Monday, January 28, 2008
Non-Sexual Dual Relationships - Conclusion
One of the core problems in blurred, dual, or conflictual relationships is the core idea presented by Pope. Pope made the claim that, " non-sexual dual relationships, while unethical and harmful per se, foster sexual dual relationships". The great fear and ethical taboo among therapists is sex with a client. According to Pope's reasoning, the primary rationale for avoiding all dual-relationships has been that they may eventually lead to a sexual relationship. This is not the only fear, but it is one of the greatest among professionals. Obviously not all non-sexual dual relationships lead to sexual ones, but it is likely that almost all sexual relationships have had to pass through a dual relationship stage at some point before turning into a fully sexual relationship. But, is it possible that some dual relationships can be beneficial to a client? In some circumstances they may be.
In the survey previously mentioned it was found that respondents considered some dual relationships to be useful. For example, some dual relationships provide role modeling, nurturing and a giving quality to therapy. This is one of the main dilemmas that people working in residential addiction treatment programs face. In many cases, the counselor/therapist can provide vital role modeling to clients.
Throughout the history of addiction treatment, addiction treatment professionals have struggled with this dual relationship dilemma. A national survey of 827 certified drug and alcohol counselors was conducted to determine their ethical beliefs and practices in the area of dual relationships. The results were compared to a national study of psychologists, psychiatrists, and social workers around 13 areas of practice behavior involving dual relationship situations and no significant difference was found between the groups. The results indicate that the same concerns over dual relationships plague professionals in many different counseling fields, not just those with graduate degrees.
Often professionals working in the field of residential addiction treatment are in recovery themselves. This presents both a unique problem and a unique opportunity for both the client and the clinician. Clinicians working in addiction treatment who are also recovering addicts are able to provide a model for recovery from addiction. However, problems arise when the clinician's recovery program coincides with the client's recovery program. This presents an unusual and tricky situation when clients, current or former, attend publicly held recovery meetings (Alcoholics Anonymous meetings, Narcotics Anonymous meetings, and other 12-step based community meetings) within their community.
The situation is this: A clinician attends her regular, local 12-step based recovery meeting. She walks into the meeting and suddenly one of her former, or perhaps current, clients waves at her from across the room. At first this may appear no different from any other situation where a professional runs into a client in a social setting, but the main difference here lies in the nature of the situation. When the addiction treatment clinician attends a recovery meeting and happens to encounter his client in the same meeting, the clinician is suddenly presented with an awkward situation. The therapist's role is now compromised. She is both therapist and patient.
The positive aspect of this particular compromising situation is that the addiction counselor is modeling positive behavior in the above example. The therapist/counselor is living what she is prescribing to the client, namely that addiction is something that can be overcome and something that she continues to address by attending recovery meetings. In this situation the dual role can be beneficial to the client.
At one time, ethical guidelines for addiction counselors were full of varying opinions on how to handle the situation mentioned above. Only recently have most of the addiction treatment licensing organizations adopted the wording of the APA ethical guidelines regarding dual relationships. According to Dr. Jerry Brown, an experienced clinical psychologist with over 20 years of experience working in the field of addiction treatment, in the past the general consensus among professionals working in the addiction treatment field was that no addiction treatment professional should attend a 12-step based meeting where his or her client(s) were also in attendance. In these situations it was suggested that the counselor or treatment professional immediately leave the meeting upon seeing the former or current client. This rule has widely been abandoned for more general statements in their ethical guidelines regarding dual relationships. The Department of Alcohol and Drug Programs Text of Final Regulations ยง13060 (c)(4) now states the following regarding dual relationships: "Engaging in social or business relationships for personal gain with program participants, patients, or residents, their family members or other persons who are significant to them" is prohibited. The attempt at defining what to do in certain situations, once an aspiration of addiction treatment licensing organizations, has become a thing of the past.
The law remains intentionally vague in certain areas so as to leave the judge and lawyers room to argue a particular angle based on the facts and circumstances of a case. It seems that the APA has chosen to do the same thing with its ethical code regarding dual relationships. If the APA were to attempt to do what addiction licensing boards have attempted to do in the past and define particular instances where dual relationships might occur and as far as to outline what the professional should do in each situation, then the APA would undoubtedly produce an exhaustive volume of rules and regulations that not even the most astute and cautious psychologist would read. Perhaps it is better that the APA keep the guidelines on dual relationships as they are and leave the interpretation to professionals. As discussed previously, not all dual relationships are harmful to the patient, but it is better left to the psychologist, the psychiatrist, the social worker and the addiction counselor as to where the line should be drawn.
Undergoing MyBlogLog Verification
In the survey previously mentioned it was found that respondents considered some dual relationships to be useful. For example, some dual relationships provide role modeling, nurturing and a giving quality to therapy. This is one of the main dilemmas that people working in residential addiction treatment programs face. In many cases, the counselor/therapist can provide vital role modeling to clients.
Throughout the history of addiction treatment, addiction treatment professionals have struggled with this dual relationship dilemma. A national survey of 827 certified drug and alcohol counselors was conducted to determine their ethical beliefs and practices in the area of dual relationships. The results were compared to a national study of psychologists, psychiatrists, and social workers around 13 areas of practice behavior involving dual relationship situations and no significant difference was found between the groups. The results indicate that the same concerns over dual relationships plague professionals in many different counseling fields, not just those with graduate degrees.
Often professionals working in the field of residential addiction treatment are in recovery themselves. This presents both a unique problem and a unique opportunity for both the client and the clinician. Clinicians working in addiction treatment who are also recovering addicts are able to provide a model for recovery from addiction. However, problems arise when the clinician's recovery program coincides with the client's recovery program. This presents an unusual and tricky situation when clients, current or former, attend publicly held recovery meetings (Alcoholics Anonymous meetings, Narcotics Anonymous meetings, and other 12-step based community meetings) within their community.
The situation is this: A clinician attends her regular, local 12-step based recovery meeting. She walks into the meeting and suddenly one of her former, or perhaps current, clients waves at her from across the room. At first this may appear no different from any other situation where a professional runs into a client in a social setting, but the main difference here lies in the nature of the situation. When the addiction treatment clinician attends a recovery meeting and happens to encounter his client in the same meeting, the clinician is suddenly presented with an awkward situation. The therapist's role is now compromised. She is both therapist and patient.
The positive aspect of this particular compromising situation is that the addiction counselor is modeling positive behavior in the above example. The therapist/counselor is living what she is prescribing to the client, namely that addiction is something that can be overcome and something that she continues to address by attending recovery meetings. In this situation the dual role can be beneficial to the client.
At one time, ethical guidelines for addiction counselors were full of varying opinions on how to handle the situation mentioned above. Only recently have most of the addiction treatment licensing organizations adopted the wording of the APA ethical guidelines regarding dual relationships. According to Dr. Jerry Brown, an experienced clinical psychologist with over 20 years of experience working in the field of addiction treatment, in the past the general consensus among professionals working in the addiction treatment field was that no addiction treatment professional should attend a 12-step based meeting where his or her client(s) were also in attendance. In these situations it was suggested that the counselor or treatment professional immediately leave the meeting upon seeing the former or current client. This rule has widely been abandoned for more general statements in their ethical guidelines regarding dual relationships. The Department of Alcohol and Drug Programs Text of Final Regulations ยง13060 (c)(4) now states the following regarding dual relationships: "Engaging in social or business relationships for personal gain with program participants, patients, or residents, their family members or other persons who are significant to them" is prohibited. The attempt at defining what to do in certain situations, once an aspiration of addiction treatment licensing organizations, has become a thing of the past.
The law remains intentionally vague in certain areas so as to leave the judge and lawyers room to argue a particular angle based on the facts and circumstances of a case. It seems that the APA has chosen to do the same thing with its ethical code regarding dual relationships. If the APA were to attempt to do what addiction licensing boards have attempted to do in the past and define particular instances where dual relationships might occur and as far as to outline what the professional should do in each situation, then the APA would undoubtedly produce an exhaustive volume of rules and regulations that not even the most astute and cautious psychologist would read. Perhaps it is better that the APA keep the guidelines on dual relationships as they are and leave the interpretation to professionals. As discussed previously, not all dual relationships are harmful to the patient, but it is better left to the psychologist, the psychiatrist, the social worker and the addiction counselor as to where the line should be drawn.
Undergoing MyBlogLog Verification
Labels: Dual-Relationships
