Dual Relationships and Boundary

Management in Social Work Practice

NASW

April 2012

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.

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)

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.

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

Categories of violations

Intimate relationships

Personal benefits

Emotional/dependency needs

Altruistic gestures

Unanticipated circumstances

Sexual relationships

Physical contact

Monetary gain

Goods and services

Promoting client dependence

Reversing roles

Performing favors

Giving gifts

Social and community events

Mutual acquaintances

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

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

Social workers’ definitions of ex-

client

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 = short-

term vs. long-term

Mattison, Srinika, & Craxton, 2002

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.

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.

Do you agree?

Consistent yet flexible boundaries are often

therapeutic and can help clients develop trust in the

social work relationship.

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.

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.