-Social dual relationship (the client and therapist are friends).

-Professional dual relationship (the client and therapist work together or are colleagues).

-Communal dual relationship ( the client and therapist live in the same community or are involved in the same activities).

-Sexual dual relationship (the client and the therapist are engaged in a sexual and/or romantic relationship)

(Zur, 2013).

These types of relationships cause an ethical conflict of interest. Having a dual relationship with a client can damage the client and therapist.

-There is a lack of objectivity

-The boundaries between roles may be unclear

In simple terms, a dual relationship is a conflict of interest and an emerging issue. An issue that is related to the mental health field. Dual relationships happen frequently, even if accidental (Sutherland, 2018).

C. specifically states that school counselors must be aware of the potential risks and benefits of extending relationships beyond the school building and school hours.

E. School counselors must act to eliminate and reduce potential harm.

https://www.schoolcounselor.org/About-School-Counseling/Ethical-Responsibilities/ASCA-Ethical-Standards-for-School-Counselors-(1)

School counselors must be careful in extending relationships beyond the professional relationship. This includes having limited attendance in off-site extracurricular activities of our students.

Taron expected the counselor to help her recover from complex post-traumatic stress disorder. Instead, she said, "more than four years after her first session her life is spiraling through sleeplessness and suicidal thoughts."

Taron states that the therapist used something called access consciousness which led to a lot of inappropriate touching, hugs, texting, and gifts between her and the therapist. Eventually, it was determined that there had been appropriate misconduct, so the Nova Scotia College of Social Workers (NSCSW) permanently revoked the social worker's registration.

This incident happened in Nova Scotia, Canada, and the laws and rules differ. However, it was determined that the social worker was negligent and her registration was permanently revoked. Social workers must be registered with the college to practice.

McMillan, E. (2021). How a client-therapist relationship left one Nova Scotian feeling more hurt than healed. CBC News

https://www.cbc.ca/news/canada/nova-scotia/social-worker-discipline-registration-revoked-1.5950785

This article should shed some light on how the client felt following the incident and what happened with the social worker.

• The client felt helpless like she had done something wrong

• She felt that the social worker had caused her more harm than before (because she had trusted and confided in her therapist).

• She could not sleep

• The incident was affecting her marriage

• she had feelings of shame

• She felt she had been put in a vulnerable position

• she felt she had limited resources to seek recourse after the incident (other therapists did not want to take her as a client due to a potential conflict of interest).

• The client said she believes she suffered transference during the sessions and her therapist took advantage of her feelings instead of setting boundaries

• She began to feel a power imbalance

• She was having suicidal thoughts

These are all the feelings and emotions this client experienced. As helpers, whether social workers, licensed counselors, school counselors, or any other mental health professional we never want to cause our clients to have these feelings. They should be able to trust us to be professional and always have their best interest in mind, even if that means referring them to someone else.

According to the article the social worker's actions amounted to:

• her registration being permanently revoked (not being able to practice anymore)

• professional misconduct

• conduct unbecoming of the profession

• incompetence and a breach of the standards of practice and code of ethics

• she also paid $15,000 toward the investigation

This finding comes from an area that does not normally address sexual misconduct but as a result of increased complaints they are looking at ways to help those who allege harm.

Erotic or Sexualized Transference: occurs when a client develops romantic or sexual feelings for their counselor

In the article, several Licensed Professional Counselors (LPC) have experienced their clients making a pass at them. Howes, a licensed clinical psychologist and counselor educator suggests that there needs to be more training and knowledge within the field about what to do when erotic transference occurs (Counseling Today, 2023).

This is a good idea, and having more knowledge will better equip those in the field with the tools they to handle these types of situations.

Howe explains that to understand transference clinicians first need to understand the how and why.

Howe states that in most cases this may be the first time that the client is feeling heard, cared for, or paid attention to. Which may cause warm and loving feelings or thoughts.

Howe also explains that feelings of transference from a client can be hard or cause anxiety for the mental health professional because it may bring up a therapist's own needs for love desireability or yearning for close connection in some case( Counseling Today, 2023).

https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/how-to-manage-sexualized-transference

The article is a good read but mostly refers to licensed professionals. However, transference can happen anytime to any person because we are human. That's why it is important to remember to remove yourself from any vunerable or uncomfortable situations asap to prevent anything unethical from happening.

In the case, Johnson v. BD Exam in Psychology the Arkansas Supreme Court found that Johnson, a psychologist violated Rule 6(a). [1} of the Psychologist Code of Ethics by having a sexual relationship with her client.

The rule states that a psychologist is prohibited from engaging in a relationship with a client. The psychologist could not have an intimate relationship with someone and have them as a client.

• The court found that Johnson acted unethically

• The court found that Johnson created a conflict of interest with her client

• The rule stated that dual relationships are prohibited and that psychologist should make every effort to avoid them ( meaning dual relationships).

Johnson v. BD. Exam in Psychology, 305 Ark. 45, 808 S.W.2d 766 (1991). https://law.justia.com/cases/arkansas/supreme-court/1991/90-356-0.html

This code pertains to licensed counselors, it is regulated by the Texas State Board of Examiners of Professional Counselors. It states that a licensee (meaning a licensed professional counselor LPC) must set and maintain professional boundaries:

• An LPC must not engage in any activity for personal gain

• The LPC must not engage in a non-therapeutic relationship with a client: A non-therapeutic relationship is any non-counseling activity initiated by either the licensee or client that results in a relationship unrelated to therapy.

• An LPC may not engage in a non-therapeutic relationship with a client if the relationship begins less than two (2) years after the end of the counseling relationship.

  The LPC may not engage in a romantic relationship or sexual contact with a client within five (5) years after the end of the counseling relationship.

• The LPC must not provide counseling to (A) family members, (B) friends, (C) educational associates; or (D) business associates.

• An LPC must not accept gifts over $50, lend, nor borrow money from a client or relative of a client

• The licensee must not enter into a non-professional relationship with a client's family member or any person having a personal or professional relationship with a client if the licensee knows or reasonably should have known such a relationship could be detrimental to the client.

This Texas code sets the law for dual relationships and other conflicts of interest that can cause a licensed counselor to break professional boundaries and be legally liable.

Conflict, boundaries, dual relationships, and termination of relationships, 22 Texas Admin. Code § 681.38. https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-681-38

Sec. 21.007. b notice on certification record of alleged misconduct. This section discusses what happens if there is alleged misconduct against an educator.

This statute pertains to misconduct and/or negligence. For example, an allegation of a dual relationship with a student or anything that puts a student at risk. If an allegation of a dual relationship were reported against a school counselor it would have to be reported even if it is found to be untrue. It will be removed; however, this is a predicament a school counselor should never place themselves in (where there is a question of misconduct) as a professional.

• The board must place a notice of alleged misconduct on an educator’s public certification record that puts a student at risk to the health, safety, or welfare of a minor student.

·       https://statutes.capitol.texas.gov/Docs/ED/htm/ED.21.htm

The Texas Education Agency (TEA) code §247.2. Code of Ethics and Standard Practices for Texas Educators.

(G) Standard 1.7. The educator shall comply with state regulations, written local school board policies, and other state and federal laws.

(J) Standard 1.10. The educator shall be of good moral character and be worthy to instruct or supervise the youth of this state.

According to (some specific sections of) TEA code §247.1 :

• A certified school counselor must be trustworthy to lead and guide students

• The Texas educator shall comply with standard practices and ethical conduct toward students, professional colleagues, school officials, parents, and members of the community, and respect and obey the law.

TEA ethical conduct toward students

(F) Standard 3.6. The educator shall not solicit or engage in sexual conduct or a romantic relationship with a student or minor.

(H) Standard 3.8. The educator shall maintain appropriate professional educator-student relationships and boundaries based on a reasonably prudent educator standard.

(I) Standard 3.9. The educator shall refrain from inappropriate communication with a student or minor, including, but not limited to, electronic communication such as cell phone, text messaging, email, instant messaging, blogging, or other social network communication

Section (3) Ethical Conduct Towards Students explains the way an educator is expected to behave, and what an educator's conduct toward their students should look like.

https://tea.texas.gov/about-tea/laws-and-rules/sbec-rules-tac/sbec-adopted/201610ch247-two.pdf

The district handbook aids educators in knowing what is acceptable and unacceptable behavior and what to do if there is a need to report

An investigation must be completed if

• If there is a solicitation of a romantic relationship with a student by an educator which may include behavior, gestures, expressions, or communication with a student that are unrelated to the educator's job duties

• Evidence that there is a romantic intent or interest in a student

• (a) Abuse or unlawful act with a student or minor; or

• (b) Involvement in a romantic relationship with or solicitation or engagement in sexual contact with a student or minor

• Parents must be notified

• Any misconduct or alleged misconduct must be reported to the State Board of Educators (SBEC).

The Ector County ISD, 2023. ECISD our students the future 2023-2024 Employee Handbook. ·       https://resources.finalsite.net/images/v1712912904/ectorcountyisdorg/cktcovsdb40oigquefnv/2023-2024EmployeeHandbook_7_25_23.pdf

American Counseling Association (ACA) Code of Ethics prohibiting sexual relationships with former clients for a period of at least five years after-therapy.

Kramer, 2016 pointed out something that I found interesting. It shows that sometimes we can get ourselves into trouble by being uninformed. She stated that in 1989 it was reported that 46% of therapist believed that becoming friends with former clients was okay. However in a 1996 study 70% percent of counselors held this belief and in 2004 83% believed that becoming friends with former clients was ethical at least some of the time (Kramer, 2016).

Standard A.6.e., Nonprofessional Interactions or Relationships (Other Than Sexual or Romantic Interactions or Relationships) of the ACA Code of Ethics states: “Counselors avoid entering into nonprofessional relationships with former clients … when the interaction is potentially harmful to the client. This applies to both in-person and electronic interactions or relationships.”

The author suggest that the decision to return to therapy or have a post-therapy relationship (assuming after the five years) should be the decision of the client, meaning they should be the one making the contact not the therapist. This is suggested to avoid confusion and power imbalance (Kramer, 2016).

Kramer, A. (2016). Why can't we be friends? American Counseling Association. Counseling Today.

https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/why-cant-we-be-friends

The best way to adhere to a law, rule, or procedure is to first understand the law, rule, or procedure and what constitute as breaking the law, rule, or procedure. Below I have included some scenarios of what Sutherland, 2018 says may be a dual/multiple relationships:

• A client asks their social worker if the social worker can come into a store the client owns, believing that the social worker would benefit from a product the client is selling.

• A parent at a community school where a therapist also has a child asks the therapist if he could also be their counselling therapist.

• A counselor has been a regular at a gym for the past year and noticed for the first time that their client was working at the front desk.

• A social worker sends a LinkedIn request to one of her former clients.

• A counselor turns up at a community play and sees her client sitting in the audience.

As stated earlier sometimes dual relationships are unavoidable and may be beneficial. Therefore, not all dual relationships create a conflict of interest. Conflict of interest have the potential to cause harm (Sutherland, 2018).

Conflict of interest: a situation in which a person is in a position to derive personal benefit from actions or decisions made in their official capacity.

We should be aware not only of a conflict of interest but also, perceived conflicts of interest.

Examples of dual relationships where a conflict of interest is involved:

• Relationships in which the therapist receives a service from the client.

• When a therapist has a personal, familial or business relationship with the client

• Situations where the therapist provides therapy to family, employees or supervises

Prevention:

While dual relationships do not always involve exploitation of a client’s knowledge, skills, resources or situation (because not all dual relationships are conflicts of interest), it is important for therapist to be aware of this possibility so that they can take active steps to prevent this, including meeting regularly with a clinical supervisor (Sutherland, 2018).

Sutherland, M. (2018). The dilemma of dual: Dual relationships in counseling. Willow Tree Counseling. https://willowtreecounselling.ca/articles/the-dilemma-of-dual-dual-relationships-in-counselling/

• Dual relationships can cloud your professional judgment and effectiveness in doing your job.

• Dual relationships can create a conflict of interest and role confusion.

• They can leave your client feeling worse than before

• They can cause power imbalances

• They can cause legal and ethical complaints, sanctions, and lawsuits.

• Dual relationships may also damage your reputation, credibility, licensure or certification, and career as a counselor/therapist (LinkedIn, n.d).

  
  

Some best practices or recommendations to combat this problem are:

• Always keep it professional

• Follow all legal and ethical laws, rules, and procedures

• Be aware of erotic or sexualized transference

• Be ready to refer or transfer a client to someone else if needed

• Talk to a supervisor or another trusted individual in the field to get advice if you are unsure what to do

• Avoid conflicts of interest and possible conflicts of interest

  
  

These recommendations can benefit any helper in the mental health field.