Ethical Decision-Making Trendelle Vaughn University of Phoenix January 17, 2010 Ethical Decision-Making Introduction Dual or multiple relationships between a therapist and his or her client has been the subject of much controversy over the past two and half to three decades. A dual relationship may exist when the therapist takes on another role outside of his or her therapist duties. This second relationship could consist of a social, financial, or personal one that occurs at the same time as therapeutic sessions are taking place.
Dual relationships between client and therapist are to be avoided at all costs; a dual relationship can be problematic for both the client and the therapist. This paper will identify what a dual relationship consists of, what the ethical dilemma of a dual relationship is, and apply each step of the first 14 steps of the ethical decision making process to a dual relationship by using a real life situation that a dual relationship came into question. Definition Dr. Ofer Zur defined dual relationship as, “Any situation where multiple roles exist between therapist and client. A dual relationship could consist of one in which the client is a family member, friend, student, or colleague of the therapist. Dual relationships could also be as simple as the therapist inviting his or her client out for munches, excepting invitations to parties, lending financial support to a client, or a relationship of a sexual nature. Dr. Janet Sonne stated, the 2002 American Psychological Association presented research that implied non-sexual dual relationships are sometimes unavoidable and in many cases are not considered unethical.
However, a dual relationship between the client and therapist of a sexual nature is considered unethical and illegal and should be avoided at all costs. While working for a not for profit agency as a youth advisor, a colleague entered a nonsexual dual relationship with a student. Step 1: Indentify the situation This step requires the therapist to evaluate and assess the ethical dilemma. As part of the assessment, the therapist wants to know is the ethical dilemma clearly defined, can the wording of the definition be misconstrued to fit the therapists actions, or do the definition hide or bend the important facts.
As previously stated, a dual relationship is any situation which multiple role exits between the client and therapist. The statement clearly defines what a dual relationship is, which can be misleading or confusing to a therapist is in what action or judgment is considered to be unethical or illegal. In the example provided, the dual relationship was clearly defined as unethical. The youth advisor violated the client therapist ethics by not only establishing a relationship with the student which became more than one of a professional level, but also the course the student was invited to the advisors home.
They spent an extremely large amount of time together after hours. The behavior of the youth advisor was a clear violation of work ethics and code of conduct. Step 2: Anticipate who will be affected by your decision According to Pope and Vasquez, “It is rare that our ethical decisions affect only a single client or a single colleague and no one else”; if a situation arises where a therapist enters a dual relationship with a client how the therapist handles the situation could have an adverse affect on the client, the therapist, on his or her practice, and other clients he or she sees as well.
In the scenario presented, the youth advisors decision to enter into a dual relationship with the student negatively affected him, the student, his fellow colleagues, and the company. Step 3: Figure out who, if anyone, is the client Is the therapist confused about who the client may be or if one individual is the client and another individual is paying, does this present a conflict of interest for the therapist based on divided loyalty or a conflict in judgment?
This step does not apply to a therapist entering a dual relationship with his or her client. Determining who is making the payments does not have an effect on whether or not a client and his or her therapist enter into a dual relationship. Step 4: Assess your relevant areas of competence Is the therapist fully competent to handle the situation? If there are other steps that could be taken to make the therapist more effective? Is there anyone else better equipped to handle the situation? Step 4 does not come into play for a dual relationship as well.
A dual relationship involves the therapist entering more than one role with the client, where this step could be a factor in a dual relationship is if a colleague points out the detrimental reactions of what the relationship could bring if the therapist continues to engage in the relationship. Step: 5: Review relevant formal ethical standard Pope and Vasquez states, “Do the ethical standards speak directly or indirectly to this situation? Are the ethical standards ambiguous when applied to this situation”, the ethical standards of a duel relationship can speak indirectly and be ambiguous when applied. Although dual relationships are considered to be avoided, there are some situations that can be avoided. However, it is not clearly stated regarding what form of a dual relationship is unavoidable and what is not when speaking of a nonsexual relationship. In the situation of the youth advisor and the student, the relationship is ambiguous on the grounds that a sexual relationship was never established between the youth worker and the student.
The student knowing where the youth advisor stayed and visiting him after hours played a role in the relationship becoming unethical. Step 6: Review relevant legal standards. What are the legal standards that speak to the ethical dilemma are there legislation and case laws that speak directly or indirectly on the situation (Pope & Vasquez, 2007)? In determining the legal standards of a therapist entering a dual relationship with his or her client depends on what type of relationship is it, a nonsexual or sexual relationship. Step 7: Review the relevant research and theory.
Pope and Vasquez ask, “Is there any new research or theory that helps to conceptualize, understand, or respond to the situation” ? There has not been new research or theory to help therapists better understands the relationships with a client that goes beyond that of a professional one. Step 8: Consider how your personal feelings may affect judgment. How does the situation play on your feelings? Does it make you mad, angry, upset or afraid? Do you feel the situation may get you in trouble?
Personal feelings are relevant if a therapist and client enter a dual relationship, the therapist has to take into account whether or not the relationship will cause him or her to develop feelings which are not favorable. If it does, this is a sign that the relationship is unethical or inappropriate. Step 9: Consider what effects that social, cultural religious or similar factors may have on the situation. The same situation may be unethical in one culture, religion, or society but be acceptable and ethical in another.
A dual relationship can take on a different meaning based on what culture, religion, or society belief may be. Step 10: Consider Consultation If at all possible, consult someone who can provide useful information or is on the situation. Furthermore, if there is an individual who has encountered the same or similar situation consults him or her for information that could be useful. This step is extremely relevant to a dual relationship between the client and therapist. There are many cases which other therapist has been involved in nonsexual relationships that can provide valuable information pertaining to the situation.
In the situation with the youth advisor, had he consulted with one of his colleagues or the supervisor about the proper way to handle the relationship the consequences that transpired could have been avoided. Step 11: Develop alternative courses of action. Determine other strategies or another approach that could be taken toward the situation. One other approach that can be taken when a dual relationship between the client and counselor develops is avoiding it. However, if a dual relationship is unavoidable take steps to protect the client and yourself by documenting the situation or keeping another individual in the sessions.
Step 12: Evaluate the alternative course of action. Step 13: Try to adopt the perspective of each person who will be affected. Try viewing the situation from the vantage point of the other individual who will be affected by the decision being made. If the therapist thinks from the standpoint of the client and how a dual relationship will affect that individual, he or she will be less likely to engage in a relationship other than a professional one. Step 14: Decide what to do and then review or reconsider it. *Importance of ethical decision-*making
Ethical decision making involves more than a belief in what is considered ethics, it involves the ability to be ethically sensitive the needs of the client, and the therapist must posse the ability to assess difficult, vague, and incomplete facts. Last, the therapist must be able to implement his or her ethical decision effectively. Moreover, the wellbeing of the client and the protection of the therapist are the top priority when providing services to clients. Conclusion Ethical decision- making is important in determining whether or not a therapist should enter a dual relationship with a client.
When applying 14 of the 18 ethical steps to decision- making to a dual relationship it is vitally important to establish who the client is, what the situation is, who will be most affected by the decision to enter the relationship, and what step could be taking to prevent the situation from occurring. In the scenario presented in the paper, the youth advisor entered into a dual relationship with the student which resulted in grave consequences for both him and the student. If he would have stopped and applied these 14 steps to his decision, the relationship could have been avoided.
References
Pope, K. S. & Vasquez M. J. T. (2007). Ethics in psychotherapy and counseling. San Francisco. CA: Josey Bass. Sonne, J. (2005). Nonsexual Multiple Relationships: A Practical Decision- Making Model for Clinicians. Retrieved January 15, 2010 from http://kspope. com/site/multiple-relationships. php#copy. Zur, O. (2010). Dual Relationships, Multiple Relationships & Boundaries In Psychotherapy, Counseling & Mental Health. Retrieved January 15, 2009 from http://www. zurinstitute. com/dualrelationships. html.
