Ethical Dilemma for Mental Health Professionals

In a national survey exploring the significant ethical challenges and dilemmas faced by helping professionals, respondents ranked “blurred, dual or conflictual relationships” among the most difficult to navigate in their day to day practice (Barnett, Et Al., p. 401). Dual relationships, also commonly referred to as multiple or nonprofessional relationships, are defined in the American Psychological Association’s ethics code as “ones in which a practitioner is in a professional role with a person in addition to another role with the same individual, or with another person who is close to that individual” (Corey, Corey & Callahan, p. 268). While any relationship occurring simultaneous to the therapeutic one has the potential to be harmful, the only relationships extensively studied in this regard have been those of a sexual nature. Most agree that such sexual relationships are unethical, resulting in boundary violations that are both harmful and exploitative to the client. Both ethical and legal ramifications exist to address this issue including revocation of one’s license to practice and both criminal and civil sanctions.

However, continued debate regarding the benefit of nonsexual multiple relationships to the therapeutic process is ongoing. Historically, there was an outright ban on engaging in such relationships. Opponents argued that due to the inevitable power imbalance existing in the therapeutic process, exploitation and harm to the client would undoubtedly be the result. Professional boundaries were enforced to prevent compromise to the level of care received and crossing such boundaries was unanimously discouraged (Nickel, p.17).

However, in more recent years, there has been a shift in the ethical code...

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...ould be signed. Finally and perhaps most importantly, thoroughly document every step of the process taken to reach your decision. This can prove to be advantageous particularly if the practitioner is accused of malpractice.

References

Nickel, M.B. (2004). Professional boundaries: The dilemma of dual and multiple relationships in rural clinical practice. Counseling and Clinical Psychology Journal, 1(1), 17-22.

Barnett, J.E., Lazarus, A.A., Vasquez, M.J.T., Moorehead-Slaughter, O. and Johnson, W.B. (2007). Boundary issues and multiple relationships: Fantasy and reality. Professional Psychology: Research and Practice, 38(4), 401-410.

Corey, G., Corey, M.S. & Callahan, P. (2007). Managing boundaries and multiple relationships. In Brooks/Cole (8th Ed.), Issues and Ethics in the Helping Professions pp. 266-321.