MikeLigalig.com

By: A. Lorenzo Lucino Jr, M.D-Ph.Dc





In the field of counseling psychology there is a plethora of situations that may affect a psychologist and is in the grounds of ethical and professional violation. It is quite common in any professional setting in which relationships occur when it should not be occurring for the sake of professionalism and in the interest of the organization of both parties. This also holds true in the field of psychology where it is inevitable that clinicians will face situations where clients initiate a discussion or interaction that could lead to multiple relationships or boundary issues in general. Two of the most commonly encountered situations are the issue regarding termination and sexual relationships (Fisher, 2009).


It is important to note that the ethics code of Psychology has addressed the issue of potential for crossing boundaries and the exploitation of clients when here is dual or multiple relationships occurring. It is important to note what is the meaning of dual and multiple relationship, it is actually when a professional has two or more roles at the same time or sequentially occurring within a client (Corey et al, 2011).


This may include assuming more than one professional role or blending of a professional and non-professional role relationship. It is important for us in the field of mental health to effectively and ethically manage multiple relationships, including dealing with the power differential that is a basic part of most professional relationships, managing boundary issues and striving to avoid the misuse of power. Sometimes it is best for us to take into consideration the ethical standards for dual and multiple relationships as proscribed by the APA, which states:  In many communities and situations, it may not be feasible or reasonable for psychologists to avoid social or other nonprofessional contacts with persons such as patients, clients, students, supervisees, or research participants. Psychologists must always be sensitive to the potential harmful effects of other contacts on their work and on those persons with whom they deal (American Psychology). A psychologist refrains from entering into or promising another personal, scientific, professional, financial or other relationship with such persons if it appears likely that such a relationship reasonably might impair the psychologist’s objectivity or otherwise interfere with the psychologist’s effectively performing his or her functions as a psychologist, or might harm or exploit the other party (Corey et al, 2011).


In the case of a patient who is terminating a professional relationship with me and that she informs me that she would like to begin some form of social relationship with me after the termination, there would be some issues that I would have to take into consideration namely the ethical, legal and personal aspect. It is reasonable to note that as a practitioner , it would be my imperative to monitor myself and to set up professional boundaries. It is prohibited that a counselor to have any sexual relations with a patient, the termination of the therapeutic relationship does not excuse professionals from engaging sexual relationships with former clients, in my honest opinion (Sadock and Sadock, 2000).


 One has to take into consideration that transference, countertransference can occur during the therapeutic relationship and as clinicians it is our duty to safeguard the patient from entangling themselves, as well as our own duty as professionals (Fisher, 2009). If a patient terminated the therapeutic relationship with me then I would maintain only a distant relationship in a non-professional setting. In my opinion it is very unprofessional to become friends with patients, there should be boundaries implemented. In my opinion, business and pleasure should never mix. However, it is important to note that Corey et al points out how practitioners have an obligation to evaluate the risk and to act responsibly. The therapeutic relationship must encourage trust and flexibility as well as boundaries and when this relationship is already broken, it is important to maintain cordiality and a professional conduct that is befitting a therapist (Corey et al, 2011). As clinicians we must be aware of our own motivations, as well as the motivations of the clients, and they must objectively assess the impact a social relationship might have on the client-therapist relationship.


It is important to note that though some therapists would like to take the position of socializing with current clients; this is ethically and clinically problematic. In dealing with the issue of counselors , including myself, having feelings of sexual attraction to clients , the feelings that addressed include surprise, startle, shock, guilt, anxiety about unresolved personal problems, fear of losing control, fear or being criticized, frustration at not being able to speak openly-or at not being able to make sexual contact, confusion about tasks, confusion about boundaries and roles, confusion about actions, anger at the client’s sexuality as well as fear or discomfort at frustrating the client’s demands (Corey et al, 2011).


In case that I do feel sexual attraction to a patient who also has sexual attraction to me, I would maintain my composure and do my best to evade any sexual relationship. The ways that I can do this would be to acknowledge the feelings of attraction, explore the reasons why I am attracted to a client as well ask if there is something about this person that meets one of my needs, never act out feelings of attraction and be careful of actions that might foster the attraction, such as sitting close to the client, hugging the client or prolonging the sessions(Sadock and Sadock, 2009).


Other ways would be to seek out experienced colleague, supervisor or personal therapist who might be able to help me decide on a course of action. Importantly, I must monitor boundaries by setting clear limits on physical contact, self disclosure and client requests for personal information. If I feel that I still am physically and sexually attracted to the patient despite other efforts then it would be advisable that I terminate the professional relationship and refer the client to another therapist (Sadock and Sadock, 2009). It is important to note that having any sexual relationship with a current client is prohibited by the APA Code of Ethics (Fisher, 2009) and would and could result in a legal proceeding that could warrant one’s loss of license and sexual harassment charges. It is advisable that one always maintains a strict professional relationship and thus evade entangling one in any social or sexual relationship with patients.







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