Abstract
This review provides a discussion of current ethical issues that emerge when psychotherapists establish dual relationships. For therapists to successfully deliver care, they have to form therapeutic engagements to achieve desirable outcomes. Any boundary violations during these engagements will be discussed to demonstrate the need for a therapist to uphold the highest possible standard. As identified in this review, dual relationships can contribute to significant conflicts of interest, power imbalance, and impaired professional boundaries that can prevent achieving desirable outcomes. Psychotherapists are constantly called upon to provide unbiased approaches focusing on efficient care delivery. When confidentiality has been compromised, effective maintenance of therapeutic interventions can be adopted to encourage improved performance for numerous therapists. Approaches that promote efficacy can be implemented to deliver effective care among therapists. For therapists to promote professional engagement, they should focus on objectivity and improved education that promotes efficiency in service delivery.
Dual Relationships in Therapy
Dual relationships can be described as situations in which clients and therapists have multiple connections and roles beyond their therapeutic engagements. These include being family members, colleagues, and friends and having professional relationships. These relationships can contribute to significant issues between therapists and their clients. Less is currently known about how psychotherapists can prevent boundary violations, especially in cases of dual engagements (Van et al., 2020). When boundary violations occur, clients can engage in compromised confidentiality that can prevent the provision of efficient services. There can also exist power imbalances that can challenge the implementation of positive approaches when delivering services. Conflicts of interest can also affect the provision of efficient care among clients, which can significantly impact the provision of positive care outcomes. Avoiding any circumstance that can lead to the exploitation of existing power is also an approach that can promote a positive outlook among individuals in society.
Issues
One of the main challenges involving engagement in dual relationships is the concern of impaired boundaries. Conflicts of interest can emerge as a result of the existence of inappropriate boundaries that often affect clients’ engagements and have a significant impact on existing relationships. Maintaining clear relations and appropriate boundaries can help improve client engagement (Van et al., 2020). Providing the best approaches that focus on maintaining clarity in boundaries can improve opportunities for client interactions. Prevention of any violations of the boundaries is also a challenge that can affect interactions between therapists and their clients. Therapists should not compromise on their power as it can affect the assertion of actions and the need to implement positive actions that address concerns faced by counselors. Therapeutic efficiency can also be affected, hindering the implementation of goals to attrition promotions of professional engagements.
Scarvaglieri (2020) claims that discouraging and even prohibiting dual relationships can help improve communities’ approaches to engaging with clients. However, in cases with small communities, it can only be possible for a therapist to avoid clients. In such cases, therapists are called to maintain privacy and keep on boundaries. Adopting professional values is the best approach to improve client engagement to maintain positive consent. When it comes to cases where a client has to engage with their therapist, especially in advocating, dual relationships can be adopted. Maintaining a positive approach when dealing with a client is required to enhance professional engagements. At all times identifying the risks and present benefits can also be considered an approach that can promote positive engagement.
Additionally, when it comes to emergencies, a therapist can connect with a client to promote positive approaches and improved competence in their role. These approaches help to maintain positive engagements that can promote improved relationships. Another professional can provide care in emergencies, especially when a therapist is unavailable (Werbart et al., 2022). Furthermore, accepting these relationships should only exist on a case basis considering the present situation of a client. The focus is maintaining positive engagements that result in improved professionalism.
One of the ethical responsibilities that a counselor should engage in entails adhering to informed consent to deal with any implications or existing risks that affect a counselor. Approaches focused on improving informed consent can be adopted to encourage positive engagement with clients. Prusiński (2022) argues that adopting regular supervision is another challenge that can contribute to conflicts of interest that can affect a therapist when delivering their services. Approaches that focus on the promotion of positive engagements can be adopted as a means of maintaining trust and improvement of therapeutic roles. Counselors should also ensure that they have obtained informed consent before proceeding to reduce any risks when delivering their services. At all times, the conduct of a therapist should be exceptional as a means of improving therapeutic focus and improvement of informed consent. Any boundaries that have been affected should be resolved by implementing approaches that focus on improved changes to therapeutic behaviors.
Therapists should be updated with the latest knowledge and information that can promote their ethical engagement. Focusing on improved education and understanding can encourage clients to promote positive engagements and behaviors that can contribute to improved performance. By enhancing awareness and improved understanding of boundary issues, it is possible to eliminate any ethical concerns that a client might have. Having positive actions and engaging in decisions that protect the lives and concerns of the clients should always be a priority (Werbart et al., 2022). Once a dual engagement has existed, a client should focus on improved positive engagements that help to protect a client from any concerns. Adopting procedures that protect objectivity at all times can also help to engage in improved therapeutic roles that focus on improved professional engagements. Self-care activities and meditation can be adopted to prevent engaging in behaviors affecting individual social engagement.
In cases where counselors have followed existing ethical codes, resolving any issues related to dual relationships has been easy. Encouraging improved awareness of a client’s needs and motivations can provide a significant approach to enhancing positive values and approaches that maintain positive behavior. Once a therapist feels that they have been conflicted in their professional relationships, they should seek consultation with their supervisor to promote efficiency (Van et al., 2020). Always setting up goals and expectations before beginning therapy can be one of the approaches that can promote positive outcomes. Approaches that focus on evaluating interactions can contribute to improved interactions with clients as a means of promoting positive behaviors.
Monitoring engagements can also be considered an approach that can enhance positive outcomes, especially in improving clients’ expectations. Routine feedback from supervisors should be sought as a means of encouraging positive engagement when delivering services (Werbart et al., 2022). In some cases, when dual relationships cannot be avoided terminating professional engagement is the best approach. In some cases, violation of existing relationships can occur significantly when boundaries have been compromised. Maintaining professional identity is the best approach that focuses on improved motivation and implementation of positive engagements. Learning from mistakes and always seeking feedback is an approach that focuses on improved engagement. Ensuring respectful engagements on a routine basis is required as part of maintaining positive values.
Conclusion
In psychotherapy and counseling sessions, dual relationships can significantly affect ethical decision-making, especially in engaging in professional judgment. Dual relationships can increase conflicts of interest, boundary violations, and confusion in professional relations, especially when providing effective therapy. Professional therapists are called upon to establish a power balance and engage honestlyAdoptingn of the most efficient values as established by outlined c is part of maintaining professional responsibilities. Outcomes can only be attained when therapeutic efficiency is adopted that enhances sharing of information and engaging in professional actions to maintain confidentiality. Approaches that focus on improved outcomes can also be achieved to enhance the performance of digital approaches in a more defined manner. Avoiding any compromising situation for a client is the best approach to promote the maintenance of positive engagements among individuals in society.
References
Prusiński T. (2022). The Strength of Alliance in Individual Psychotherapy and Patient’s Wellbeing. Frontiers in psychiatry, p. 13, 827321. https://doi.org/10.3389/fpsyt.2022.827321
Scarvaglieri C. (2020). First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals. Frontiers in Psychology, 11, 585038. https://doi.org/10.3389/fpsyg.2020.585038
Van Benthem, P., Spijkerman, R., Blanken, P., Kleinjan, M., Vermeiren, R. R. J. M., & Hendriks, V. M. (2020). A dual perspective on first-session therapeutic alliance: a strong predictor of youth mental health and addiction treatment outcome. European child & adolescent psychiatry, 29(11), 1593–1601. https://doi.org/10.1007/s00787-020-01503-w
Werbart A, Byléhn L, Jansson TM, Philips B. (2022). Loss of Rituals, Boundaries, and Relationship: Patient Experiences of Transition to Telepsychotherapy Following the Onset of COVID-19 Pandemic. Front Psychol. 2022 Mar 24; 13:835214. Doi: 10.3389/fpsyg.2022.835214. PMID: 35401368; PMCID: PMC8988038.
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