| Last month, a client whom you had been seeing for individual therapy sessions for about two years terminated. Both you and she felt that therapy had helped her resolve the social and vocational problems she had first presented and that it was time to terminate the therapeutic relationship. Yesterday she sent you an invitation to a house warming party she was hosting. Should you attend the party? |
| You are a supervisor in a child welfare agency. Recently one of your employees has been depressed following separation from his wife of 10 years. You feel that his personal problems have not detrimentally affected his work, but you notice that your supervisory sessions have been more focused on issues regarding the separation, i.e. stormy battles with his ex-wife, plans for joint custody of the children, and his search for a new apartment. He has also shared with you that this separation is particularly traumatic for him as it reminds him of when his parents separated when he was 10. You have had several lunches with him to discuss his problems. Microwaves are on sale at a local department store. You are thinking about buying one for him and visiting him in his new apartment, as you know in his new bachelor state he could use a microwave. |
Both of these case examples relate to the revised 1994 NASW Code of Ethics. Developed by the 1993 Delegate Assembly and effective July 1994, the Code of Ethics now explicitly warns social workers about engaging in "dual relationships with clients or former clients in which there is a risk of exploitation or of potential harm to the client. The social worker is responsible for setting clear, appropriate, and culturally sensitive boundaries." Another recent Code revision warns social workers in a "professional position vested with power, such as that of employer, supervisor, teacher, or consultant" to not use their position "to his or her advantage or to exploit others."
The first case example asks whether a social worker can enter a social relationship with a client after a therapeutic relationship has been terminated. The current Code of Ethics as well as previous Codes are explicit about avoiding sexual relationships with clients. Now the social worker is also advised to avoid any type of dual relationship including social non-sexual. The current revision seems to extend this prohibition about social relationships to former clients as well as current clients. In terms of the first example, an interpretation of the Code suggests the social worker should not attend the former client's house warming party as a way to avoid the possibility of developing a social relationship. A key issue is whether there is risk of exploitation or potential harm to the client. Would it harm the former client if the presence of the social worker became known to the other party attendees? What if the former client decides to return to therapy after the party?
Some social workers may argue that it may be therapeutic to attend an event to which a client invites the social worker. For example, attending a graduation of a client who has struggled with educational goals or the wedding of a client who has improved interpersonal skills may be a way for the social worker to affirm a client's growth and positive achievement. Also, if an important goal in therapy is to empower the client and promote independence, should we hold clients to "once a client always a client" or rather recognize that relationships between people may change over time?
While there may be times that dual relationships may develop, especially in terms of past clients, the professional social worker has the responsibility to continually examine the development of another type of relationship in terms of potential harm and exploitation of the client. A recent article in Social Work presented a case example in which a therapeutic relationship evolved into a social relationship and a role reversal occurred which left the former client feeling exploited. The power differential in therapy relationships increases the possibility of exploitation and potential harm to the client in a social relationship.
Should the social worker attend the party? The social worker should be cautious about accepting this invitation. Possibly the social worker may attend this one event with her former client and feel pleased to see how much her client has resolved problems addressed previously in therapy in terms of becoming more independent and increasing interpersonal skills. However, the social worker should think through very carefully all the possible consequences of attending this party.
Might not this party mark the beginning of a social relationship with a client in which the client may be harmed? Perhaps the client may become too dependent on the former therapist. Maybe a role reversal will occur and the social worker may now look to the former client for advice and guidance. How does a social relationship evolve when the former therapist knows everything about the new friend, which the other person (the client) knows virtually nothing about a new friend (the former therapist)? These and other questions should be asked and social workers should be very careful about proceeding to develop a social relationship with a former client.
In general, the Code of Ethics is often thought to apply primarily to those in direct practice, but the new code addition explicitly discusses the risk of exploitation by a supervisor or employer. In terms of the second case vignette, the supervisor although well-meaning should examine very carefully her behavior toward her recently separated supervisee. First, in terms of recent supervisory sessions, it seems that she has begun to "therapize" her supervisee which is certainly inappropriate. To begin a therapy relationship with her supervisee either within the supervisory sessions or in her private practice would constitute a dual relationship in which there is risk of exploitation. Also, we know that the supervisee's work performance has not been affected; thus the supervisor can not justify her discussion with him about his personal life as relevant to their agency work.
Second, there is certainly a suggestion that a social relationship might be developing. The supervisor should be very careful about the possibility of abusing her power and exploiting this worker. Although at this time the supervisee seems not to have complaints about his supervisor's attention, the question can be raised about what options he has if he does not want to proceed in developing a social relationship with his supervisor. According to the revised Code of Ethics, the supervisor, because of greater power, has the primary responsibility to guard against using this power to his or her advantage. In terms of administrative skills, what is the effect of developing a social relationship with one supervisee on other staff members? The supervisor should question her own practice in terms of developing multiple relationships in which there is a risk of exploitation of power. The professional relationship is that of supervisor-supervisee; it should not become that of therapist-client or friend-friend.
The following guidelines are suggested to help social workers who may be struggling with questions of dual relationships according to the revised Code of Ethics: