Dual Relationships in Counseling and Ministry

The subject of dual relationships in the helping professions has received increased attention over the past years (Borys & Pope, 1989; Koocher & Keith- Spiegel, 1998; Reamer, 2003; Nigro, 2004). Dual relationships may occur in many forms. St. Germaine (1993, 1996) suggests that dual or multiple relationships involve situations in which professionals engage with clients in more than one relationship, whether social, sexual, religious, or business. Kagle and Giebelhause (1994), state that  a professional enters into a dual relationship whenever he or she assumes a second role with client, becoming social worker and friend, employer, teacher, business associate, family member, or sex partner. A practitioner can engage in a dual relationship whether the second relationship begins before, during, or after the social worker relationship (p. 213).

Multiple or dual relationships occur when a pastor or therapist assume two or more roles with a client or has connections with a client that are in addition to the helping relationship (G. Corey et al., 2003; Kitchener & Anderson, 2000; Welfel, 2002).

Much attention has been given to sexual intimacy between therapist and client and this is a frequently claimed violation in the professional world of both pastor and therapist. Guarding against sexual intimacy is the theme of many seminars. Ethical codes address this issue in no uncertain terms. “Counselors view sexual intimacies or relationships with clients and former clients as inappropriate and unethical. Boundaries must be clear and roles defined as to avoid any conflict” (Faiver, et al., 2004, p. 153).

I don’t want to undermine the importance of this issue, but it will not be the focus of this article. Instead, this article examines the issue of non-sexual dual relationships in both professional and pastoral counseling set in rural, as well as urban, practices. The implications for decision-making brought about by dual relationships and parameters of concern generated by situations that can promote dual relationships will also be discussed.  In a previous study done by Anderson and Kitchener (1996), eight categories of non-romantic, non-sexual relationships with former clients were identified. Three of these categories were then divided into subcategories of “circumstantial” and “intentional.” The eight categories, in descending order of frequency, were: Find a therapist for immediate help.

1. Personal or friendship (n=18)  2. Social interactions and events (circumstantial, n=9; intentional, n=9)  3. Business or financial (n=12)  4. Collegial or professional (n=12)  5. Supervisory or evaluative (circumstantial, n=2; intentional, n=8)  6. Religious affiliation (n=9)  7. Collegial or professional plus social (n=7)  8. Workplace (circumstantial, n=3; intentional, n=2)  Pope (1991) is correct when he suggests that “dual relationships are relatively easy to define; they are much more difficult for many of us to recognize in our practice” (p. 21). A boundary violation “is to usurp someone’s legitimate territory and invade his or her privacy by disregarding tacit or explicit limits” (Lazarus, 1994, p. 255).
2. Pastors and practitioners agree that any engagement with a client or colleague that is manipulative, exploitive, deceitful, or coercive is a violation of the client’s ethical rights.  Churches and church related ministries are pre-disposed to opportunities where dual and multiple relationships can easily exist. The wise pastoral counselor can avoid such relationships by understanding personal vulnerability, subscribing to and articulating clear professional ethics, and building a platform of accountability. The American Association of Christian Counselors addresses the concern of dual and multiple relationships by stating, “dual relationships involve the breakdown of proper professional or ministerial boundaries.
3. A dual rela- tionship is where two or more roles are mixed in a manner that can harm the counseling relationship” (_AACC Code of Ethics_, 2004, p. 8).  AACC is correct in pointing out that not all dual relationships are harmful or unethical. The _Code of Ethics_ (2004) suggests in section 1-140, “…it is client exploitation that is wrong, not the dual relationship itself…” (p. 8). In section 1-142 of the Code an exception to the rule is provided by emphasizing that there is an informed consent and that no harm or exploitation to the client is present (Code of Ethics, 2004, p. 8).
4. The AACC _Code of Ethics_ (2004) returns the rule to its traditional purpose and understanding—not that such relations are per se wrong, but that they are intended to avoid any harm or exploitation in the helping relationship. This code further discusses how Christian counselors confront issues like dealing with family, friends, personal acquaintances (_Code 1-143_), confronting problems of business and economic relationships (_Code 1-144_), and that seemingly ever present problem of counseling fellow church members (_Code 1-145_). Foundationally, the Christian counselor seeks to “take all reasonable precautions to limit the adverse impact of any dual relationship” (_Code of Ethics_, 2004, p. 9).
5. George Ohlschlager (2005), who drafted the code and Chairs the AACC Law & Ethics Committee, informed me that dual relationships has attracted more controversy over the years than any other section of the code. Professional clinicians have tended to view it as being a little loose (though most prefer it over the way the rule is stated in other professional codes), while pastors have mostly complained of it being too strict. He has long resisted writing two separate rules—one for each group— believing that would further fragment two groups he would rather see united in a common mission.  Scopelliti, et al. (2004) point out that for the practitioner in a rural setting, “community expectations may not only influence where clinicians shop, socialize, or interact, but also the role they play in their community” (p. 954). Unlike the professional counselor who practices in a rural setting, the professional counselor who practices in an urban setting has greater old_resources to avoid such relationships.
6. A question many may have about non-sexual dual relations is “why all the fuss?” Lazarus (1994) suggests that perhaps we may have taken our well-intentioned ethical guidelines too far. He states, “Rigid roles and strict codified rules of conduct between therapist and client can obstruct a clinician’s artistry” (1994, p. 255). Pope (1991) provides us some balance to the discussion by suggesting these inherent difficulties with dual relationships:   The very nature of the therapeutic relationship is potentially distorted.   Sound professional judgment is compromised.   Because there is always the potential that the therapist may be compelled to testify in court, the treatment and testimony become suspect.   There is an unequal footing should the therapist-client relationship become a business partnership.
7. The very nature and premise of psychotherapy could be drastically changed if dual relationships were permitted.    The cognitive process of therapy is jeopardized.  It is clearly imperative that professional and pastoral counselors in practice have an obligation to become informed and aware of the issues related to dual relationships. How can we prepare ourselves and what is the decisionmaking process to take when faced with the dilemma of a dual relationship? Let me suggest the following guidelines.   Read and review the ethical standards of your professional organization.   Prepare for the possibility of dual relationships. Keeping alert to possible danger can alleviate potential problems when or where they could arise.   Set appropriate boundaries with your clients. It is much easier to set boundaries at the beginning of the therapeutic relationship than attempting to make difficult changes later.   Determine whether the dual relationship is avoidable or unavoidable. If it is an unavoidable situation, then the remaining suggestions will be extremely important.   Evaluate the motives, risks, and benefits related to entering into a dual or multiple relationship.   Document your decision-making process. If you do not have clear, extensive, and well thought out records written down, it is as though it never happened.
8. Younggren (2004) is correct when he suggests that good record keeping is a strong defense against perceived misconduct.   Develop an accountability resource. Work with peers or colleagues who can evaluate with you any decision-making processes. You might also consider working under a supervisor to oversee and provide guidance. For the pastoral counselor, it is wise to have both an outside resource as well as a trusted inside source.   Refer. If at all possible, consider referring the client to another therapist. Professional clinicians and pastoral counselors alike will constantly encounter dual or multiple relationships. No clinician should dismiss these rules, as every experienced supervisor can tell a terrible story of therapy gone bad— without intending to do so—because an inexperienced supervisee did not honor this rule. At the same time, no church should allow the rule to dominate over and adversely affect the richness of pastoral relations.  However, if we adhere to these guidelines and practices with strong ethical principles and Christian commitment, disasters can be avoided and our profession will remain strong.
9. _Ronald D. Allen, Ed.D., LPC, NCC is Associate Professor and the Director of the Center for Counseling and Family Studies at Liberty University. His areas of teaching include Research Design and Statistics, Individual Appraisal, Counseling the Adolescent, Crisis Counseling, and The Helping Profession._  References  American Association of Christian Counselors. (2004). AACC Christian Counseling Code of Ethics. Forest, VA: Author.  Anderson, S. K., & Kitchener, K. S. (1996). Nonromatic, nonsexual posttherapy relationships between psychologists and former clients: An exploratory study of critical incidents. Professional Psychology: Research and Practice, 27, 59-66.  Borys, D. S., & Pope, K. S. (1989).
10. Dual relationships between therapist and client: A national study of psychologist, psychiatrists, and social workers. Professional Psychology: Research and Practice, 20, 283-293.  Corey, G., Corey, M. S., & Callanan, P. (2003). Issues and ethics in the helping professions (6th ed.). Pacific Grove, CA: Brooks/Cole.  Faiver, C., Eisengart, S., & Colonna, R. (2004). The counselor intern’s handbook (3ed.). Belmont, CA: Brooks/Cole-Thompson.  Kagle, J. D., & Giebelhausen, P. N. (1994). Dual relationships and professional boundaries. Social Work, 39, 213-220.  Kitchener, K. S., & Anderson, S. K. (2000). Ethical issues in counseling psychology: Old themes—new problems. In S. D. Brown & R. W. Lent (Eds.), Handbook of counseling psychology (3rd ed., pp. 50-82). New York: Wiley.  Koocher, G. P., & Keith-Spiegel, P. (1998). Ethics in psychology: Professional standards and cases. New York: Oxford University Press. Lazarus, A. A., (1994). How certain boundaries and ethics diminish therapeutic effectiveness. Ethics & Behavior, 4(3), 255-261.