2-1 Discussion_ PSY 570

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Good afternoon, class, The most common form of ethical complaints brought before the APA ethics committee involves sexual and nonsexual boundaries and role blurring. According to the American Psychological Association (APA), a multiple-role relationship is defined as a relationship that occurs when there is an overlap in roles between the professional and personal relationship of therapists and clients, such as a therapist holding a professional relationship with a client while assuming a personal relationship as well (Koocher & Keith-Spiegel, 2016). Multiple-role relationships can also be categorized through conflicts of interest, such as a client’s sister dating the therapist or a declaration of intent to assume a relationship with a person or close association. These relationships can assume a sexual or nonsexual basis; however, for the relationship to fit the defined criteria of the APA, the initial relationship must have a confirmed connectedness to the parties. The vast majority of multiple-role relationships begin with the primary role being the therapy client; however, there are instances where the role is assumed by other significant individuals, such as the client’s family member. (Koocher & Keith-Spiegel, 2016). Multiple-role relationships or dual relationships are present in various degrees; however, many individuals perceive these relationships to be sexually or romantically based. Despite this, there are several instances where multiple-role relationships are nonsexual. For instance, Dr. Murphy, a well-known, successful therapist, has a close friend, Scarlett, who frequently discusses her marital issues with Dr. Murphy. Through friendly guidance from Dr. Murphy, Scarlett is able to convince her husband, Oliver, to attend counseling. As Dr. Murphy is well- renowned, Scarlett seeks referrals for family and marriage therapists from Dr. Murphy; however, Dr. Murphy volunteers to take on their case and save them the hassle of finding a therapist. In this case, Dr. Murphy is assuming the role of friend and therapist, which has blurred the boundaries of professional and personal. Although there are evident cases where the crossing of boundaries or roles positively impacts a therapeutic alliance, goal, or outcome, it is important to recognize that these crossings are perceived differently from the client's perspective. Despite the intentions or context of the relationship, the intentions can be perceived differently by each party; therefore, the intent of one individual may not be received in congruency by the other (Koocher & Keith-Spiegel, 2016). In the instance of Dr. Murphy, the blurring of boundaries and roles has created a conflict of interest. Although it is not illegal to counsel family and friends, it is not advised. By taking on Scarlett’s case, Dr. Murphy has blurred the roles of personal and professional relationships; therefore, it has created an environment highly susceptible to bias and subjectivity. Although Dr. Murphy’s intentions are in good nature, they could have drastic repercussions on the quality of treatment, as the multiple roles may impose impairments on the capacity of treatment and practice Dr. Murphy offers. The presence or potential for “faulty expectations, mixed allegiances, role confusion, and misinterpretations of motives can lead to disappointment, anger, and sometimes the total collapse of relationships” (Koocher & Keith-Spiegel, 2016, p. 250).

There are differing opinions on the crossing of boundaries or roles in mental healthcare. Some mental health professionals contend that the concept of maintaining rigid boundaries or roles encourages a “mechanical application” of psychotherapy rather than a therapeutic alliance based on empathy and the singularity of clientele (Koocher & Keith-Spiegel, 2016). On the opposing side, mental health professionals contend that lax boundaries and role-bending place the client and therapist at a greater risk for unethical conduct, such as exploitation or harm. As the ethics codes specify more lenient restrictions, therapists can avoid conflicts in boundaries or role-bending by practicing self-awareness and mindfulness. For instance, therapists should focus their attention on creating a safe sanctuary, free of external influences; however, when engaging in multiple-role relationships, therapists should be mindful of the basis of the relationship to avoid even the appearance of self-interest or conflict of interest. As multiple-role relationships require the therapist to wear various hats, it is crucial to be self-aware of the dynamics and functions of the personal relationship and their differences in comparison to the professional relationship. (Koocher & Keith-Spiegel, 2016). As multiple-role relationships are a frequent occurrence in the mental health profession, there are circumstances to which they are permitted; however, the permittance of such a relationship is greatly dependent upon the boundaries drawn among therapists and clients to ensure an appropriate division between personal and professional relationships. Furthermore, it is dependent upon the permissibility of other aspects of the Code of Ethics. For instance, therapists need to take appropriate precautions when conducting therapy outside of the traditional setting and prepare the client and therapist for potential instances where contact is made outside of therapy, such as at the grocery store (Koocher & Keith-Spiegel, 2016). In Dr. Murphy’s case, it is not advised and, generally unethical, to have conflicts of interest in matters of therapy; however, for the sake of discussion, the dual relationship could be permitted if Dr. Murphy appropriately establishes boundaries between personal and professional relationships. Dr. Murphy should also require the normal fee for sessions regardless of the personal relationship while also avoiding the acceptance or exchange of gifts, goods, or gestures from Scarlett or Oliver. Dual relationships and multiple-role relationships are not inherently negative; however, as mental health professionals, individuals must proceed with these relationships with the utmost care and caution, as the repercussions could be damaging to both the client and therapist. Thank you for reading! - Rachel M. References: Koocher, G. P., & Keith-Spiegel, P. (2016). Chapter 1. In Ethics in Psychology and the Mental Health Professions: Standards and cases (Fourth, pp. 4–5). story, Oxford University Press.

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