What Steps Should Clinicians Follow When Working Through an Ethical Dilemma?

What factors should clinicians weigh when evaluating whether a dual relationship is appropriate?

When assessing whether a dual or multiple relationship poses an ethical concern, clinicians should first examine the power differential between themselves and the other individual. Power is often relative rather than absolute. Someone who is licensed, more experienced, or in a position to write a letter of recommendation may exert more influence in an interaction than they initially realize, and clients or trainees may perceive far more power in the relationship than the clinician assumes. This awareness should inform decisions such as whether a supervisor can appropriately provide a favor to a supervisee or whether socializing outside a clinical or academic role is appropriate.

Clinicians should also consider the duration and nature of the relationship, including whether contact is brief and episodic or ongoing, and whether a professional relationship has truly and permanently terminated before entering into a different kind of connection with the same individual. 

For example, a family returning after a completed evaluation to request services for a different family member raises questions worth thinking through in advance. When uncertainty exists, consultation with a trusted colleague, rather than making a unilateral decision, is strongly recommended, since another professional may offer a perspective the clinician cannot access on their own.