Boundaries And Dual Relationships In Counseling

KENYATTA UNIVERSITY
SCHOOL: HUMANITIES AND SOCIAL SCIENCES

DEPARTMENT: PSYCHOLOGY

UNIT NAME: PROFESSIONAL ISSUES AND ETHICS

UNIT CODE: APS 424

NAME: FAITH KWAMBOKA ONGERA

REG NO: C77/0521/2009

TASK: ESSAY ON DUAL RELATIONSHIP

LECTURER: MR KAREGA MUCHIRI

DUE DATE: 28th NOVEMBER 2012

Many professionals in the west are not worried by boundaries and dual relationships, for instance in the UK accountants and solicitors often get work from their friends, or friends of friends, hairdressers can go out for a meal with their customers. In the early days in counseling there was no concern about boundaries and dual relationships. Freud came from a small, tight- knit social group of middle class Vienna. He gave patients gifts, financial
support and legal advice; it was inevitable since his patients were his trainees, friends, the wives of his friends and his own daughter. Carl Jung according to historians had engaged in sexual dual relationship with his client Sabina, who became not only his patients, but his student, colleague, and lover. This later resulted into confusion and suffering for both Jung and Sabina. Gradually codes of conduct were developed to govern professional behavior; the driving force being complaints from people who felt they were emotionally damaged by what happened to them.
Multiple issues in supervision have become an interesting and multifaceted topic to study among professionals. According to Herlihy & Corey, (1992) Multiple or dual relationships are those in which therapists assume two roles simultaneously with a person or persons engaging their professional assistance. These roles may be both professional in nature such as a therapist and a supervisor or a combination of professional and nonprofessional, such as a therapist and a friend.
According to British Association for Counseling and Psychotherapy (BACP) ethical framework for good practice in counseling and psychotherapy (2010). ‘The existence of a dual relationship with a client is seldom neutral and can have a powerful beneficial or detrimental impact that may not always be easily foreseeable. For these reasons practitioners are required to consider the implications of entering into dual relationships with clients, to avoid entering into relationships that are likely to be detrimental to clients and to be readily accountable to clients and colleagues for any dual relationship that occur’.
In the world of counselor in the united states, it is common for supervisors to undertake more than one role with those that they are overseeing(Bernard and Goodyear, 2009).In counseling practice making multiple relationships is unavoidable and inevitable, according to Herlily &Corey (2001), they state that multiple relationships can be healthy and normal as long as the supervisors and supervisees are aware of situations that might lead to the developments of associations with serious ethical implications where roles can be conflicting.
Pearson & Piazza (1997) state that dual relationships are problematic since they are so pervasive, difficult to recognize at times, sometimes unavoidable, sometimes harmful but may be also beneficial and the subject of conflicting advice. In addition multiple relationships may cause a therapist to lose impartiality as well as impair the therapist professional judgment. When there is boundary violation as an outcome of interactions between the supervisor and supervisee, then the relationship will be problematic and harmful. Multiple relationships can also be confusing and dangerous this is because of the inherent hierarchal relationship within the supervision, since supervisors have powers over the relationship, they have the potential to misuse this power. The supervisor can misuse this power by exploiting the supervisee for his or her own self interests for example the supervisor can do this by inviting the supervisee out for a date or making sexually suggestive jokes. In terms of supervision, these situations may be very difficult for a supervisee to handle because of the potential for negative consequences like being blackmailed.

According to Pearson & Piazza (1997), multiple relationship issue can occur when a supervisor and a supervisee have a professional relationship at the beginning that manifests into a personal relationship. When such a relationship is sexual in nature, it is always considered unethical (ACA code of ethics; Larrabee and miller, 1993). Supervisors and supervisee may often have things in common or share interests making it possible for personal friendship to develop. When personal components is added to the professional relationship this may cause harm by creating realistic or imagined perceptions from other, for instance other students may view their supervisor as favoring one of them and this will eventually cause tension among students.

It is a common knowledge in the public domain that some high profile and powerful men particularly politicians, sportsmen and film stars sexually exploit and abuse women. According to Clarkson (1995) some early psychoanalysts had sexual relations with their client’s examples being Jung, Khan and Rogers. In all these cases there seem to have been no complaints. In the 21st century it is more likely that sexually abused clients will lodge a complaint but the difficulty in doing this must not be underestimated even though the climate is more accepting. Women who have had sexual contact with their therapists have a set of symptoms which are so characteristic and recognizable that they form a syndrome. The psychological symptoms include low self esteem, feelings of isolation and loneliness, cognitive dysfunction, increased suicidal risk, profound fear, increased illness leading to admission to hospital, identity disturbance and inability to trust (Gabriel, 2001), thus a sexually abused woman or man has a long way down the road of recovery to have the necessary strength to initiate a complaint.

According to Amanda et al, (2012) sexual dual relationship in counseling is never condoned, since it is damaging to the client; therefore, there must be a total prohibition.
Worldwide, the codes of ethics for counselors and psychotherapists have a total ban on sexual activity with a current client. Client’s safety should come first and always paramount. A number of professional associations have a lifetime ban of sexual relationships with clients and ex-clients believing that power differential can never be totally resolved. Practitioners should carefully exercise considerable caution before, entering into personal or business relationship with former clients and should expect to be professional accountable if the relationship becomes detrimental to the client or the standing of the
profession.

There are many situations between therapists and clients where there is a possibility of a non sexual dual relationship being formed or where one is inevitable. Examples are; accepting a gift, accepting barter in lieu of fees, going to an important celebration in a client’s life such as wedding, retirement party, and graduation.
In survey of western trained counselors are believed then majority of the therapists will receive a present from a client at some point in their professional career. A survey by Amos and Margison (1998) found that 92% of those they surveyed had received one. Reflecting on such incidents therapists have sometimes felt it was the right and natural thing to do, but other times they felt a bit uneasy or even deeply so. This suggests that giving and accepting of gifts is a complex transaction.

Amos and Margison (1998) did a research on therapists and gifts.
They found out that there were seven functions in matters concerning gifts; as a symbolic exchange, to bind the therapist, to act out something that cannot be discussed openly, to elicit a response, as a precursor to a boundary violation, as a workable aspect of the transference, as a defense against the transference. It is essential to know the cultural context in which gifts is given, for instance in Japan and many of the far eastern cultures gifts are considered an essential part of good manners. In Japan every hospitable act must be marked with a gift. It would, therefore, be correct to give a present to a therapist who was welcoming and friendly. In western cultures women are more likely to give present than men. If receiving of presents were to be banned, this should be explained to clients, but even with an explanation the denial of something of enormous importance to members of another culture would be insensitive and even result in a breakdown of the counseling relationship. It is noted that a ban on acceptance of gifts would be counterproductive therapeutically because the gift has so many possible functions that can be explored in the therapy and may aid the client understanding of him or her. With every gift there are overt messages but also many hidden massages, which may be part a symbolic exchange and in part an acting out of something that cannot be put in
words.

People from many professionals do business with their friends and manage boundaries by choosing what to discuss and what to avoid. In case of counselors’ part of managing boundaries is that in the initial contracting there is clarity about what confidentiality means and how social meetings will be handled. Seeing more than one family member of a family can result in a dual relationship. Indian culture is more collectivist in nature and both family and community are important to the helping process (Syme 2006). Therefore the presence of multiple relationships in the counseling process may be naturally inherent and acceptable. Automatic exclusion of family members or community leaders in the counseling experience may be deemed offensive and harm the therapeutic relationship. Counselors must take into consideration cultural differences when working with clients (Arrendondo et al.1996). Dual relationship can be created when one offers counseling to a friend, neighbor or a member of the client’s family, most of the professional associations’ advice caution, since this relationship might impair the counselor’s objectivity and professional judgment. The counselor takes appropriate professional precautions such as informed consent, consultation, supervision and documentation to ensure that judgment is not impaired and no exploitation occurs. Accepting barter in lieu of fees can lead to dual relationship. An actual object that is used for barter may have hidden messages. In the west the reason for barter is that it enables people on low income to receive therapy. When dissatisfactions arise it brings about other dynamics such as resentment into the therapeutic relationship. The American counseling association mentions bartering in its codes of ethics. It discourages it because such arrangements create inherent potential for conflicts, exploitation and distortion of the professional relationship but it does not prohibit it, instead it states that counselors may participate in bartering only if the relationship is not exploitative, if the clients requests it, if a clear written contract is established and if such arrangements are an acceptable practice among professionals in the community.

In determining whether to proceed with dual relationship, it is critical to consider whether the potential benefit to the client of such relationship outweighs its potential harm. Some relationships may have potential benefits to clients than potential risks. It is the responsibility of the counselor to develop safeguards aimed at reducing the potential for negative consequences. Herlihy and Corey (2006) indentified the following guidelines:

Set healthy boundaries early in the therapeutic relationship, informed consent is essential from the beginning and throughout the therapy process.

Involve the clients in ongoing discussions and in the decision the decision making process and document your discussions. Discuss with clients what you expect from them and what to expect from you.

Consult with fellow professionals as away to maintain objectivity and identify anticipated difficulties.

When dual relationships are potentially problematic or when the risk for harm is high, it is always wise to work under supervision. Document the nature of this supervision and any actions you take in your records.

Self monitoring is critical throughout the process. Ask yourself whose needs are being met and examine your motivations for considering becoming involved in a dual or multiple relationships.

According to Arnold & Ofer (2002) state that the prohibition of dual relationship in therapy comes from four sources;
The federal and state professional regulating agencies instituted the prohibition to attempt to protect clients from harm by exploitative therapists.
Traditional psychoanalysis embraced this prohibition for the purposes of ensuring the degree of detachment and neutrality that is necessary for the analysis of the transference.
Our litigious culture induces fear in therapists of courts, boards, ethics committees and attorney. This fear manifests itself through the blind application of strict risk management guidelines and compels most therapists to employ defensive practices that include extreme such measures as absolute avoidance of all forms of dual relationships.
The mainstream traditional, urban psychotherapeutic models (vs. the rural community model) which like the analytical model emphasize privacy, anonymity, separation and strict boundaries in therapy.
In conclusion, counselors are professional thus are involved with their supervisors, peers and clients in many ways. These involvements have the potential to help them at times or hinder them at times. It is a professional responsibility to understand these involvements, to manage them properly and to ensure fidelity to the client is maintained. Professional guidelines give counselors the freedom to manage the situations of dual relationship as they arise, they can be responsive to the cultural and social pressure as well as the therapeutic needs of clients

REFERENCES
Amanda, et al (2012).Peer support in negotiating multiple relationships within supervision among counselor education doctoral students.10.
Corey, G., Corey, M.S., & Callanan, P. (1998). Issues and ethics in the helping professionals (5th Ed.). Pacific groove. Brooks/Cole
Gabriel, L. (2001). Speaking the Unspeakable: Dual Relationships in Counseling and Psychotherapy, unpublished doctoral thesis, York St John.

Herlihy, B & Piazza, N (1997) Classification of dual relationship in counseling: multiple roles and responsibilities; Alexandria; American counseling association

Syme, G. (2006); fetters or freedom: Dual Relationships in helping professions counselor education and supervision.28 (1), 57-59