Dual Relationships, During and After Therapy

I’ve been thinking about dual relationships, what exactly they are and why they sometimes exist between a therapist and client.

I’m going to start by offering my own ideas about what a dual relationship is in the context of counselling. When we form a therapeutic relationship between therapist and client, we do so with the understanding that this relationship will offer something different to other relationships; it will offer confidentiality, an ethical frame and, in particular, carefully considered boundaries which allow the relationship to exist, uncomplicated by the typical demands and counter-demands of human relationships. We do this to allow a safe space for the client to freely express and explore their most difficult experiences, and hidden areas of self.

A dual relationship arises when the client and therapist have an additional relationship which exists outside of the therapeutic frame. Perhaps a business relationship, a family connection, a friendship, a teacher/student role, colleagues or neighbours, members of the same congregation – some relationship which necessitates a different dynamic, different expectations and different boundaries.

My title for this blog acknowledges dual relationships which occur after therapy, and this is because I believe the therapist’s ethical responsibility towards their client exists beyond the termination of therapy. When friendships, business relationships or even romantic relationships occur between therapist and client after therapy, this, in my view, still represents a dual relationship, no matter how much time has passed.

So how do we navigate dual relationships? Well, I suppose I think, for the most part, we ought to avoid them. As anyone who reads this blog regularly is probably aware, I am particularly keen that the counselling profession does more to acknowledge the potential for harm to occur in therapy, and to take collective responsibility for the harm that does occur, and has occurred for many clients.

For me, dual relationships are one, largely avoidable area where harm could foreseeably occur. This is particularly true in relationships where there is a shift from the relationship serving the emotional needs of the client only, to emotional needs of both parties being met within the relationship.

A major benefit of therapy is that the client need not worry about having to hold the emotional energy of the therapist. As soon as the relationship requires two-way emotional holding of the other, there is a shift in the dynamics which is unlikely to meet with the expectations of either party. When this gap between expectation and reality presents itself, there is great potential for hurt to occur, and potentially for this to taint any positive outcomes achieved in therapy.

I find the idea of therapists forming sexual relationships with clients or former clients particularly troubling. The BACP ethical framework states that “exceptionally”, such relationships post-therapy may be permissible, however here I must diverge from the guidance of the framework and say that in my view, there is never a good reason to form a sexual relationship with a former client.

Where an additional business relationship occurs, it is equally important to consider the potential harm to the therapeutic alliance and therefore to the client. Is such a relationship completely necessary? I would think very rarely, and if there is another option, in my view it should always be perused before a dual relationship is arranged.

If a dual relationship is unavoidable, like anything, it needs to be discussed carefully with the client to manage boundaries and reduce the risk of harm. I would also emphasise the importance of ongoing supervision and consultation with colleagues (as per the BACP ethical framework 2018) in order to obtain more objective views on the necessity and ethics of any dual relationship.

Above all, in my view it is vital to be mindful of what it can feel like to be a client. The inevitable imbalance of power in the relationship, the strong feelings that a client can have for a therapist (and vice versa) could easily impact on clear decision-making from either party. Perhaps some clients may feel reluctance to say ‘no’ to a dual relationship, even if they are not sure whether it is what they want – in instigating a dual relationship, I would argue that we cannot always be certain that we are properly upholding the ethical principle of client autonomy.