Lecture 6 Flashcards
Multiple role relationships
Standard 3.05. A multiple relationship occurs when a psychologist is in a professional role with a person and at the same time is in another role with the same person, at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or promises to enter into another relationship in the future with the person or a person closely associated with or related to the person. A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists. Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical. (these can also be concurrent or consecutive)
Boundaries
Gutheil & Gabbard (1993) - boundary crossings - if to facilitate progress, for benefit of client, not a violation. Boundary violations - not ok.
Multiple Role Relationships
Business - should not do business with client. Bartering services for services: same have done this, shouldn’t do it, but nothing says you can’t. Bartering services for goods: again no. Family or close friends: no unless an emergency - same with employees. Socializing with clients and students: sometimes ok. Friendships with clients and students: probably not. Friendships after therapy or graduation: can be ok. Acquaintances as clients: depends on how well you know them.
What to do if one comes up - 3.05
If a psychologist finds that due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the ethics code.
Harm
Role expectations are incompatible - e.g. dating someone who gives you grades. Conflicts of interest are involved. Power differential becomes great.
3.06 Conflict of Interest
Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial, or other interests or relationships could reasonably be expected to impair their objectivity, competence, or effectiveness in performing their functions as psychologists or expose the person or organization with whom the professional relationship exists to harm or exploitation.
Erring
Most likely to err: improperly trained, poor personal boundaries, needy (chronic or situational). Risky times: new (not experienced), mid-career (career not going that well), and seniors (think you know everything)
Rural communities
Dual relationships sometimes cannot be avoided, more out of office incidental contact with clients, evaluate the potential for harm, conflict of interest, exploitation, etc. Talk about it with the client, consult and document.
Psychologist in rural community
Psychologist specialized in treatment of children/adolescents, husband’s father died, moved to town of 10,000 in KS. Office policies identified her as the wife of that farmer. Had 3 kids, so clients in birthing class, school, coaches, church, husband’s farming products sold to clients. Informed consent, confidentiality, incidental encounters, education of her family, no work with family members of her close friends.
Psychologists in health care
Different culture and practices (they often just treat everyone in the family). 60% of primary care appointments have psychosocial aspect. When referred out to MH, 10% comply. Patients may see primary care provider across the life span and may require periodic MH services. All multiple relationships are not unethical. Ethical decision making (Ivey & Doenges, 2013). Duration, chance of future contact, level of service, alternative resources for patient.
Gifts
Can’t take expensive ones because it’s hard to be objective. Can accept if not manipulative and not too expensive. Have to think about context and intentions. You don’t give clients gifts unless appropriate and done for the benefit of the client (they might misinterpret gifts).
Ethical decision making (Youngren, 2002)
Is the dual relationship necessary? Is the dual relationship exploitative? Who does the dual relationship benefit? Is there a risk that the dual relationship could damage the client? Is there a risk that the dual relationship could disrupt the therapeutic relationship? Am I being objective in my evaluation of this matter? Have I adequately documented the decision making process in the health record? Did the client give informed consent regarding the risks to engaging in the dual relationship?
Sexual relationships
3.08 - exploitative relationships. 7.07 sexual relationships with students and supervisees. 10.06-10.08 sexual intimacies with clients etc. (not until 1981 did 10.06-10.07 become unethical). 10.08 added in 1992 along with 7.07.
3.08 Exploitative relationships
Psychologists do not exploit persons over whom they have supervisory, evaluative, or other authority, such as clients/patients, students, supervisees, research participants, and employees.
