Counselling and legislations

1. COUNSELLING AND LEGISLATIONS
D U A L A N D M U LT I P L E
R E L AT I O N S H I P S I N C O U N S E L L I N G
P R A C T I C E , S T R AT E G I E S F O R
M A I N TA I N E T H I C A L S TA N D A R D S ,
L I M I TAT I O N S O F E T H I C A L C O D E

2. INTRODUCTION
 All counsellors are bound by a Code of Ethics and Practice,
as well as by whichever professional body they belong to.
 The clauses state that:
 No information is exchanged with a third party, unless with
prior client consent.
 The content of the meeting remains private and confidential.
 In extreme circumstances, where the counsellor becomes
concerned for the personal safety of the client, the client is
informed that confidentiality may be broken. A Risk Help Plan
can be created to provide additional support for the client.

3.  In order that the client feels comfortable in expressing
him/herself in an uninhibited way, the relationship
between the client and the counsellor needs to be built
on reciprocal trust.
 It is the counsellor’s responsibility to provide a safe,
confidential environment, and to offer empathy,
understanding and respect.

4. DUAL AND MULTIPLE RELATIONSHIPS IN
COUNSELLING PRACTICE
 Dual relationships (Zur, 2014) refer to situations where two
or more connections exist between a therapist and a client.
 Examples of dual relationships are when a client is also a
student, friend, employee or business associate of the
therapist.
 Zur defines many types of dual relationships, including social,
professional, business, communal, institutional, forensic,
supervisory, sexual, and digital, online, or internet dual
relationships.

5.  While all dual relationships involve boundary crossing,
exploitative dual relationships are boundary violations.
 Multiple relationships are situations in which a therapist is
engaged in “one or more additional relationships with a
client in addition to the treatment relationship.
 Multiple relationships may be sexual or nonsexual.
 Nonsexual multiple relationships may include social,
familial, business or financial relationships, and possibly
others

6.  Multiple relationships are distinguished from incidental
contacts.
 Incidental contacts are situations in which the
psychologist and client have an interaction in another
setting that is unplanned and very brief.
 Examples may include noticing that the psychologist and
client are attending the same concert or community
event, being members of the same organization, or
briefly crossing paths in the community” (Barnett, 2014).

7.  Dual relationships are also referred to as multiple
relationships, and these two terms are used
interchangeably in the research literature.
 According to the APA: A multiple relationship occurs
when a psychologist is in a professional role with a
person and
 (1) at the same time is in another role with the same
person,

8.  (2) at the same time is in a relationship with a person
closely associated with or related to the person with
whom the psychologist has the professional relationship,
or
 (3) promises to enter into another relationship in the
future with the person or a person closely associated
with or related to the person
 Zur (2013) also asserts that dual relationships or
Multiple Relationships in psychotherapy refers to any
situation where multiple roles exist between a therapist
and a client.

9. TYPES OF DUAL RELATIONSHIPS
 Foreseeable dual roles are those that the therapist has time
to consider or contemplate before engaging in them.
 For example considering whether or not to provide
psychotherapy to someone with whom you have had a prior
social or business relationship.
 An unforeseeable dual role is a role that cannot be
reasonably foreseen.
 Ex. joining a gym and then finding out one of the fitness
instructors is a client of yours.

10.  A social dual relationship is where therapist and client
are also friends or have some other type of social
relationship.
 Social multiple relationships can be in person or online.
 Having a client as a Facebook 'friend' on a personal,
rather than strictly professional basis, may also
constitute social dual relationships.

11.  Other types of therapist-client online relationships on social
networking sites may also constitute social dual or multiple
relationships.
 A professional dual relationship or multiple relationship
is where psychotherapist or counselor and client are also
professional colleagues in colleges, training institutions,
presenters in professional conferences, co-authoring a book,
or other situations that create professional multiple
relationships.

12.  A special treatment-professional dual relationship may
take place if a professional is, in addition to
psychotherapy and counseling, also providing additional
medical services, such as progressive muscle relaxation,
nutrition or dietary consultation,etc
 A business dual relationship is where therapist and
client are also business partners or have an employer-
employee relationship.

13.  Communal dual relationships are where therapist and
client live in the same small community, belong to the
same church or synagogue and the therapist shops in a
store that is owned by the client or where the client
works.
 Communal multiple relationships are common in small
communities when clients know each other within the
community.

14.  Institutional dual relationships take place in the
military, prisons, some police department settings and
mental hospitals where dual relationships are an
inherent part of the institutional settings.
 Some institutions, such as state hospitals or detention
facilities, mandate that clinicians serve simultaneously or
sequentially as therapists and evaluators.

15.  Forensic dual relationships involve clinicians who serve as
treating therapists, evaluators and witnesses in trials or
hearings. Serving as a treating psychotherapist or counselor
as well as an expert witness, rather than fact witness, is
considered a very complicated and often ill-advised dual
relationship.
 Supervisory relationships responsibilities and function
inherently involve multiple roles, loyalties. A supervisor has
professional relationships and duty not only to the supervisee,
but also to the supervisee's clients, as well as to the profession
and the public.

16.  Dual Relationships Can Be Avoidable, Unavoidable,
Common - Normal, Mandated, Unexpected
 Voluntary-avoidable: Usually these dual relationships take
place in large cities or metropolitan areas where there are
many therapists
 Unavoidable: Multiple relationships are often unavoidable in
rural areas, sports psychology, drug and alcohol recovery
inpatient, outpatient or 12 step programs, such as AA, and on
Native American reservations. Supervisory relationships
inherently involve multiple role and multiple relationships, as
supervisors have responsibility to the supervisee, the client,
the community, and the profession at large.

17.  Dual relationships are sometimes unavoidable in institutions,
such as mental hospitals.
 Common - Normal: Multiple relationships are a common part
of universities and colleges as well as training institutions,
such as psychoanalytic, cognitive-behavioral, somatic and
other teaching institutions.
 Mandated: These dual relationships take place primarily in
the military, prisons, jails and in some police department
settings. Inherent in these settings is that the mental health
professional is mandated to have multiple accountabilities.

18.  At times, psychologists in forensic mental institutions are also
involved in mandated multiple relationships (especially when
ordered by a judge to serve in a dual role of evaluator and
treater).
 Unexpected: Unexpected multiple relationships occur when a
therapist is not initially aware that the client they have been
working with is also a friend, colleague, co-worker or even an
ex-spouse of another client.
 Similarly, unexpected dual relationships take place when,
unbeknownst to the psychotherapist, the client joins the
therapist's church, book club, or baseball recreation league.

19.  Dual Relationships Can Be Concurrent Or
Sequential
 A concurrent dual relationship takes place at the
same time as therapy.
 A sequential dual relationship takes place after
therapy has ended.
 For example, after therapy ends a therapist decides to
embark on social or business relationships.

20. STRATEGIES FOR MAINTAIN ETHICAL STANDARDS
 The fundamental values of counselling and psychotherapy
include a commitment to:
 Respecting human rights and dignity
 Protecting the safety of clients
 Ensuring the integrity of practitioner-client relationships
 Enhancing the quality of professional
knowledge and its application
 Alleviating personal distress and
suffering

21.  Fostering a sense of self that is meaningful to the
person(s) concerned
 Increasing personal effectiveness
 Enhancing the quality of relationships between people
 Appreciating the variety of human experience and culture
 Striving for the fair and adequate provision of counselling
and psychotherapy services

22. ETHICAL PRINCIPLES OF COUNSELLING AND
PSYCHOTHERAPY
 Being trustworthy: honouring the trust placed in
the practitioner (also referred to as fidelity)
 Being trustworthy is regarded as fundamental to
understanding and resolving ethical issues.
 Practitioners who adopt this principle: act in accordance
with the trust placed in them; strive to ensure that
clients’ expectations are ones that have

23.  reasonable prospects of being met;
 honour their agreements and promises;
 Regard confidentiality as an obligation arising from the
client’s trust;
 restrict any disclosure of confidential information about
clients to furthering the purposes for which it was
originally disclosed.

24.  Autonomy: respect for the client’s right to be self-
governing
 This principle emphasises the importance of developing a
client’s ability to be self-directing within therapy and all
aspects of life.
 Practitioners who respect their clients’ autonomy:
 ensure accuracy in any advertising or information given in
advance of services offered; seek freely given and
adequately informed consent;
 emphasise the value of voluntary participation in the
services being offered;

25.  engage in explicit contracting in advance of any commitment
by the client;
 Protect privacy;
 protect confidentiality;
 normally make any disclosures of confidential
 information conditional on the consent of the person
concerned;
 and inform the client in advance of foreseeable conflicts of
interest or as soon as possible after such conflicts become
apparent.
 The principle of autonomy opposes the manipulation of clients
against their will, even for beneficial social ends.

26.  Beneficence: a commitment to promoting the
client’s well-being
 The principle of beneficence means acting in the best
interests of the client based on professional
assessment.
 It directs attention to working strictly within one’s limits
of competence and providing services on the basis of
adequate training or experience.
 Ensuring that the client’s best interests are achieved
requires systematic monitoring of practice and
outcomes by the best available means.

27.  There is an obligation to use regular and on-going
supervision to enhance the quality of the services
provided and to commit to updating practice by
continuing professional development.
 Non-maleficence: a commitment to avoiding harm to
the client
 Non-maleficence involves: avoiding sexual, financial,
emotional or any other form of client exploitation;
avoiding incompetence or malpractice; not providing
services when unfit to do so due to illness, personal
circumstances or intoxication.

28.  Justice: the fair and impartial treatment of all clients and
the provision of adequate services
 The principle of justice requires being just and fair to all
clients and respecting their human rights and dignity.
 A commitment to fairness requires the ability to appreciate
differences between people and to be committed to equality
of opportunity, and avoiding discrimination against people or
groups contrary to their legitimate personal or social
characteristics.

29. PERSONAL MORAL QUALITIES
 The practitioner’s personal moral qualities are of the
utmost importance to clients.
 Many of the personal qualities considered important in
the provision of services have an ethical or moral
component and are therefore considered as virtues or
good personal qualities.
 Personal qualities to which counsellors and
 psychotherapists are strongly encouraged to aspire
include:

30.  Empathy: the ability to communicate understanding of
another person’s
 experience from that person’s perspective.
 Sincerity: a personal commitment to consistency
between what is professed and what is done.
 Integrity: commitment to being moral in dealings with
others, personal straightforwardness, honesty and
coherence.
 Resilience: the capacity to work with the client’s
concerns without being personally diminished.

31.  Respect: showing appropriate esteem to others and their
understanding of themselves.
 Humility: the ability to assess accurately and acknowledge
one’s own strengths and weaknesses.
 Competence: the effective deployment of the skills and
knowledge needed to do what is required.
 Fairness: the consistent application of appropriate criteria to
inform decisions and actions.
 Wisdom: possession of sound judgement that informs practice.
 Courage: the capacity to act in spite of known fears, risks and
uncertainty.

32. GUIDANCE ON GOOD PRACTICE IN COUNSELING AND
PSYCHOTHERAPY
 Good standards of practice and care require
professional competence; good relationships with
clients and colleagues; and commitment to being
ethically mindful through observance of
professional ethics.

33.  Good quality of care
 Good quality of care requires competently delivered
services that meet the client’s needs by practitioners
 Practitioners should give careful consideration to the
limitations of their training and experience
 If work with clients requires the provision of additional
services operating in parallel with counselling or
psychotherapy, the availability of such services ought to
be taken into account, as their absence may constitute
a significant limitation.

34.  Good practice involves clarifying and agreeing the rights and
responsibilities of both the practitioner and client at
appropriate points in their working relationship.
 Practitioners are advised to keep appropriate records of their
work with clients
 All records should be accurate, respectful of clients and
colleagues and protected from unauthorised disclosure.
 Clients are entitled to competently delivered services that are
periodically reviewed by the practitioner.
 These reviews may be conducted, when appropriate, in
consultation with clients, supervisors, managers or other
practitioners with relevant expertise.

35.  Maintaining competent practice
 All counsellors, psychotherapists, trainers and
supervisors are required to have regular and on-going
formal supervision/consultative support for their work in
accordance with professional requirements.
 Regularly monitoring and reviewing one’s work is
essential to maintaining good practice.
 A commitment to good practice requires practitioners to
keep up to date with the latest knowledge and respond
to changing circumstances.

36.  They should consider carefully their own need for
continuing professional development and engage in
appropriate educational activities.
 Practitioners should be aware of and understand any
legal requirements concerning their work, consider these
conscientiously and be legally and professionally
accountable for their practice.

37.  Keeping trust
 The practice of counselling and psychotherapy
depends on gaining and honouring the trust of clients.
 Clients should be adequately informed about the nature
of the services being offered.
 Practitioners should obtain adequately informed
consent from their clients and respect a client’s right to
choose whether to continue or withdraw.
 Practitioners should ensure that services are normally
delivered on the basis of the client’s explicit consent.

38.  Respecting privacy and confidentiality
 The professional management of confidentiality concerns the
protection of personally identifiable and sensitive information
from unauthorised disclosure.
 Disclosure may be authorised by client consent or the law.
 Communications made on the basis of client consent do not
constitute a breach of confidentiality.
 Exceptional circumstances may prevent the practitioner from
seeking client consent to a breach of confidence due to the
urgency and seriousness of the situation, for example,
preventing the client causing serious harm to self or others.

39.  Responsibilities to all clients
 Practitioners have a responsibility to protect clients when
other practitioners are placing them at risk of harm.
 They should review the grounds for their concern and
the evidence available to them and, when appropriate,
raise their concerns with the practitioner’s manager,
agency or professional body.
 If they are uncertain what to do, their concerns should be
discussed with an experienced colleague, a supervisor
or raised with this Association.

40.  Providing clients with adequate information
 Practitioners are responsible for clarifying the terms on
which their services are being offered in advance of the
client incurring any financial obligation or other
reasonably foreseeable costs or liabilities.
 All information about the services should be honest,
accurate, avoid unjustifiable claims, and be consistent
with maintaining the good standing of the profession.
 Particular care should be taken over the integrity of
presenting qualifications, accreditation and professional
standing.

41. LIMITATIONS OF ETHICAL CODE
 Informed Consent
 A counselor must respect their client's right to choose
whether they will engage in counseling and what
issues are to be addressed during ongoing treatment.
It is the counselor's duty to discuss and outline the
counseling process with their client, in addition to
creating a treatment plan that both you and your client
agree upon.

42.  Confidentiality
 With few exceptions, counselors are expected to keep the
information shared during a counseling session confidential and
agree not to divulge any information without prior permission
from your client.
 Unlike physicians and lawyers, counselors do not share the right
of privileged communication, meaning that information discussed
with your client and any private notes pertaining to your client can
be subpoenaed by a court of law.
 Counselors are also required to break their promise of
confidentiality when the threat of foreseeable harm to the client or
other identified parties is made, including the abuse or neglect of
a minor or incapacitated adult.

43.  The parents of a minor child may also have legal rights in
your state to discuss issues raised during therapy
sessions with their child.
 The specifics of what needs to be reported to whom
ultimately varies based on local and state laws, so
counselors should consult with their state Board of
Licensed Professional Counselors and local court clerk
for information pertinent to their specific duty to warn.

44.  Imposing Values
 The Code of Ethics supported by the American
Counseling Association discourages the act of imposing
on personal values in your clients.
 Your role as a counselor is to assist your clients through
their personal struggles, not to tell them what they
should and should not believe or act upon.
 A Christian counselor should not condemn her Muslim
client for her faith, nor should she suggest a treatment
option that would be in direct violation of her client's
faith..

45.  Practice and Supervision
 Counselors should not practice outside of their area of
expertise without proper training and supervision.
 A counselor practicing in an academic setting may have
received basic training in the treatment of patients with
chemical addictions; however, if this counselor has not had
experience in the treatment of addictions, she should seek
supervision and training in the area prior to engaging in active
treatment with an addictions client.
 When appropriate, counselors should refer their clients to other
counselors qualified in treating their patient's specific needs.

46.  Primum Non Nocere
 Counselors, like all medical professionals, are held to
the Hippocratic oath, that above all else, they should do
no harm to their client.
 In the counseling profession, this requires that the
counselor take careful consideration when engaging in
the therapeutic treatment of a patient.
 Your client's presenting issue, while at first may seem
purely emotional or psychological in nature, may be the
result of multifaceted problems, ranging from physical
health to a lack of social support.

47.  The concept of doing no harm also extends to the
personal relationship that counselors have with their
clients.
 Dual relationships -- maintaining a personal, professional
or romantic relationship outside of the counseling session
with a client -- is prohibited by the American Counseling
Association's code of ethics, as these relationships have
the potential to become exploitative