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.
Takeaway
Do therapists and their clients ever become friends?
It is not advisable for clients to be friends with their therapists as this creates an imbalance in power and might affect the therapeutic process in the future. The relationship of trust people often build with their therapist does cause some people to wonder whether therapists and their clients can become friends.
What should your therapeutic relationship with your therapist be?
A client-and-therapist relationship usually works best when both agree to meet their therapy goals. It must involve mutual understanding and respect, non-judgmental openness, and security. When this is the basis for the therapeutic relationship, positive things can happen for the client’s positive personal growth, which is the whole point of therapy.
Can you overshare topics unrelated to therapy with a therapist?
Oversharing usually happens in therapy sessions between a therapist and a client for different reasons. For whatever reason, it is your therapist's duty to help you uncover and evaluate those topics.
What are the boundaries of the therapeutic relationship based on the code of ethics?
Some of the code of ethics or guidelines for mental health therapists include the following:
Avoid dual relationship
Maintain exclusivity
Set clear goals
Respect patients’ autonomy
If the therapist and client are in the same field, they may interact at professional events, and they need to be cautious to not overstep any ethical boundaries.
Can therapists know their clients beyond their mental health state?
Though therapists usually focus on the mental health state of their patients during therapy, it can also help them understand their patients better if they know what is going on with them beyond their mental health.
When can a therapist become friends with a client?
Clients generally shouldn't be friends with their therapists during therapy, as this might affect the therapeutic process. Furthermore, it is important to point out that ethical guidelines prohibit a licensed professional counselor from having friendships with their current clients. In some cases, a former client and ex therapist may become friends in the future, such as after five years, but they should be aware that in the transition from a working relationship to friends there can be a power differential in the relationship.
How do you know if your therapist is attached to you and vice versa?
Attachment can be common in psychotherapy, as therapy involves a deeply vulnerable connection and personal feelings. Therapists are trained to manage these emotions and ensure the attachment is used constructively to promote positive treatment outcomes. The counselor role is purely to support the client. If a client becomes overly attached, it can sometimes be uncomfortable for the therapist, but they work to maintain emotional boundaries while addressing the client’s underlying needs. Attachment in therapy can also involve transference, in which a client unconsciously has feelings that came from past relationships and will assume that they are related to the therapist.
Is it okay for a therapist to hug a client?
There are no ethical rules about physical contact in the form of hugs between a therapist and a client. Some therapists prefer not to hug clients because they want to maintain a more distant professional relationship, while others feel comfortable offering a current client a hug in certain circumstances.
Can I talk to my therapist outside of therapy?
There is no one way that a therapist and client are supposed to interact outside of therapy. Whether or not you talk to your therapist outside of therapy depends on what you decide together as part of the therapy relationship. For example, you might both feel comfortable talking if you see each other in public, or you might prefer to pretend that you don’t know each other.
What not to share with a therapist?
There is nothing about your personal life that you shouldn’t discuss with your therapist over the course of your therapy. Part of a therapist’s ethics is not to judge anything you say. The more that your therapist knows about you the better they will be able to help you in your healing process.
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