Multiple Relationships in Psychotherapy and Counseling

Prior to the 21st century, psychotherapists were mainly advised by ethicists and risk management so-called experts to completely avoid dual relationships, which were viewed as “boundary violations”. The prevalent, and rather absurd, belief was that dual relationships are generally unethical and often lead to sexual relationships. Among the forces that helped to change this absurd view was Arnold Lazarus’ and Ofer Zur’s 2002 book, Dual Relationships and Psychotherapy. It broke new ground by pointing out that not only were dual relationships often unavoidable, but that, when carefully and clinically considered, they could be a beneficial part of psychotherapy and part of a healthy community.

Dr. Zur’s subsequent numerous publications and extensive teaching on the ethical and clinical aspects of dual relationships has employed critical thinking to thoroughly explore this important new perspective. This new perspective takes into account that multiple relationships are unavoidable in numerous settings, such as rural, military, forensic, rehabilitation and spiritual communities and several educational settings.

Eventually most ethicists (regretfully, not all) and most major professional mental health associations revised or clarified their view of multiple relationships and debunked the unfounded and rather paranoid negative ‘old’ view of multiple relationships. As a result, many previously frowned upon, so-called “boundary violations” are now considered as flexible “boundary crossings” and an adjunct to good psychotherapy.

A few more points regarding multiple relationships in different settings:

• Cyberspace, social media and TeleMental health have significantly been changing the psychotherapy landscape. They introduce both acknowledged/unacknowledged and avoidable/ unavoidable multiple relationships.
• In rural communities, where dual relationships are often unavoidable and are part of the richness of a healthy interdependent community, there is a complex tension for therapists between confidentiality, privacy, and being active members of community.
• Psychotherapists who are actively members of a religious community report that multiple relationships often constitute some of the most complex, rich and difficult ethical problem they face.
• Clients who have successfully graduated from addiction and residential treatment centers may eventually become co-employees and/or co-facilitators.
• Forensic and police settings make multiple relationships practically unavoidable, often creating tension between therapists’ fidelity to the client, to the courts and to the prison or police administration. It is not unheard of that judges impose or introduce complex multiple relationships when they order forensic treaters to conduct competency to stand trial or sanity evaluations.
• In educational settings, instructors of experiential group therapy classes, inevitably find themselves in the dual role of class instructors and group facilitators.