Posted: February 3rd, 2023
Below are vignettes that address the ethical dilemma of professional boundaries and dual role relationships. Read each vignette and analyze the potential ethical/legal issues reflected in the vignettes, and comment on the availability of options for each of the therapists depicted in the vignettes. How would you have handled these situations?
Vignette 1
John is a licensed marriage and family therapist in a large metropolitan area where he has been in private practice for nearly ten years. John prides himself on being an ethical therapist who strives to maintain appropriate professional boundaries. However, in spite of his careful and professional conduct, John tends to worry that someday he may end up being listed in the Disciplinary Actions of the BBS. In fact, a few of his colleagues tease him and tell him he’s being overly obsessive about making a mistake. Once, when John unexpectedly encountered one of his clients at a local supermarket, he gave his patient a quick wave of his hand and immediately left the store. John recently discovered that more than one of his patients attends exactly the same church services that he does. Now John wonders whether he ought to attend a different church service or perhaps, a different church.
Vignette 2
Howard is a licensed clinical social worker with a very busy private practice. Howard’s office manager, Susan, is an extremely competent individual who performs her job with great skill. One day Susan informed Howard that she would have to take a leave of absence from her position immediately due to an emergency in her family. Due to the nature of the emergency, Susan states that she will probably be unable to return to work for several months or longer. Howard is caught off-guard and is understandably worried about the prospects of finding a qualified replacement for Susan in so little time. To make matters worse, he seriously doubts that Susan will ever return to her job. After a few days, at the point that Howard is beginning to feel overwhelmed, a solution seems to drop into his lap. Ann, one of Howard’s current patients, informs Howard that she knows someone who would be “perfect” for the vacant office manager job. Surprisingly, the person that Ann recommends is actually a former patient of Howard’s by the name of Tara. Howard knows Tara well, having treated her for almost two years. He recalls that Tara is a very bright and responsible person and that she probably would be perfect for the job. Although Tara completed therapy with Howard about six months ago, he still has her file in his office cabinet. Howard recognizes that this is an important decision. Consequently, after giving it some very serious thought, Howard called Tara the following day and offered her the job.
Vignette 3
Maria is a licensed child psychologist who has recently enrolled her 10-year-old daughter in the area’s only art class. Her daughter quickly made friends with one of the other students and asked if she could come over for a play date. Maria discovers the student is one of her clients. She speaks with the client’s mother and the mother assures her she feels comfortable with the girls’ developing friendship. Maria agrees to the play date.
SOLUTION
Vignette 1:
A therapist named Sarah is seeing a client named Alex in therapy sessions. Alex mentions that he is interested in taking a workshop that Sarah is offering in the community. Sarah knows that Alex is a good fit for the workshop, and she believes that it would benefit him greatly. However, she is not sure if it is ethical for her to invite him to attend the workshop.
Potential ethical/legal issues: Sarah is facing a potential boundary issue, as she is in a dual role relationship with Alex – both as a therapist and a workshop facilitator. This could lead to exploitation and power imbalances, as well as compromise the therapeutic relationship and objectivity.
Available options: Sarah should avoid inviting Alex to attend the workshop and instead refer him to another professional who can offer the workshop. She should also document the situation in her therapy notes and consult with a supervisor or professional organization for guidance.
Vignette 2:
A therapist named John is seeing a client named Claire in therapy sessions. Claire confides in John that she is struggling with addiction and is seeking support. John, who is also in recovery, offers to take Claire to a 12-step meeting with him after their therapy session.
Potential ethical/legal issues: John is in a dual role relationship with Claire – both as a therapist and a fellow member of a 12-step program. This could compromise the therapeutic relationship, objectivity, and confidentiality.
Available options: John should avoid taking Claire to a 12-step meeting and instead refer her to a peer support group or other resources. He should also document the situation in his therapy notes and consult with a supervisor or professional organization for guidance.
In conclusion, both Sarah and John are facing potential ethical and legal dilemmas in their dual role relationships with their clients. It is important for therapists to maintain professional boundaries, objectivity, and confidentiality in order to ensure the well-being of their clients.
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