Your agency policy states that it is okay for employees to accept homemade gifts from clients. A client gives you an ornately carved cradle that sells for $800 each. Would you always, sometimes, or never accept a gift like this from a client?
A former client owns an auto repair shop and offers to fix your car for the same cost as any other shop would charge, but the client will “take good care of your car.” Would you always, sometimes, or never take your car to this auto repair shop?
4,800 psychologists, psychiatrists and social workers
were surveyed (return rate of 49%) to examine attitudes and
practices regarding dual relationships, social involvements,
financial involvements and incidental involvements.
** 800 male and 800 female clinicians were randomly selected from the membership directory for: American Psychological Association, American Psychiatric Association and the National Association of Social Workers
** Survey forms sent out and 1,108 individuals returned surveys that could be used.
Dual Relationships: A National Study
Dual Relationships: A National Study .2% .4% 5% 40% 38% 13% 3% Accept gift worth under $10. 0% .4% .6% .1% 0% .5% 98.3% Engage in sexual activity with client .7% 2.6% .3% .6% 4.2% 23.2% 68.4%% Sexual activity after termination .5% 2.3% .8% 1.4% 13.1% 37% 44.9% Accept gift over $50 Item in % 1-never NR NS 5-always 4-most 3-sometimes 2-rare
Dual Relationships: A National Study .5% 1.4% .8% 2.4% 13.6% 37.9% 43.2% Go out to eat after session with client .2% 1.2% .5% .7% 4.6% 29.2% 63.5% Invite client to social event .5% 2.1% .3% .9% 7.5% 18% 70.8% Sell product to client .5% .5% 1.3% 2.9% 29.5% 39.3% 26% Disclose details of personal stresses with client Item in % 1-never NR NS 5-always 4-most 3-sometimes 2-rare
Dual Relationships: A National Study .1% .8% 4.6% 20.8% 41% 26.3% 6.3% Accept invite to special event .7% 4.2% 2.7% 12.7% 28.2% 30% 21.4% Accept service as payment for therapy .6% 1.9% 2.1% 10.2% 32% 38.4% 14.8% Become friends after termination Provide therapy to relative or friend of client Item in % 12.6% 1-never NR NS 5-always 4-most 3-sometimes 2-rare .5% 1% 4.2% 21.4% 38.8% 21.4%
Self Reported rates of Boundary-Related Behaviors
Telling a client you are angry with him or her
Hugging a client
Accepting a client’s gift worth at least $50
Accepting a gift worth less than $5 from a client
Accepting favors (e.g. a ride home) from clients
Lending money to a client
Inviting clients to a party or social event
42.5% responded –“sometimes to “very often”
69.4% responded – “sometimes” to “very often”
41.7% responded from “sometimes” to “very often”
19.1% responded “rarely”
58.1% responded from “sometimes” to “very often”
35.7% responded “rarely”
23.9% responded “rarely”
15.4% responded “rarely” or “sometimes”
Self Reported rates of Boundary-Related Behaviors
Disclosed details of current personal stresses to a client
Went out to eat with a client after a session
Accepted a client’s invitation to a special occasion
1 . The ideal - The professional is close enough to be emotionally involved. Clients feel protected and supported in their vulnerability. Te professional is also distant enough to allow clients the autonomy they need to heal.
2. Shrinking the boundary space - If we are uncomfortable with our power, we may reposition ourselves a buddies or peers. We come in too close. Clients may feel confused, angry, or unsafe; they know that we have more power, though we are acting as if we don’t.
3. Expanding the boundary space - If we’ve been too close, we might react by moving too far away. We forget client’s vulnerability and abandon them. We remove ourselves from the complex emotional relationship and thus act outside it. We may begin to think of clients as walking diagnoses – objects to be acted upon. Clients may feel alone, unheard, confused, unsafe.
Most professional associations agree that concurrent sexual and professional relationships are unethical (sexual relationships comprise 20% of complaints and other kinds dual relationship complaints 7%.)
Even after termination, some professionals believe “once a client, always a client”
1. Most ethical codes draw strong distinctions between sexual and nonsexual dual relationships.
Although the codes considered here prohibit the counselor from having a sexual relationship with a current client, variation occurs in the prohibition of such a relationship with former clients and the length of time that must pass for such a relationship to be permissible.
2. Other relationships cited in the ethical standards include those of friendship, business association and supervision.
These interactions also lie on a time line encompassing outside relationships that existed before counseling, those that develop during
the course of counseling and those that arise following termination.
3. One variable in determining the ethical ramifications of a potential dual relationship is its avoid ability.
Sexual dual relationships with clients are among the most serious of all ethical violations
Some codes say that counselors should not engage in sexual relationships with former clients within a minimum of two years after ending the counseling relationship (per some licenses, two years recommended in other situations, some feel it is never appropriate) .
1. Counselors make every effort to avoid dual relationships with clients that could impact professional judgement or increase the risk of harm to clients.
2. When a dual relationship cannot be avoided, counselors should take appropriate professional precautions such as informed consent, consultation, supervision and documentation to ensure that judgement is not impaired and no exploitation occurs.
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You’re a program supervisor and develop a close friendship with one of the program staff. It’s obvious to everyone in the office that you’re friends. However, after a somewhat negative performance review, one of your other staff members complains that you don’t treat everyone fairly. What would you do?
You and Keisha, a deaf woman, have been close friends for a long time. Keisha has recently moved and will become a client in your office. You are the only counselor in the office who knows sign language. Would you always, sometimes, or never agree to work with this client?
You are a VR counselor, and a client with whom you’re working is newly in recovery from alcohol and other drug problems. You see this client is sometimes struggling with recovery, and often is not able to get much support. You consider sharing with the client that you are in recovery yourself.
Your community has a very limited number of interpreters, most of whom are children of deaf adults. Several of the interpreters who are available to work in your program are siblings or cousins. Is this a problem? Would you always, sometimes, or never agree to hire family members?
You are a rehabilitation counselor in a small town and, while at a social function, you see a client with whom you have been unsuccessful contacting for an appointment. You take the client into another room, and proceed to discuss her vocational plans.