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Dual Relationships:
Navigating an Ethical Mine Field
Kenneth A Kish, ACSW
Detroit Receiving Hospital and University Health Center
University Psychiatric Center--Central Campus
101 East Alexandrine Street
Detroit, Michigan 48201
(313) 745-4811
This workshop will increase awareness of a common ethical issue--the need to avoid dual
relationships with clients. This ethical principal is found in the Code of Ethics of the American
Psychological Association and the National Association of Social Workers. As these codes are
frequently adopted by state boards of licensing and regulation, this issue is relevant to many
others who work in human services and are under some form of state regulation. It is also good
practice to adhere to this ethical principle.
Not so long ago, it was more common to hear that a therapist had a relationship with a client or
have even married a client. Some of the great names in the history of psychiatry and psychology
have married their patient/client. This was an accepted practice in the past.
Today, such a relationship would likely raise concern and might even be illegal. Awareness of the
power implicit in the relationship between a therapist and a client has resulted in concerns over the
abuse of such power. Sexual contact with clients was prohibited in ethical codes initially. In 1980,
the American Psychological Association went a step further when it prohibited dual relationships
as did the National Association of Social Workers in 1990.
Dual relationships are basically any relationship outside of the client-therapist relationship,
especially one which might conflict with the interests of the client or exploit the client. This
definition will be further developed and examples of problematic extra-therapeutic relationships
will be provided. Small group discussion of ethical dilemmas will be utilized. Lastly, suggestions
regarding how to avoid the pitfalls of dual relationships will be presented.