Multiple Relationships, Multicultural Considerations, and

Question 1

What might secondary/multiple relationships with clients include? What are they unethical and when are they not?

Answer 1

Multiple relationships are secondary relationships with clients, including but not limited to:

• -Social relationships
• -Business relationships
• -Community connections

Potentially leads to boundary crossings or violations.

• -crossings are ntentional actions likely to benefit clients
• -Violations are cause or are likely to cause harm and should have been predicted by professional

Question 2

What are the two accepted options in the sequence of multiple relationships?

Answer 2

1. Concurrent
   Professional and personal simultaneously
   More difficult to form
2. Consecutive
   Professional then personal
   Personal then professional more avoidable
   Professional then professional  car buying ex.,

Which are most troubling?

Question 3

Why are multiple relationships frowned upon or avoided?

Answer 3

Danger of multiple relationships stems from conflicts of social roles
Role differences exist along a spectrum
Risk of problems increase the greater the disparity in expectations and obligations

Question 4

What do the Ethics Codes say about multiple relationships?

Answer 4

ACA Code of Ethics, Section A.5 Roles and Relationships with Clients (Welfel, 2010, p. 220).

APA Ethical Principles, 3.04-3.05 and 3.08, avoiding harm, multiples relationship, and exploitative relationships (Welfel, 2010, p. 221).

AAMFT Code of Ethics, Principle 1 Responsibilities to Clients, section 1.3.

Commonalities:

• Take care not to exploit others
• Multiple relationships should be avoided
• Be confident multiple relationship is in other’s best interest

Question 5

What are three dynamics to consider when Evaluating Risk of Boundary Violations?

Answer 5

1. Fiduciary responsibility-obligation ot promote other’s self-esteem; we receive fee and satisfaction of good work; secondray relationship mustn’t
2. Emotional involvement
3. Power differential

Question 6

What does Fiduciary Responsibility have to do with evaluating boundary violations?

Answer 6

• Primary obligation to promote client’s well being
• Alternative conceptualization: duty to abstinence from gratifying self-interests in therapy; only reward is fee paid and satisfaction of therapeutic gains
• Ethically bound to enhance client’s autonomy and independence

Question 7

How do multiple relations potentially act against obligation to enhance client’s autonomy & independence?

Answer 7

consider an example

Question 8

What does Emotional Involvement have to do with evaluating boundary violations?

Answer 8

• Client’s emotional connection is critical to therapy outcomes
• Client trust & confidence in therapist
• Clarity around relationship roles and expectations
• Secondary relations with different roles creates confusion in emotional reaction to both roles
• Your relaitonship with them may cloud your judgemnet, more/less directive, personal value on friendship could conflict professional value, obligation, e.g. mandatory reporter

Question 9

What does Power differential have to do with evaluating boundary violations?

Answer 9

• Imbalanced relationship put client at disadvantage in secondary relationship
• Danger of role slippage, loosening of boundaries around both relationships

Question 10

What ethical principles are threatened by the power differential?

Answer 10

Autonomy (& voluntariness)
Justice
nonmaleficence

Could argue for fidelity, beneficence easily as well.

Question 11

What do the ethical codes say about accepting gifts from clients?

Answer 11

ACA Ethics Code: Consider therapeutic relationship, value of gift, clients motivation to give, and counselor’s motivation to accept

APA Code: No specific mention, but implored not to exploit clients

AAMFT Code: don’t give or receive gifts of substantial value or gifts that integrity/efficacy

Question 12

What situations may complicate avoidance of multiple/secondary relationships?

Answer 12

Small & rural towns

• –Difficult to avoid secondary relationships
• –Though more likely to have multiple relationships, are no more likely to engage in boundary violations

Small/highly integrated populations

Question 13

How might ethical codes approach Bartering? What are the risks?

Answer 13

Discouraged but acceptable to barter with clients as long as not exploitative or harmful to clients

APA adds avoiding if clinically contraindicated

Question 14

What are the three levels of culture?

Answer 14

1. Concrete
   Visible and tangible “festivals” “celebrations”
2. Behavioral
   Reflection of values
   language, gender roles, family structure
3. Symbolic
   Values and beliefs

Question 15

What are the Personal Dimensions of Identity

Answer 15

A, B, C Dimensions

Question 16

What are included in A Dimensions?

Answer 16

Unchangeable attributes of you’re situations, e.g., age, race, culture, sexual orientation, gender, social class, language, physicality

Question 17

What are included in B Dimensions?

Answer 17

• Consequences of A & C
• Changeable significant attributes of your situation, e.g., educational background, relationship status; hobbies, work, experience, religion

Question 18

What are included in C Dmensions?

Answer 18

Historical Moments, e.g., country declaring war, Japanese-Americans being held in internment camps, etc.

Question 19

Discuss the ethics of Multicultural Competency

Answer 19

• –Cultural self-awareness and sensitivity are essential
• –Awareness of how background influence attitudes, values, and biases
• –Recognize limits of competency
• –Recognize sources of discomfort
• –Possess knowledge about oppression, racism, discrimination, and stereotyping
• –Possess knowledge about social impact on others

Question 20

What statements do the ACA, APA, and AAMFT Codes make about multicultural practice?
What do the ethical principles say about multicultural counseling?
Where do the principles and the codes fall short?

Answer 20

Be competent

Do Justice