by Stacey Prince
The American Psychological Association’s official stance on dual relationships is to try to avoid them. Associations with clients that extend beyond the therapy relationship have the potential to be exploitive, harmful, and at the very least confusing. This includes friendships, business relationships, and certainly sexual relationships, which are categorically prohibited with both former and current clients, for obvious and sound reasons.
However, the reality is that in certain communities paths can cross in ways that create sometimes unavoidable dual relationships. For example, if you are the only mental health professional in a rural community who treats a particular disorder, you may end up providing psychotherapy to someone with whom you have another type of association as well (for example, your child’s schoolteacher, or the owner of a local business you frequent). In these situations the APA ethical guidelines encourage us to carefully consider the pros and cons of such relationships, weighing the necessity of treatment and availability of alternatives against the potential risks. The guidelines suggest that multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not necessarily unethical, but that the clinician should carefully consider all potential outcomes when entering into such relationships.
Another community in which dual relationships are sometimes unavoidable is the LGBT community. Even in a sizable city such as Seattle, clients and therapists frequently run into each other at LGBT social and political events, there may be a higher incidence of intentional dual relationships when therapists wish to support LGBT owned businesses, and we more often find ourselves in the awkward situation of dating someone who is friends with (or once dated, or once was the client or therapist of) one’s own client or therapist. In an article on this topic Laura Brown (1998) referred to lesbian and gay communities as “sociological and psychological small towns,” in which members frequently and unavoidably cross paths.
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As an Asian American Psychologist, I struggle with this issue as well. I had no idea how small of an "ethnic minority" community we are here in Seattle until I searched for my own psychotherapist. I find myself gravitating toward People of Color as my medical, psychological, professional support systems, which inevitably means that I juggle trual/dual relationships regularly. In terms of my other social identities of both Agent and Target positions, I am a heterosexual, able-bodied, middle-class, educated woman. I imagine that the more Target identities we belong to, the smaller our "towns" become, and the more honest we need to be with ourselves and others. This is so complex, sometimes stressful and shameful - other times rewarding and empowering - I so appreciate the start of this type of dialogue because we too often struggle with this in isolation.
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