Navigating Dual Relationships in Counselling: Ethical Guidance for Practitioners

Ken Kelly: Dual relationship, where someone that has some kind of connection to us, asks us if we can help them with something.

Rory, what’s the dangers?

Rory Lees-Oakes: The dangers are clients don’t get the best service that they should, and also they may leave therapy.

So a dual relationship is where we know the client in another setting. So say for instance, a client phones up and says, I want to make an appointment. They come in and you realise that this client is the teacher at your child’s school and that you sit talking to them at parents evening.

These things have to be very precisely managed. But I want to share a story from my own training experience of a dual relationship that is sometimes not spoken about. So many years ago when I trained, my peer came into class and she was very eager to talk about her practice and her client.

So the tutor said, okay, fire away. And she said, what’s happened is I went to see my supervisor and I spoke about my client and I talked about my client, and my supervisor said, oh, I know who your client is, he was my client a few months ago and went on to share information to my peer that the client hadn’t disclosed to her.

One being that the client was an alcoholic, and it absolutely ruined the therapeutic relationship for my peer because every time she sat in front to the client, she held knowledge that the client hadn’t disclosed to her. And she had to play this game of working with the client and not leaking this information where the client may say, I never told you that, where did you get that from?

And eventually, and inevitably, the relationship broke down and the client left unsatisfied and not getting the best service. And none of this was my peer’s fault. The supervisor should have been a bit more thoughtful about sharing information because it was a dual relationship.

Now, fast forward to two weeks ago, I have a letter in the post bag. Not from a therapist, from a client.

What happened was that the person who wrote in had a therapist, it didn’t work out very well and they moved on to an another therapist. And during the conversation with the second therapist, she discovered that the second therapist’s supervisor, was her first therapist. And as with my peer all those years ago, had disclosed information to her second therapist that the person writing in hadn’t disclosed.

And as a consequence of that, the relationship broke down. And at the end of the letter was, she was frightened to go back to therapy because she had issues of trust. And I was bloody furious when I read that, bloody furious, I was, I had to go get two cups of tea.

Ken Kelly: We’re gonna have to bleep that, Rory.

Rory Lees-Oakes: Yeah, just bleep it out, and I’m making light of it because it’s my presenting style. But, I was really saddened by this, and disappointed. And I know sometimes we can’t avoid dual relationships, but in cases like this, it would’ve just taken the supervisor to have kept their own counsel, or maybe just referred the supervisee on, but it completely wrecked the therapeutic relationship.

So dual relationships can cause real damage to therapeutic relationships.

And it’s not an often discussed side of it, the supervisor knowing the client. So there we are, Ken.

Ken Kelly: That’s a really nice introduction and overview of this. And you mentioned it’s not a very often discussed topic.

This is something that we do face as qualified practitioners, as you’ve used in your example there. It’s gonna happen. If it hasn’t already happened, it will happen. It’s cyclic, it just comes around and it’s really sneaky. It can sneak in a way that you don’t initially see it.

So we’ve identified what dual relationship is, we’ve identified some actual occurrences of that in practice. I’m gonna give five points here of why dual relationships are problematic.

So the first one is a loss of objectivity. The counsellor may struggle to remain impartial if they have a personal business or family relationship with the client, and this can cloud judgement and reduce the effectiveness of therapy. That’s one.

Another one is power imbalance and exploitation. Now, those are big words. We talk about all these topics separately, but dual relationship increases the risk that the counsellor, even unintentionally, could take advantage of the client. The therapeutic relationship inherently carries a power differential, and as soon as there is a dual relationship that is or can be magnified and it’s unseen.

Another one is confidentiality risks. Boundaries around what is shared in the counselling room may become blurred in other settings, potentially breaching confidentiality. If that person is a family member, a colleague within the same working organisation, it can be tricky.

Confused boundaries, which I think is probably the most obvious one. The client may become unsure whether the counsellor is responding as a therapist or a friend or a colleague, which undermines the safety and the clarity needed for effective therapy work.

And one last one is damage to the therapeutic alliance, which you’ve already touched on, Rory, and given beautiful examples of. Dual roles can lead to loss of trust, if the client feels that the counsellor is not fully there for them, and that’s the dual relationship.

Can you fully be there and not have the information coloured as it is, coming in? A clear frame of reference, a clear window to look at that with. So those five areas where dual relationships might show themselves to be problematic.

And I think of this, Rory. There are many people that go into businesses with family members or friends. And at the time of going into that relationship, it’s the greatest idea. Everybody’s excited and it’s wonderful. But there’s a dual relationship within that. And it plays out in business.

If you look at the stats in the business world, those can be really troubling unless they’re very boundaried, they can be really troubling relationships. And one or the other can become unhappy with it as it goes out. Rory, what does our ethical bodies tell us about dual relationships? Is it mentioned by the BACP, the UKCP, the NCPS?

And we’re obviously using the ethical bodies here in the UK, but of course, wherever you are, look to your ethical body. But Rory, share a little bit about what we work to in the UK.

Rory Lees-Oakes: Yes, ethical bodies have been aware of the difficulty and the challenges of dual relationships as long as I’ve been a therapist, and certainly the more well known bodies such as the BACP, UKCP, and of course the National Counselling and Psychotherapy Society, all have within their codes of practice or ethical frameworks, paragraphs that say that dual relationships sometimes can’t be avoided, however, they must be managed and where possible, we should avoid them. And they all state that.

I think probably the BACP has a deeper reflection, they have four topics within their framework where they where they talk directly to dual relationships. But generally speaking in the psychotherapeutic profession, we avoid them where we can, and make other arrangements.

And I want to talk about the other arrangements, because I think up till about 2019, you were pretty much stuck with the locality of where you lived. You would see a supervisor and usually everybody knows each other. It’s a very a cliquey kind of world, everybody seems to know each other. But now with the advent of online and telephone therapy that loomed after the pandemic, the answer to this may be quite simple.

If your supervisor does know the client, you’re no longer hampered by just looking for supervising the local area. You go to any of the directory’s, you find anybody who does online work, you could speak to someone hundreds of miles away in a different parts of the country via a video link and have your supervision like that.

And I think that’s probably one of the benefits that the online world has brought us, Ken, that we could cast our net very far where it comes to professional consultation.

Ken Kelly: Yeah, always when we speak about online and telephone working, make sure that you’ve done the training that is recommended by your ethical body.

And remember that may well have changed. Pre COVID would’ve been one set of recommendations, it’s a lot more robust now, so make sure that is checked up on.

And if you do find that you need some training, counsellingtutor.com, click on our products tab and we have a really good online and telephone counselling training course that gives you the information that you will need to transfer face-to-face working to that medium.

Staying with this, I wanted to go through some examples, Rory. Because, we hear about something, but how do we actually pin that into real life?

I wanna share the following examples. Counselling a friend. Now this happens a lot at student level, I’m studying to become a counsellor or a psychotherapist, and a friend may say, oh, I’ve been struggling with X, Y, Z for a really long time, and I was thinking of reaching out and speaking to someone. Because I know you and you are my friend, I wonder if I can tell you about my stuff. So, scenario, a counsellor agrees to provide therapy to a long term friend struggling with anxiety, what are the challenges? The counsellor may avoid asking probing questions to protect the friendship. The client may withhold information to avoid damaging the relationship, and it’s difficult to maintain confidentiality if the counsellor sees them socially.

Within counselling, confidentiality is sacred, but within friendships, how often is a friend telling us, oh, don’t tell anybody about X, Y, and Z. And before we know it we’re telling another friend. Now you mustn’t really mustn’t tell anybody this by X, Y, Z, because we’re not bound by the confidentiality of the ethical framework as we are in therapy. So there’s that risk.

And then counselling a colleague is another example here. You may be in an organisation where the organisation says, oh, you are a counsellor, you’ve got these skills, and this X, Y, Z person is struggling a little bit. So what are the challenges?

So the scenario is a therapist is asked to provide counselling to someone in the same organisation, and the challenges here, workplace dynamics and hierarchy may influence what that therapeutic process feels like for both parties. Can you imagine giving therapy to the person who is responsible for giving you salary increases and promotions?

Confidentiality may be compromised if others in the workplace are aware of the relationship. They know they’re coming to counselling, and they know you are a counsellor, they know all the relationships, so that may weaken that confidentiality, and the counsellor might avoid addressing issues that could impact the working relationship.

I’ll share one more, and this is counselling a family member. And, it may be a distant family member that you don’t see too often, that you won’t see every five years or something, but it’s still a family member.

Now, scenario, the counsellor agrees to support a cousin experiencing grief. And the challenges, emotional entanglement can cloud professional boundaries. Prior knowledge, this is a big one this, prior knowledge of the client’s history might lead to assumptions or biased interpretations. And the last one here is there’s a risk the client may not feel free to speak openly. Prior knowledge is a massive one, and I think it links into what you presented, having a knowledge. Let’s say I’m working with a cousin and I know that cousin drinks too much. I may see all their problems through that lens. I can’t be impartial and just welcome that person in because I was at that New Year’s party where they were dancing on the tables and they don’t remember it. I’m clouded by all of that dual relationships.

Summary of the core challenges: blurred boundaries lead to role confusion, the client may not feel safe or fully open, risk of emotional harm or exploitation, counsellor may struggle to remain ethically grounded and objective, and then possibility of ethical complaints or damage to your professional reputation.

Final thoughts, Rory, on boundaries?

Rory Lees-Oakes: I mean in terms of boundaries, which is very much all about dual relationships. I would say that they’re not automatically unethical. I think we throw the term unethical around a little bit too much but they need very careful managing and also a huge amount of reflection.

And I think the starting point is client safety, the dignity, the relationship between the therapist and the client is sacrosanct really, because the research is really clear. One of the biggest parts of the curative factor of therapy, is the therapeutic relationship.

And anything that tarnishes that, or fractures that, is almost certainly going to impact on the client. I would say that we need, where possible, to remove ourselves from dual relationships, or at least think very carefully before we go into a relationship where a dual relationship either exists or emerges.

Ken Kelly: And that’s the tricky thing, we’ve spoken about avoiding dual relationships here for ethical reasons, and for the safety of our own practice and the client. But there’s another discussion to be had and that’s what you do and how you manage it, if it should show itself.

Because they can emerge. Like you say, you can be in session six of somebody that you’re working at a very deep level with and it can emerge that there is a dual relationship. And what do you do? Do you pull the rug from under their feet and say, oh, I can’t work with you anymore. And off you go and you’re now on your own again.

Or are there other ways of managing it? And of course there are other ways of managing it. But that’s something to take away from this as a practitioner. Maybe give some thought to, what would you do if a dual relationship emerged during therapy?

And I’ll give you a clue, step one, speak to your supervisor. Unless of course the challenge sits with your supervisor, in which case go to step two, speak to your supervisor.

Rory Lees-Oakes: Or take counsel from a trusted colleague, I think that peer discussions, to get a second opinion, as a qualified practitioner.

But yeah, dual relationships, tricky and need managing with sensitivity.