Therapy Ethics

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Hi Dr. Darcy:

I'm a counseling student in New Zealand and am practicing counseling on other students at my training institute. This guy asked if I could counsel him in April. He is a counseling student as well, but 2 years below me. I was hesitant to take him on, because I quite liked him and would have preferred to be friends, but… I took him on and have had 14 sessions with him.

Recently my client has started being a counselor for others at the training institute too. Now we are ex-client and counselor and peer counselors at the training institute. Our work together has had a huge impact on me. [My feelings are] quite powerful… So powerful, that when he talked about wanting to be a father I immediately wanted to be the mother of his children! This was in a session! (don't worry, I didn't say it).

I know ethically I'm not supposed to [enter a relationship] with a former client. Our relationship is complicated because he is also a counseling student and peer now. Is it okay to become friends? I have a crush on him and I think he may have one on me too. I don't know what to do, please help!!!

ANSWER

I’ve reviewed the New Zealand Association of Counselors Code of Ethics to familiarize myself with any possible differences between our professional ethics. As I suspected, they are very similar.

Humans can’t control their feelings. If we could, no one would need therapy. What we can control, and what we must control as practitioners, is our reaction to our feelings. And you MUST control the urge to act on your feelings. When I say that you must control the urge to act on your feelings, I’m telling you that under no circumstances should you attempt to partake in a friendship with this man. It will, beyond any reasonable doubt, grow into a sexual relationship. That you don’t see this should tell you that you shouldn’t trust your own judgment on this issue.

You’ve seen this patient (and I’m going to reference him as such to underscore the category under which he falls) for 14 intimate hours. During those 14 hours, you learned things about him that you never would have learned under normal circumstances. He shared deep emotional stories about his life, his desires, and his fears, and he did this because of the safety that the therapeutic relationship provides. It is this guarantee of safety that enabled him to be so vulnerable so quickly with you. The ethics of our profession require you to safeguard that with which you have been entrusted.

These rules were established because without them we can harm our patients. Having a sexual relationship with a patient, former or current, means there will always be a power imbalance, with you in the advantage. In order for your relationship to take root, you’ll need this man to lie about the fact that he was initially your patient. If he agrees to keep your secret, it will be because he is trying to protect you. It won’t be for him – most of us want to disentangle ourselves from secrets, knowing the harm they cause. It would be an exploitation of his feelings for you that would compel him to lie about your original relationship, and it is that exploitation that is at the forefront of why we have Codes of Conduct in our profession.

I’m trying to appeal to your values as someone who entered a helping profession. I can easily point you to your code of ethics, section 5:13 Sexual and Other Inappropriate Relationships With Clients to remind you that you’ll risk losing your license if you pursue a relationship with this man. But if that were a great enough deterrent, you wouldn’t have written to me in the first place.

I think this is one of those pivotal life moments for you: You can choose to act impulsively, immaturely, and likely harm this man who you claim to care about, or you can seek out counsel from a supervisor who can help you become a stronger person and a better therapist. The choice is yours.

Writer's Stats: Female, Heterosexual.