Part of what makes therapy meaningful and therapeutic is that the relationship a client has with their therapist is not a personal one. If a patient and therapist have a personal relationship, the relationship adopts a different dynamic, becoming what is known in the psychotherapy world as a dual relationship.
A dual relationship is when the therapist has two relationships with the client. They could be friends, colleagues, business partners, neighbors, and even romantic partners at the same time that they are therapist and client.
But how do you navigate a dual relationship as a mental health professional?
Here, we look at how dual relationships can be detrimental in some cases, and how to deal with them professionally.
Signs A Healthy Patient-Therapist Relationship Was Breached, According To A Mental Health Professional
Sometimes dual relationships are unavoidable – for example, it turns out you and your client are part of a similar social circle, live in the same neighborhood, or attend the same house of worship.
Some dual relationships are unavoidable, but all dual relationships cause interference in therapy that could be beneficial, or problematic. Dual relationships become detrimental in a psychotherapist-client relationship when there is a lack of objectivity, the boundaries between roles are blurred, there are no guidelines as to when therapy will conclude, or the different power dynamic enables the therapist to potentially cause harm in other aspects of the patient’s life (the children of both the therapist and the client are in the same class and become friends).
How To Create And Maintain Healthy Boundaries With Patients As A Psychotherapist
It is up to the psychotherapist to create and maintain healthy boundaries with patients. Your role as the mental health professional is to determine when a dual relationship has become too personal to remain professional and effective from a therapy stance. If you can no longer provide effective psychotherapy from an objective standpoint and can no longer solely be wearing your therapist hat during these interactions, you should terminate their therapy sessions with you.
Another thing you should do as the professional in these situations is take into consideration your own comfort level as well as your patient’s comfort level. Some patients may want to “please” their therapist or they see you as a friend and might not disclose their discomfort. This is something to broach during a therapy session. It’s important that the discussion around comfort should be led by you, the professional. Never leave it to your patient to bring this up. By leading the conversation, you remove any pressure the patient may feel around the subject.
Another way to keep the relationship professional is to monitor your self-disclosure during therapy sessions. Before disclosing anything personal to a patient, always pause and consider if your disclosure will be therapeutically helpful to them. Will they benefit from hearing what you have to say? If the answer is no, it is best not to share your experience.
If you find yourself in a dual relationship with a patient and you conclude that it can no longer be considered clinically appropriate, you need to terminate the clinical relationship. It’s important that you discuss this with the patient during a planned termination session. During this session, offer a referral to another provider if the patient desires, and ask the client how they want to be acknowledged by you in the future should they see you in public at a social activity or event. For example, if your former client says hello and another individual asks how you know each other, how should you answer that, according to your client’s wishes?
Dual relationships can be unavoidable, but they can interfere with the healthy boundaries between a mental health professional and their client. It’s important that you take control of the situation as the professional, and determine when the relationship becomes detrimental to the efficacy or objectivity of therapy.
Do you need some guidance on navigating dual relationships as a psychotherapist? Contact me at Balderman Wellness.