Dual Relationships and Boundary Management in Social Work Practice

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Kenneth Simmons
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1 Dual Relationships and Boundary Management in Social Work Practice NASW April 2012

2 Dual Relationships Defined Dual or multiple relationships occur when professional assume two or more roles at the same time or sequentially with a client, such as: assuming more than one professional role or blending of professional and nonprofessional relationships. Examples of dual relationships include: bartering for goods or services; providing therapy to a relative or friend s relative, socializing with clients, becoming emotionally or sexually involved with a client or former client, or combining roles of supervisor and therapist.

3 NASW Code of Ethics Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate and culturally sensitive boundaries. (1.06) Social workers should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced. (1.09) Social workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client. If social workers engage in conduct contrary to this prohibition or claim that an exception to this prohibition is warranted due to extraordinary circumstances, it is social workers not their clients who assume the full burden of demonstrating that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally. (1.09)

4 Boundary Crossing Gutheil and Gabbard (1993) distinguish between boundary crossings and boundary violations. A boundary crossing occurs when a social worker is involved in a dual relationship with a client or colleague that is not intentionally exploitive, manipulative, deceptive, or coercive. Are not inherently unethical, such as when a worker shares personal information to help clients work through their own issues.

5 Boundary violation A boundary violation occurs when a social worker engages in a dual relationship with a client or colleague that is exploitive, manipulative, deceptive, or coercive. A key feature is a conflict of interest that harms clients or colleagues

6 Categories of violations Intimate relationships Sexual relationships Physical contact Personal benefits Monetary gain Goods and services Emotional/dependency needs Altruistic gestures Promoting client dependence Reversing roles Performing favors Giving gifts Unanticipated circumstances Social and community events Mutual acquaintances

7 When dual relationships are unethical? Interfere with the social worker s exercise of professional discretion Interfere with the social worker s exercise of impartial judgment Exploit client, colleagues, or third parties to further the social worker s personal interests Harm clients, colleagues, or third parties Corey & Herlihy, 1997; Epstein, 1994; NASW, 2000; Reamer, 1998/2001

8 Client or former client? Literature suggests three possible positions regarding the definition of former client, largely within the context of sexual behavior: 1. There is no such thing as ex-client once a client, always a client. 2. A specified time period after termination of services defines a transition from client to ex-client. 3. A client ceases to be a client at the point of termination of services. Reamer, 1998; Silbertrust, 1993; Sloan, Edmond, Rubin, & Doughty, 1998

9 Social workers definitions of exclient Study published in Social Work in 2002 showed a distinct difference between public-sector and private sector social workers in defining the point at which a client becomes and ex-client: Public sector = upon termination of services Private sector = once a client, always a client May point to differences in approach to working with clients = shortterm vs. long-term Mattison, Srinika, & Craxton, 2002

10 Do you agree? Dual relationships are inherent in the work of all helping professionals, regardless of work setting or client population. Despite certain clinical, ethical, and legal risks, some blending of roles is unavoidable, and it is not necessarily unethical or unprofessional.

11 Are they harmful? St. Germaine (1993) maintains that although dual relationships are not always harmful to clients, it is essential for professionals to recognize the potential for harm associated with any kind of blending of roles. Kitchener and Harding (1990) contend that dual relationships range from those that are potentially seriously harmful to those that have little potential for harm.

12 Do you agree? Consistent yet flexible boundaries are often therapeutic and can help clients develop trust in the social work relationship.

13 Minimizing risks Within the last 10 years the trend in state licensure boards has been to prohibit all dual relationships, including nonsexual dual relationships (O Laughlin, 2001). Even more disturbing than the absolute ban on dual relationships with current clients is the ban on social, business, or financial relationships until 24 months has passed since the last professional contact.

14 Measures to minimize risks Herlihy and Corey (1997) and St. Germaine (1993) identify the following measures aimed at minimizing the risks inherent in dual or multiple relationships: Maintain healthy boundaries from the start. Secure the informed consent of clients and discuss with them both the potential risks and benefits of dual relationships or any kind of blending off roles. Remain willing to talk with clients about any potential problems and conflicts that might arise. Consult with other professional to resolve any dilemmas. Seek supervision when dual relationships become particularly problematic or when the risk for harm is high. Document any dual relationships in clinical case notes. When necessary, refer clients to another professional.

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