Dual Relationships, Effective Therapists and Reasonable Patient Care

To take a line from Pope Francis's visit to the US this past week, good counselors will

"accompany you in your suffering."

Yes, just that itself is healing! To share your life experiences -maybe things that you have never shared with another living human being, can be therapeutic and healing.
But, there are other requirements to an effective and helpful relationship with your therapist.

After many decades of trial and error, the professional counseling field has developed a set of ethics and laws to protect the consumer. In the case of mental health, the consumer is often vulnerable and seeking, many times facing tragedy, mental, physical or emotional pain, great loss, or debilitating fear. For these reasons, professional boundaries have been established.

Here are some things that are never professionally sound practices from a licensed clinician (believe it or not, I still here stories like this)

1. Working for your counselor or "trading" services, i.e. therapy visits for office cleaning and bartering are strictly forbidden and constitute a "dual relationship."

2. An occasional anecdote is reasonable, but, if you know more about your counselor than he/she knows about you, something is wrong.
3. Any financial dealings beyond paying for your therapy service is clearly of concern and a huge red flag. Misconduct includes borrowing/lending/selling/buying/gift giving.

 4. If a therapist is unable to continue to see a client, it is a reasonable standard of care that three other clinicians be provided. If a client terminates therapy, this should be respected wholly by the therapist. A patient has the right to end therapy at any given point.

5. Physical relationships, out of office invitations, intimately socializing beyond the therapy hour are unethical and can result in loss of licensure for the therapist.

A patient/client must not feel an emotional "obligation" to their clinician. For this reason, ethical counselors will maintain clear and professional boundaries that keep the client's treatment goals as the singular goal of the relationship. 

These principles do not suggest that a counselor should not or will not care for his client. Caring is a necessary ingredient to helpful counseling! But, they provide limits to the relationship so that the client, and his/her mental and emotional well-being, is able to remain the primary focus of treatment services.

All Licensed Therapists in California can have their license verified online through the Board of Behavioral Sciences, Dept of Consumer Affairs.