thinking about money or other things first this can be a trap.
Investing money in a client’s business or investment opportunity or asking them to invest in one of yours, these are all bad ideas.
Lending money to your therapist is an absolute NO! If your counselor asks to borrow money run as fast as you can. Consider lodging a complaint on your way out to the appropriate person.
Think also about the insider trading issues. Do you want to end up in court because you made an investment based on a tip from a client? Clients, do you want your therapist testifying in court about your therapy session and how this investment idea came up in the first place?
All of these ethics issues can start with just that little finger through the ethical loophole. Giving someone bus fare out of your own pocket, paying them a few bucks to mow their lawn, becoming involved in their religious or social activities, all of these can lead to trouble.
Client, I know that you may like your therapist, want to do something nice but remember that their ethics code like a priest vow of poverty may preclude them from accepting gifts, stock tips or other offers by you to do things for them.
For me, as a therapist, the best gift a client can give me is to tell me that something we did in session has helped them have the happy life they want. Hearing that I have been able to help, that makes my day.
Sorry if we can’t hang out or attend some social event together. I like you as a person but I respect our professional relationship and you as a client too much to mess this up by getting into another dual relationship with a client.
Next Friday ethics part 4 – the bad news for all you romantics at heart. Why falling in love with clients or your therapist so often ends so very badly.
David Joel Miller, LMFT, LPCC
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books
- What if your Therapist loses their cool? (counselorssoapbox.com)
- Will the Counselor, therapist, psychologist keep your secret or tell? (counselorssoapbox.com)
- What do you do if your therapist cancels? (counselorssoapbox.com)
- Can you force a teenager to go for therapy? (counselorssoapbox.com)
- How do you fire a psychologist or counselor? (counselorssoapbox.com)