Code Of Ethics in Mental Health: Do Therapists And Their Clients Ever Become Friends?

While the relationship between a therapist and their patient is important, it can also be complex. Therapists and their clients can have a unique bond that often allows individuals to freely tell their thoughts, conflicts, challenges, and dreams. Because of this connection, it’s not uncommon for patients to feel close to their counselors, even after ending therapy. This feeling may leave many wondering, “Can therapists be friends with former clients?”

Do therapists and their clients ever become friends?

This can be a complicated question, and the answer may depend on a variety of factors. One of these factors is the guidelines that dictate how counselors should act in a therapeutic setting, particularly the rules regarding dual relationships.

What are dual relationships in therapy?

The therapeutic relationship between a patient and therapist, also known as the therapeutic alliance, is a dynamic that may be affected by any conflicting relationships you and your therapist may have. These are known as “dual relationships” or “multiple relationships.” In counseling, a dual relationship might occur when a therapist and client develop a connection that moves beyond the traditional therapeutic alliance. In a traditional alliance, therapists can function as allies and advisors, with the goal often being to create a safe space within which clients can work toward their personal and mental health goals. Dual relationships have the ability to disturb this safe space and lower the efficacy of a patient’s treatment. 

Forms of dual relationships

Dual relationships can take many forms, with the term being applied to friendships, sexual relationships, and even situations where the therapist has a close relationship with someone associated with the client. This associate could be the patient’s friend, significant other, family member, or anyone else in their lives. Ideally, one of the main priorities of a therapist should be to respect the therapeutic alliance. This means that multiple relationships, including friendships, can be challenging to navigate. 

What do the code of ethics guidelines say about friendships between therapists and patients?

Various psychological and counseling associations have laid out codes of conduct for therapists’ relationships with their clients.

APA on the question, “Do therapists and their clients ever become friends?”

In other words, the APA advises against therapists entering a dual relationship with their patients if they have reason to believe it would cause harm to their client or the therapeutic relationship. Based on these guidelines, friendships between a client and their therapist would most likely be prohibited. The rules may differ for former clients who are no longer in therapy. 

When it comes to a therapist befriending a former client, the answer can vary depending on the circumstances. The American Psychological Association prohibits sexual or romantic interactions between clients and former therapists for a minimum of two years after the end of therapy. However, the APA does not offer official guidelines for friendships between clients and former therapists. This makes it a bit of a gray area, so the decision to create a friendship may depend on factors such as the type of therapy, the reason for seeking treatment, and the amount of time that has passed since finishing therapy. 

It could be important to remember that just because there are no rules against becoming friends with your former therapist, doing so may not be to your benefit. Befriending your former therapist could lead to several ethical and professional complications. Moreover, if you decide to restart therapy, you may have to find a new therapist since your newfound friendship may compromise the therapeutic alliance.

Is the therapeutic relationship with your therapist different in online therapy?

In recent years, online therapy has grown in popularity as an effective, convenient, and cost-efficient alternative to traditional therapy. Those whose schedules make it difficult to commute to a therapist’s office for in-person sessions may benefit from the flexibility offered through an online platform such as BetterHelp. Through these services, clients can receive therapy via instant messaging, voice call, or video call wherever and whenever it’s most convenient. The ability to send messages to a therapist outside scheduled therapy sessions may also benefit those who need extra support or have questions about implementing the strategies they’ve been developing in therapy. 

Effectiveness of online therapy for mental health

The effectiveness of online therapy has been thoroughly researched. One review published in the Cureus Journal of Medical Science found that internet-based therapy was effective at helping clients manage mental health conditions, including depression and anxiety. Previous research found internet-based therapy to be more effective than in-person therapy at helping clients recover from depression.  

You may wonder whether the nature of online therapy changes the therapeutic relationship. While the delivery mode differs, online therapy still prioritizes the therapeutic alliance. Ideally, this form of remote therapy upholds the same ethical and moral standards as in-person therapy—one of many reasons it can be considered an effective alternative.